Midwife’s Role in the Mother-to-Child Transmission Prevention Program in Primary Health Care in Yogyakarta

Niken Meilani, Nanik Setiyawati, Sammy Onyapidi Barasa


Curing and eradicating Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) are to the core principles of the United Nations’ Sustainable Development Goals (SDGs). The incidence of HIV in the world remains high. Although midwives play a pivotal role in PMTCT implementation, the factors associated with midwives’ role in its implementation are not well understood. The aim of this study was to determine factors associated with midwives’ role in implementation of PMTCT. This study used a cross-sectional design. The subjects were 80 midwives at 14 primary health care in Yogyakarta City, Indonesia. The study was conducted from April to August 2017. Data were analyzed through univariate, bivariate with chi-square and Fisher’s exact test, multivariate with logistic regression. The results showed that 47.5% of midwives were in the poor category regarding implementation of PMTCT. Information availability through socialization (p-value = 0.047) and knowledge level (p-value = 0.016) were found to be related to PMTCT implementation. There was no relationship between age, length of work, education level, marital status, availability of information, midwife’s attitude, perception of the availability of facilities and institutional support with midwife behavior in PMTCT implementation. Multivariate analysis showed that level of knowledge was the most dominant factor affecting PMTCT implementation (OR:6.2; CI 95% = 1.8-21.4). We recommend that efforts should be made to continuously improve the knowledge of midwives on PMTCT implementation through peer support and training in order to achieve sustainable development goals.


Human Immunodeficiency Virus, midwives, pregnant, prevention

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HIV.gov. The global HIV/AIDS epidemic [homepage on the Internet]. 2019. Available from: https://www.hiv.gov/hiv-basics/overview/data-and-trends/global-statistics

Kementerian Pemberdayaan Perempuan dan Perlindungan Anak Republik Indonesia. Kasus HIV/AIDS di Indonesia meroket [homepage on the Internet]; 2014. Available from: http://www.kemenpppa.go.id/index.php/page/read/30/385/kasus-hiv-aids-di-indonesia-meroket

Nasronudin. HIV&AIDS pendekatan biologi molekuler, klinis dan sosial. Surabaya: Airlangga University Press; 2013

Komisi Penanggulangan AIDS. Data HIV/AIDS DIY 2016 [homepage on the Internet]; 2016. Available from: http://aidsyogya.or.id/2016/data-hiv-aids/data-kasus-hiv-aids-diy-sd-maret-2016/

Ogbanna K, Govender I, Tumbo J. Knowledge and practice of the prevention of mother-to-child transmission of HIV guidelines amongst doctors and nurses at Odi Hospital, Tshwane District. South African family practice [serial on the Internet]. 2016; 58(5): 167-71. Available from: https://www.tandfonline.com/doi/full/10.1080/2078­6190.2016.1228561

Mohammed E Y F, Kever RT, Martins S D, Afolabi O, Bulama K U. Knowledge, attitudes and practices of nurses on Prevention of Mother-to-Child Transmission (PMTCT) of Human Immuno-deficiency Virus (HIV) in state specialist hospital, Maiduguri, Borno State. Internasional Journal of Nursing and Midwifery [serial on the Internet]. 2016; 8(2): 12-7. Available from: https://academicjournals.org/journal/IJNM/­article­-full-text-pdf/42B169F57392

Ujiji O A, Rubenson B, Ilako F, Marrone G, Wamalwa D, Wangalwa G, Ekstrom A M. Is ‘opt-out HIV testing’ a real option among pregnant women in rural districts in Kenya?. BMC Public Health [serial on the Internet]. 2011; 11(3): 151. Available from: http://www.biomedcentral.com/1471-2458/11/151

Green L W. Health promotion planning an educational and environmental approach. Mountain View Toronto - London: Mayfield Publishing Company; 2010

Harahap S, Tukiman, Syarah V. Perilaku bidan KIA/KB dalam pelaksanaan program Prevention of Mother-to-Child Transmission (PMTCT) di Rumah Sakit Haji Kota Medan tahun 2013. Jurnal USU [serial on the Internet]. 2015; 1(3): 2. Available from: https://jurnal.usu.ac.id/index.php/kpkb/article/view/5172

Okoli J C, Lansdown G E. Barriers to successful implementation of Prevention of Mother-to-Child Transmission (PMTCT) of HIV programmes in Malawi and Nigeria: a critical literature review study. The Pan African Medical Journal [serial on the Internet]. 2014; 19(10): 154. Available from: https://www.ncbi.nlm.nih.gov/pmc/­issues/247193/

Setiyawati N, Meilani N. Determinan perilaku tes HIV pada ibu hamil. Jurnal Kesmas Universitas Indonesia [serial on the Internet]. 2015; 9(2): 3. Available from: http://jurnalkesmas.ui.ac.id/kesmas/article/view/565

World Health Organization. PMTCT strategic vision 2010-2015: Preventing Mother-to-Child Transmission of HIV to reach the UNGASS and Millennium Development Goals: moving towards the elimination of paediatric HIV; 2009

Okike O, Jeremiah I, Akani C. Knowledge, attitude and practical general medical practitioners in port harcourt towards the prevention of mother-to-child transmission. The Nigerian Health Journal [serial on the Internet]. 2011; 11(9): 3. Available from: https://www.ajol.info/index.php/nhj/article/view/90523

Both JMC, Roosmalen JV. The impact of Prevention of Mother-to-Child Transmission (PMTCT) programmes on maternal health care in resource-poor settings: looking beyond the PMTCT Programme - a systematic review. International Journal of Obstetrics and Gynaecology [serial on the Internet]. 2010; 117(12): 1444-50. Available from: https://www.ncbi.nlm.nih.gov/pubmed/20937071

Car L T, Velthoven M H V, Brusamento S, Elmoniry H, Car J, Majeed A, Atun R. Integrating Prevention of Mother-to-Child HIV Transmission (PMTCT) programmes with other health services for preventing HIV infection and improving HIV outcomes in developing countries. NBCI Journal [serial on the Internet]. 2011; 15(6): 6. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21678382

Horwood C, Haskins L, Vermaak K, Pakathi S, Subbaye R, Doherty T. Prevention of Mother-to-Child Transmission of HIV (PMTCT) programme in KwaZulu-Natal, South Africa: an evaluation of PMTCT implementation and integration into routine maternal, child and women’s health services. Tropical Medicine and International Health [serial on the Internet]. 2010; 15(9): 992–9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/20561313

Auvinen J, Kylma J, Valimaki M, Bweupe M, Suominen T. Midwives' perspectives on male participation in PMTCT of HIV and how they can support it in Lusaka, Zambia. Midwifery Journal [serial on the Internet]. 2014; 30(1): 17-27. Available from: https://www.midwiferyjournal.com/article/S0266-6138(13)00046-6/fulltext

Turan B, Budhwani H, Fazeli P, Browning W R, Raper J L, Mugavero M J, Turan J M. How does stigma affect people living with HIV? the mediating roles of internalized and anticipated HIV stigma in thr effects of perceived community stigma on health and psychosocial. HHS Author Manuscripts [serial on the Internet]. 2018; 21(1):283-91. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/­PMC5143223/

Saki M, Kermanshahi S M K, Mohammadi E, Mohraz M. Perception of patients with HIV/AIDS from stigma and discrimination. Iranian Red Crescent Medical Journal [serial on the Internet].2015; 7(6): e23638. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/­PMC4537784/

Badriah F, Tahangnacca M, Alkaf R, Abe T, Hanifah L. Implementation of program for the prevention of mother-to-child transmission of HIV in South Jakarta. National Public Health Journal [serial on the Internet].2018; 12(4): 159-64. Available from: http://journal.fkm.ui.ac.id/kesmas/article/view/1707

DOI: http://dx.doi.org/10.21109/kesmas.v14i2.2774


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