Effectiveness of Reminders and Social Support Framework on Birth and Health Outcomes among HIV Exposed Infants in Nyahururu County Referral Hospital, Kenya

Abstract

The reminder systems and social support mechanisms not only reduce antiretroviral therapy (ART) default rates but also ensure continuity of care, which is essential for improving both maternal and infant health outcomes. The role of short message service (SMS) reminders has significantly enhanced antenatal care (ANC) attendance, adherence to antiretroviral drugs (ARVs), viral suppression, and prevention of mother to-child transmission (PMTCT) of HIV. In Kenya, mother-to-child transmission remains a concern, with Laikipia County showing a higher infection rate among infants. These trends highlight the urgent need for targeted interventions in Laikipia County to improve infant health outcomes. The objective of the study was to assess the effectiveness of reminders and the social support framework on birth and health outcomes among HIV exposed infants (HEIs) at Nyahururu County Referral Hospital in Laikipia County. A quasi-experimental design was used in this study. In addition, 220 HIV positive pregnant mothers attending the comprehensive care Centre were recruited. Systematic random sampling was used to select the respondents. Both primary and secondary data were collected using structured questionnaires. The collected data were analyzed using Statistical Package for Social Sciences (SPSS) software, version 28. Descriptive statistics, including frequencies and percentages, were used to summarize and organize the data. Correlation, regression and Chi- square statistic was used to test for association/relationship between variables and level of significance. All statistical tests of significance were conducted at a coefficient level of alpha less than 0.05 with the help of SPSS 2.5 for windows. Results showed that 63.1% of mothers in the reminder group adhered to three to four ANC visits, compared to 57.7% in the routine group. In addition, the study found that most mothers in both groups had spontaneous vaginal deliveries (96.4% in the reminders group), with fewer requiring medical interventions. Moreover, the findings showed that 77.7% of mothers in the reminder group practiced exclusive breastfeeding for six months, compared to 65.0% in the routine follow-up group, indicating. Moreover, the study found a significantly higher proportion of infants in the reminder group tested HIV negative (98.2%) compared to 95.0% in the routine group. Survivorship was also higher, with 95.5% of infants in the reminder group surviving past one year, compared to 86.0% in the routine follow-up group. The correlation coefficient of 0.78 signified a strong positive relationship between the use of on reminders and improved health outcomes for HIV exposed infants, including higher survival rates (p-value=0.000). The Chi Square value of 20.8 reflected a significant association between the use of reminders and improved health outcomes for infants, underscoring the substantial impact of on reminders on enhancing infant health and survival rates (p-value=0.000). The study concludes that the use of reminders significantly enhances and infant health outcomes. The study recommends integrating structured reminder systems and social support into maternal and child health programs to improve adherence to ANC and ART, enhance birth outcomes, promote exclusive breastfeeding, and boost infant health and survival among HIV exposed populations.