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18843

An Economic Empowerment (EE) Initiative Linked to Prevention Mother-to-Child Transmission (PMTCT) Peer Support Groups In West Nile Uganda: Participation As a Predictor of Socioeconomic Changes

Friday, October 19, 2012
Room R06-R09 (Morial Convention Center)
Nicholas M. Levin1, Katherine Gnauck, MD, FAAP1, Lynne Fullerton, PhD1, Jackson Adriko2, Moses Anguzu2, Brenda Seevers, PhD3 and Alex Adaku, MD2, (1)University of New Mexico Health Sciences Center, Albuquerque, NM, (2)Arua Regional Referral Hospital, Arua, Uganda, (3)New Mexico State University, Las Cruces, NM

Program Evaluation

Background: In sub-Saharan Africa, PMTCT programs report low uptake and high lost to follow-up often attributed to poverty, stigma and living in rural areas. Rural areas are classically associated with lack of income generating opportunities. Economic empowerment (EE) initiatives linked with HIV/AIDS health services may be more readily accessible to HIV-positive women and thus more likely to improve relative socioeconomic status. We examined changes in socioeconomic indicators of the members of our EE initiative in West Nile Uganda to assess program effectiveness.

Methods: In 2008, a grassroots sewing workshop EE initiative was linked to the Regional Referral Hospital PMTCT Peer Support Group in Arua, Uganda. In-depth interviews and focus groups were used to develop a tool of locally relevant socioeconomic indicators (Table 1). This tool was administered in Fall 2011 to workshop members (59/60) by trained national project staff. Participation was defined as: Low= 0-2 day/week; High= 3 or more days/week.

Results:  Table 2 describes participant characteristics. The median six month income for High participation women (33,900 Ugandan Shillings) was significantly greater than Low participation women (15,000 Ugandan Shillings) (p=0.003). Nearly half (47%) of High participation women lived in tin roofed (v. thatched roof) dwellings contrasted with only 21% of Low participation women (p=0.043). Other socioeconomic indicators reflecting food security, medication access, livestock ownership and children's education access yielded no significant differences between the two groups.

Conclusions: High participation in this EE initiative predicted a higher median income and may reflect higher skill and proficiency development. The greater prevalence of tin-roofed houses among the High participation women together with our other indicators warrant tracking over time to capture further detail of socioeconomic change. The results of this study support the effectiveness of EE initiatives to address poverty among HIV-positive pregnant women and mothers in developing countries.  Future studies should examine additional hypotheses related to PMTCT uptake and clinical compliance for economic empowerment (EE) initiatives linked with HIV/AIDS health services. 

Table 1. Socioeconomic Indicators

Cash

Household items

Real Estate

Education/Healthcare access

1. Lending or borrowing

2. Savings

3. Earnings from SEEM

1. Transportation vehicles

2. Livestock

3. Food security

1. Type of dwelling

2. Dwelling owned

3. Dwelling Land owned

1. Private school

2. Member (mother) medication bought  other   than ARV's

Table 2 .

 Demographics of Workshop Participants              

Description

High Participation n=30

(³ 3 days /week) (%)

Low Participation n=29

(< 2 days /week) (%)

Participants/Days in workshop

30/59 (50.85)

                  29/59 (49.15)

Age  (years)

<30

30-39

40+

4/30, (13.33)

17/30, (56.67)

9/30, (30.0)

5/29, (17.24)

20/29,(68.97)

4/29,( 13.79)

ARV medications

            26/30 ( 52)

                 24/29 (48)

Education (primary level only)

            24/30 (48)

                26/29 (52)