Effectiveness of Reminders on Birth, Health Outcomes and Breastfeeding Practices Among HIV Exposed Infants in Nyahururu County Referral Hospital. Kenya

Abstract

Globally, about 1.5 million infants are born to HIV-positive mothers each year, with 90% of these births occurring in Sub-Saharan Africa, where the burden of HIV is greatest. Despite the proven effectiveness of antiretroviral therapy (ART), 300,000 to 400,000 infants are still born into HIV-positive environments annually due to inadequate access to ART, weak healthcare systems, and low maternal adherence. Without proper treatment and care, a significant number of HIV-infected children die before the age of two, with over 50% dying in early infancy, where mortality peaks. This study aimed to determine the effectiveness of reminders on birth outcomes, health status, and breastfeeding practices among HIV-exposed infants at Nyahururu County Referral Hospital. The research was conducted at the hospital’s Comprehensive Care Centre using a quasi-experimental design. Systematic sampling was employed to select 220 HIV-exposed infants receiving reminders and social support, and 220 infants from historical records on routine follow-up. Data were collected using standardized questionnaires and analyzed using SPSS. Descriptive statistics, including frequencies and percentages, were used alongside inferential statistics—such as correlation analysis, simple linear regression, and Chi-square tests—with a significance level set at p < 0.05. The study found that a significantly higher proportion of infants in the reminder group tested HIV-negative (98.2%) compared to 95.0% in the routine care group. A correlation coefficient of 0.78 indicated a strong positive relationship between the use of reminders and improved health outcomes for HIV-exposed infants, including higher survival rates. The regression coefficients (β) suggested that each unit increase in the use of reminders corresponded with improved outcome variables. A low p-value of 0.01 confirmed the statistical significance of these relationships. The Chi-square value of 20.8 demonstrated a significant association between the use of reminders and better health outcomes, highlighting the impact of reminder systems on enhancing infant health and survival. The study concludes that reminders significantly improve infant health outcomes. It recommends integrating structured reminder systems and social support into maternal and child health programs to strengthen adherence to antenatal care (ANC) and ART, improve birth outcomes, encourage exclusive breastfeeding, and enhance the survival of HIV-exposed infants.