This study aimed to identify factors affecting women’s utilisation of the prevention of mother-to-child transmission (PMTCT) of HIV, evaluate the quality of PMTCT services, describe health outcomes of mothers and infants and to identify factors that influence mother-to-child transmission (MTCT) of HIV. Structured interviews were conducted with 384 women who had utilised PMTCT services. Information was also obtained from the health records of these women and of their infants. Better educated women, who had male partners and were self-employed were more likely to use PMTCT services. Being unmarried, poor and feeling stigmatised made it difficult for women to use these services. Respondents were satisfied with PMTCT services except that clinics sometimes had no medications. The health care workers followed the Ethiopian guidelines during HIV testing and counseling but not when prescribing treatment. Although the respondents’ CD4 cell counts improved, their clinical conditions did not improve. The MTCT rate was significantly higher if infants did not receive ARVs, had APGAR scores below seven, weighed less than 2.5kg at birth, were born prematurely, and if their mothers had nipple fissures. PMTCT services could be improved if more women used these services, health care workers followed the national guidelines when prescribing ARVs, clinics had adequate supplies of medicines, all infants received ARVs, and mothers’ nipple fissures could be prevented. Antenatal care should help to avoid premature births of infants weighing less than 2.5kg and having APGAR scores below 7. Future research should compare formula feeding versus breastfeeding of infants with HIV-positive mothers / Health Studies / D. Litt. et Phil. (Health Studies)

Adolescent pregnancies are high risks obstetric occurrences. Antenatal care (ANC) provides opportunities to recognise and treat obstetric complications, enhancing the pregnancy outcomes for mothers and babies. This study investigated factors influencing pregnant adolescents' utilisation of ANC services in Bulawayo, using the Health Belief Model's major tenets. A quantitative descriptive design was used in four phases: 80 adolescents' ANC records were audited; structured interviews were conducted with 200 adolescents attending ANC and with 80 adolescents who had delivered their babies without attending ANC; and 52 midwives completed questionnaires portraying their perceptions on adolescents' utilisation of ANC services in Bulawayo. Documentation of ANC services provided to adolescents did not meet the expected standards. Poor or non utilisation of ANC services was influenced by socio demographic factors, individual perceptions of adolescents about antenatal care, perceived benefits of and perceived barriers to the utilisation of ANC. Most pregnant adolescents could not access these services because they could not pay the ANC and/or delivery fees charged at government clinics/hospitals. Midwives required more training in providing and recording adequate ANC services. Free ANC and delivery services could enhance adolescents' pregnancy outcomes in Zimbabawe. An information brochure on the importance of ANC attendance for adolescents has been compiled, based on the research results (see Annexure J). / Health Studies / D.Litt. et Phil. (Health Studies)

Adolescent pregnancies are high risks obstetric occurrences. Antenatal care (ANC) provides opportunities to recognise and treat obstetric complications, enhancing the pregnancy outcomes for mothers and babies. This study investigated factors influencing pregnant adolescents' utilisation of ANC services in Bulawayo, using the Health Belief Model's major tenets. A quantitative descriptive design was used in four phases: 80 adolescents' ANC records were audited; structured interviews were conducted with 200 adolescents attending ANC and with 80 adolescents who had delivered their babies without attending ANC; and 52 midwives completed questionnaires portraying their perceptions on adolescents' utilisation of ANC services in Bulawayo. Documentation of ANC services provided to adolescents did not meet the expected standards. Poor or non utilisation of ANC services was influenced by socio demographic factors, individual perceptions of adolescents about antenatal care, perceived benefits of and perceived barriers to the utilisation of ANC. Most pregnant adolescents could not access these services because they could not pay the ANC and/or delivery fees charged at government clinics/hospitals. Midwives required more training in providing and recording adequate ANC services. Free ANC and delivery services could enhance adolescents' pregnancy outcomes in Zimbabawe. An information brochure on the importance of ANC attendance for adolescents has been compiled, based on the research results (see Annexure J). / Health Studies / D.Litt. et Phil. (Health Studies)