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AIDS Research and Treatment
Volume 2013, Article ID 937456, 8 pages
http://dx.doi.org/10.1155/2013/937456
Research Article

Utilization of and Barriers to HIV and MCH Services among Community ART Group Members and Their Families in Tete, Mozambique

1International Centre for Reproductive Health-Mozambique, Rua José Macamo 269–1A, Maputo, Mozambique
2Médecins Sans Frontières, Avenida Eduardo Mondlane 38, Tete, Mozambique
3Changara District Health Services, Changara Sede, Tete, Mozambique
4UNICEF, 1440 Avenida do Zimbabwe, Maputo, Mozambique

Received 28 April 2013; Accepted 2 July 2013

Academic Editor: Soraya Seedat

Copyright © 2013 Diederike Geelhoed et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Mozambique continues to face many challenges in HIV and maternal and child health care (MCH). Community-based antiretroviral treatment groups (CAG) enhance retention to care among members, but whether such benefits extend to their families and to MCH remains unclear. In 2011 we studied utilization of HIV and MCH services among CAG members and their family aggregates in Changara, Mozambique, through a mixed-method assessment. We systematically revised all patient-held health cards from CAG members and their non-CAG family aggregate members and conducted semistructured group discussions on MCH topics. Quantitative data were analysed in EPI-Info. Qualitative data were manually thematically analysed. Information was retrieved from 1,624 persons, of which 420 were CAG members (26%). Good compliance with HIV treatment among CAG members was shared with non-CAG HIV-positive family members on treatment, but many family aggregate members remained without testing, and, when HIV positive, without HIV treatment. No positive effects from the CAG model were found for MCH service utilization. Barriers for utilization mentioned centred on insufficient knowledge, limited community-health facility collaboration, and structural health system limitations. CAG members were open to include MCH in their groups, offering the possibility to extend patient involvement to other health needs. We recommend that lessons learnt from HIV-based activism, patient involvement, and community participation are applied to broader SRH services, including MCH care.