Abstract:

Background: Large portion of Nigeria’s population use the services of non-formal health care providers like patent medicine vendors (PMV) and traditional birth attendants (TBA), seeing that 65% of deliveries in Nigeria occur in such non-formal health setting. Though studies demonstrate increase in HIV/AID awareness among PMV/TBAs there is yet an unclear evidence of their level of participation in the HIV/AIDS response, even as health financing and engagement of these private sector becomes important implementation research question in Nigeria. This study aims to compare level of awareness versus level of participation of the non-formal health care providers in the HIV/AIDS response in Nigeria.

Method: By cross-sectional design, questionnaire was used to get responses from 210 PMVs and 135 TBAs across 6 Local Government Areas in Ebonyi State, Nigeria. Responses were analyzed using percentages and frequency distribution.

Results: Mean age is 34 years. Highest education level was secondary school at 59%. HIV/AIDS awareness level was >80% but participation was at 48%.

Conclusion: HIV Awareness has increased among TBA/PMV but their participation level in HIV/AIDS response is still low. Integration of this group into public health sector could increase participation.

References:

[1] Abiodun O, Sotunsa J, Ani F, Olaleye A, Taiwo A: Elimination of Mother- To-Child Transmission of HIV in Nigeria: The Roles, Preparedness and Determinants of Successful Involvement of Traditional Birth Attendants. J AIDS Clin Res 2015;6:481.

[2] Catholic Relief Services (CRS) (2004) Training curriculum for traditional birth attendants. http://www.coregroup.org/storage/documents/Diffusion_of_Innovation/trainingAccessed September 2015

[3] François Nankobogo and Nilufar Egamberdi: The Role of Private Sector in the Fight Against HIV/AIDS in Sub-Saharan Africa, Thematic Stakeholder Consultations Bamako, Mali, December 2007; 10:10.

[4] HIV/AIDS Division, Federal Ministry of Health. National Operational Plan for the Elimination of Mother to Child Transmission (EMTCT) of HIV in Nigeria, 2015–2016. 2014. HIV/AIDS Division Federal Ministry of Health, Abuja, Nigeria. Web: www.nascp.gov.ng.

[5] Lagomarsino G, Nachuk S and Kundra SS. Public Stewardship of Private Providers in Mixed Health Systems: Synthesis Report From the Rockefeller Foundation–Sponsored Initiative on the Role of the Private Sector in Health Systems. Washington, DC: Results for Development Institute; 2009.

[6] Ministry of Health. National Sexual and Reproductive Health and Rights Policy 2009: Lilongwe. 2009. http://www.healthpolicyproject.com/pubs/455_FINALPolicyReviewFPHIVIntegration Accessed October 2015

[7] National Population Commission (NPC) [Nigeria] and ICF International. 2014. Nigeria Demographic and Health Survey 2013. https://dhsprogram.com/pubs/pdf/FR293/FR293.pdf Accessed October 2015

[8] Nigel Rollins: Prioritizing National PMTCT Implementation Research, J Acquir Immune Defic Syndr 2014; 67:2

[9] Olumide Abiodun, John Sotunsa, Oluwatosin Olu-Abiodun et al. The Effect of Training on Traditional Birth Attendants’ PMTCT Related Knowledge and Care Practices in Nigeria. J AIDS Clin Res 2015;6:9

[10] Pamela Rao, Tesfai Gabre-Kidan, Deus Bazira Mubangizi, and Sara Sulzbach: Leveraging the Private Health Sector, J Acquir Immune Defic Syndr. August 1 2015;57:2,4.

[11] Sara Sulzbach, Susna De and Wenjuan Wang: The private sector role in HIV/AIDS in the context of an expanded global response: expenditure trends in five sub-Saharan African countries. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. Health Policy and Planning 2011;26:72-84

[12] The Business of Health in Africa: Partnering with the Private Sector to Improve People’s Lives. Washington, DC: International Finance Corporation; 2007.

[13] USAID: Nigeria Private Sector Health Assessment, 2008. http://www.shopsproject.org/sites/default/files/resources/5137_file_FINAL. Accessed October 2015

[14] World Health Organization: WHO Traditional Medicine Strategy; 2014-2023. 2013. Publications of the World Health Organization are available on the WHO web site (www.who.int) assessed September 2015

[15] Wang W, Sulzbach S and De S. Utilization of HIV-related services from the private health sector: a multi-country analysis. Soc Sci Med. 2011; 72: 216–223.