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Factors Associated with Loss to Follow up of Hiv-Exposed Infants-Caretaker Pairs Enrolled in the Early Infant Diagnosis Clinic

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Factors Associated with Loss to Follow up of Hiv-Exposed Infants-Caretaker Pairs Enrolled in the Early Infant Diagnosis Clinic FACTORS ASSOCIATED WITH LOSS TO FOLLOW UP OF HIV-EXPOSED INFANTS-CARETAKER PAIRS ENROLLED IN THE EARLY INFANT DIAGNOSIS CLINIC: A CASE STUDY OF LIRA REGIONAL REFERRAL HOSPITAL BY ELANG MARGRET 2009/HD20/16870U SUPERVISORS: PROFESSOR FRED NUWAHA DR. RAYMOND TWEHEYO A RESEARCH PROPOSAL SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE AWARD OF DEGREE OF MASTERS OF PUBLIC HEALTH MAKERERE UNIVERSITY. 2015 DECLARATION I hereby declare that to the best of my knowledge, this dissertation is my original work and has never been submitted to this university or any other institution of higher learning for an academic award or publication. I hereby submit it for the award of the degree of Masters of Public Health of Makerere University. ………………………………. … Date................................. Elang Margret (Author) This dissertation has been submitted with the approval of the following supervisors: ……………………………………. Date........................................ Professor Fred Nuwaha - Makerere University School of Public Health ……………………………………. Date.................................... Dr. Raymond Tweheyo - Makerere University School of Public Health i DEDICATION I dedicate this book to my Father and Mother; Micheal and Rose Okalo for their constant encouragement to always aim higher and for the loving support and care they have given me while writing this dissertation. ii ACKNOWLEDGEMENTS I would never have been able to finish my dissertation without the guidance of my supervisors, help from friends, coupled with emotional and spiritual support from my family. I wish to express my deepest gratitude to both my supervisors‟ Professor Nuwaha Fred and Dr. Tweheyo Raymond, who spent their valuable time guiding me and reading through the several drafts of the proposal and dissertation. Thank you very much for the informative contributions you made towards the success of this work. I also want to extend my thanks to the acting Executive Director of Lira Regional Referral Hospital Surgeon Dr. Ochen William and the entire EID unit staff especially sister Ejang Dorothy for their unconditional support and willingness to help me get all the relevant information necessary to make this research successful. I also extend special thanks and appreciation to all the research participants who accepted to be part of this study for the priceless time and information they availed me. Special acknowledgments go to all my fellow MPH classmates 2009-2011 I would also like to thank my parents, Micheal and Rose Okalo, my sister, her husband Coen Van der Heijden, and my son Haxton Opio for the constant encouragement coupled with emotional and spiritual support. Above all, I wish to thank the Almighty God for making this possible. iii TABLE OF CONTENTS DECLARATION ............................................................................................................................ i DEDICATION ............................................................................................................................... ii ACKNOWLEDGEMENTS ......................................................................................................... iii LISTS OF TABLES .................................................................................................................... vii LIST OF FIGURES ................................................................................................................... viii LIST OF ACRONYMS ............................................................................................................... ix LIST OF OPERATIONAL DEFINITIONS ............................................................................... x ABSTRACT .................................................................................................................................... i CHAPTER 1: INTRODUCTION ................................................................................................ 1 1.1 Introduction ........................................................................................................................... 1 1.2 Background ........................................................................................................................... 1 1.3 Statement of the problem ...................................................................................................... 3 1.4 Study objectives ..................................................................................................................... 5 1.5 Research questions ................................................................................................................ 5 1.6 Justification of the study ........................................................................................................ 6 1.7 Conceptual framework .......................................................................................................... 7 1.6.1 Brief narrative of the conceptual framework .................................................................. 7 1.8 Conclusion ............................................................................................................................. 8 CHAPTER 2: LITERATURE REVIEW .................................................................................... 9 2.1 Introduction ........................................................................................................................... 9 2.2 Magnitude of loss to follow up in Uganda and sub Saharan Africa ...................................... 9 2.3 Factors influencing loss to follow up of HIV-exposed infants ............................................ 11 2.3.1 Predisposing factors ...................................................................................................... 11 iv 2.3.2 Enabling factors ............................................................................................................ 14 2.3.3 Need factors .................................................................................................................. 17 3.1 Introduction ......................................................................................................................... 19 3.2 Study design ........................................................................................................................ 19 3.3 Study setting ........................................................................................................................ 19 3.4 Study population.................................................................................................................. 19 3.5 Eligibility criteria ................................................................................................................. 20 3.5.1 Inclusion criteria ........................................................................................................... 20 3.5.2 Exclusion criteria .......................................................................................................... 20 3.6 Sample size determination ................................................................................................... 21 3.6.1 Sampling procedure .......................................................................................................... 21 3.6 Measurements ...................................................................................................................... 21 3.6.1 Independent variables ................................................................................................... 22 3.6.2 Dependant variable ....................................................................................................... 22 3.7 Data collection, management and analysis .......................................................................... 22 3.7.1 Data collection .............................................................................................................. 22 3.7.2 Data Management ......................................................................................................... 23 3.7.3 Data Analysis ................................................................................................................ 23 3.8. Quality control .................................................................................................................... 23 3.9 Ethical issues ....................................................................................................................... 23 3.10 Dissemination .................................................................................................................... 24 v CHAPTER 4: RESULTS............................................................................................................ 25 4.1 Introduction ........................................................................................................................... 25 4.2 Background characteristics of the respondents .................................................................... 25 4.3 Descriptive Analyses on respondent key Variables and Indicators ..................................... 26 4.4 Descriptive Analyses on key infant Variables and Indicators. ............................................ 27 4.5 Association between the different factors and the rate of loss to follow up ........................ 30 4.6 Examining and Evaluating factors that affect the overall loss to follow up ........................ 37 CHAPTER 5: DISCUSSION OF THE RESULTS .................................................................
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