Exploring fertility decisions among pregnant HIVpositive women on antiretroviral therapy at a health centre in Balaka, Malawi: A descriptive qualitative|
Biseck, T.; Kumwenda, S.; Kalulu, K.; Chidziwisano, K. & Kalumbi, L.
The proportions of women of reproductive age living with the human
immunodeficiency virus (HIV) vary between different regions of the
world, with significantly higher proportions in sub-Saharan Africa. Family
planning is one of the major issues that couples and families affected with
HIV must confront. We aimed to assess the cultural and social factors
associated with childbearing and family planning knowledge, decisionmaking,
and practices among HIV-positive pregnant women attending
antenatal clinic at a health centre in Balaka, Malawi.
This was a qualitative descriptive study carried out at Kalembo Health
Centre in Balaka. A purposive sampling technique was used to select
pregnant women enroled in the antiretroviral therapy (ART) programme.
A sample size of thirty-five women was decided upon after data saturation.
Qualitative inquiry was used during data collection. Data were analysed
using systematic text condensation, while numbers and percentages were
generated using Microsoft Excel.
Out of 35 participants, 20 were aged between 25 and 34 years, and 18
had been married at least three times. All 35 women wished to have their
own biological child. Factors, reported by participants, that promote
childbearing included: the desire to please their husbands, fear of losing
their husbands to others if they did not bear children, the knowledge that
ART would help prevent their children from acquiring the virus, the desire
to prove to others that they can also bear children, and a lack of family
planning leading to unplanned pregnancies.
The factors that lead to pregnancies among women on ART in Balaka
ranged from assured safety of the child from HIV, lack of contraception,
to other factors related to their partners. The authors recognize and
support the freedom for women to become pregnant and bear children,
and, in the context of HIV infection, fertility and reproductive services
should include a comprehensive approach towards addressing issues of
HIV and AIDS and childbearing among infected women.