HIV Transmission Risks Between Mothers and Children - Literature review Example

 Critique Introduction With the rapidly expanding knowledge on health and society, many health researches are increasingly being published to help address some of the health related problems. A detailed critique of the punished researches can effectively be used to assess the understanding of the contents and the research methodologies used in most of the researches (Curtise and White, 2005, p.218). This paper critically analyzes two articles that were published on mother to child HIV transmission and the potential risks that may increase the likelihood of such transmissions. Generally the paper will focus on the evaluation of the research processes used in the two articles, their overall strengths and weaknesses as well the potential application of the particular researches to medical health practice. The critique will be based on both qualitative and quantitative research frameworks. The major causes of HIV transmission risks between mothers and their children include the potential contact between the mother’s and fetus blood during the labor contractions, contact between the fetus and the infected body fluids of the mothers genital tract during birth and the rupture of membranes during birth. Consequently many researches have over the past few years, increasingly sought to propose and discuss various ways of minimizing and preventing the risks of mother to child transmission of HIV particularly during the delivery. Critique of a qualitative paper The first article titled “Research article Prevention of mother-to-child transmission of HIV infection” is a qualitative research journal that was published in 2010 by O’Gorman, Nyirenda and Theobald. The three authors carried out a fairly descriptive research in a rural district in Malawi in their attempt to explore the various views regarding the prevention of mother to child HIV transmission. The title is relevant to the topic of the study and the authors also succinctly summarized the key points of the research in the abstract. Similarly the purpose of the study as well as the overall goals of the researchers is subjectively described in the introduction. Main qualitative research methodologies employed included the use of focus group discussions and semi structured interviews. According to Long and Godfrey (2004, p.128), qualitative researches generally explore the thoughts and opinions of others with regard to the topic of the study and therefore the research design should be able to deliver accurate findings which are free from study biasness. The three authors seem to have used ethnographic tools in their research design and this is particularly evidenced by the fact that the research sought to understand the context of the topic of the study as opposed to testing the relevant theories associated with the research study. As a research design, ethnography is often used in researches that target particular social groups within a specific period of time. On the other hand, phenomenology research designs are use in situations where the researchers only want to expand the understanding of the subject of the study particularly according to their own perception. Believability and robustness of the study In a qualitative research, there are a number of elements which significantly influence the believability and robustness of a research study. Generally the main elements of determining the trust worthiness of a research include its credibility, dependability, conformability and transferability (Hoye and Severinsson, 2007, p.67). With regard to the credibility of the article, the authors have used a number of quantitative techniques to ensure that their findings are credible. For example the respondents where given semi structured interviews to ensure that their answers were restricted to the subject of the study. To supplement the findings from the structured interviews, the researchers also employed the use of focus group discussions which allowed the participants to freely share their ideas and experiences. By using both semi structured interviews and focus group discussions together, the researchers ensured that that their findings were credible enough to support their grounded theory. The research however failed to use a proper selection criterion in choosing their respondents. On the other hand, to enhance the transferability of their research, the three researchers published their research in a peer reviewed journal. This consequently ensured that other researchers can easily access the publication and assess its findings. Additionally the researchers have also admitted the limitations of their research and welcome further research in their subject of study. Confrimability of qualitative researches depends on the degree to which their findings can be confirmed and corroborated by other similar researches. In this regard, by highlighting some of the limitations of their research such as the absence of a literature review, the authors have made it easier for other researchers to evaluate the extent of conformity or distortion of their research in relation to the other similar studies. Finally in terms of the applicability of the research findings, the authors ensured that their research is more applicable by conducting their qualitative research in a remote rural environment where drugs are not affordable and the people are worst affected. The authors used opportunistic and purposive sampling in the selection of the 22 interviewees who participated in the research. The participants were selected from the community members who played a role in the provision of antenatal and prenatal care to the pregnant women. Some of the respondents were traditional birth attendants, fathers and husbands, community elders and grand mothers. The study would have however been made more representative if the authors could have used stratified sampling to choose their respondents (Hoye and Severinsson, 2007, p.69). By conducting the interviews under trees, in the research vehicle and in an empty school, the authors failed to ensure the privacy and confidentiality of their respondents. Instead they should have conducted the interviews in a quite and secluded environment to limit the potential distraction of the respondents and reduce the likelihood of biasness of the findings. The authors however observed ethical considerations in their research by seeking a written approval from the authorities and making sure that the respondents remained anonymous throughout the study. Critique of the quantitative research article The second article used in this critique is a quantitative research is titled “The mode of delivery and the risk of vertical transmission of human immunodeficiency virus type 1”. The research was published in 1999 by the international perinatal group after conducting a quantitative study evaluating the relationship between cesarean delivery and mother to child transmission of HIV virus. The methods used in the research were generally quantitative in nature since the researchers sought to collect primary data and use their results to support their hypotheses and research arguments. This critique will therefore use quantitative research evaluation tools to access the reliability of the research design and the validity of the results. The research design was fairly appropriate and the authors conducted their research on 100 mother child pairs who were HIV infected. Methodology The research methodologies used were largely based on a meta-analysis of patient information of the participants. The sample space that was used was fairly adequate to ensure the accuracy of the findings. The researchers worked under the hypothesis that the elective cesarean section procedure reduced the HIV infection risk significantly (Desai and Dikshit, 2012). For example, the researchers used a sample of 100 mother child pairs who were then systematically advised not to breast feed their babies and all their delivery and health status data evaluated. The method was not biased since the pairs were randomly chosen among the women who had given birth in the hospitals and the data collected was first hand. Sample The researchers focused on the different types of delivery and they collected the infection rate data and analyzed it to get to their conclusion. The sample space was mainly collected from different parts of the western world and other developed countries. The information collected was directly from the individual patients in various facilities who were paired into groups of 100 participants according to the mode of delivery they underwent. The researchers were particularly interested in the rate of MTCT during birth and its relation to the available birth methods. It took them a series of experiments to collect the data and analyze it in mathematical graphs that were interpreted to give their conclusion (The International Perinatal Group, 1999, p. 978). The fact that the researchers worked under a hypothesis could have caused some bias in the accuracy of the study since a hypothesis manipulates the way of thinking of researchers (Pfieffer, Whelan & Martin, 2000, p.430). It makes them strive towards achieving results that agree with their assumptions. The mathematical representations of the information involve a lot of estimation. It may have given the correct general idea on the topic under study, but the accuracy was compromised. The study was done in hospitals in developed countries. It didn’t include poor regions in the world like countries in Africa where some of the delivery methods are not available (Wainberg and Brenner, B.G 2010, p.74). Its applicability is, therefore, not universal. People in the poor countries where the health care facilities are ill equipped cannot access the elective cesarean section delivery method. It is an expensive method in these nations. Critique of the results The results of the quantitative research were presented in tables and diagrams for easy interpretation (Ferguson and Brannick, 2012, p.128). The data in the tables provided is a bit disorganized. It makes it hard to follow the information given. Simpler organized tables would have given a better representation of the data collected. Elective cesarean section has been proved to reduce the rate of MTCT of HIV since there is minimal contact of the mother’s blood with that of the child during birth. The research failed to give information on the possible risks of the surgical process that have been identified by other researchers in the medical field. It is important for pregnant women to know the risks they take before accepting this processes (Hasan & Salayta, 2011, p. 206). The researchers recommend this method of delivery to infected mothers who wish to protect their children from HIV; however, the method is not applicable in the poor nations where health facilities are not adequately equipped. Discussion In summary, the qualitative research article was fairly well written although the authors failed to include a literature review as well as correct a few limitations of their research design. The authors however admitted their limitations and gave room for future qualitative researches to be conducted on the subject of the study. On the other hand, the Quantitative research was socially biased since it only used samples from the developed countries. Both research works gave information that is parallel to information given by other researchers who have taken their time to investigate on the best way to prevent. The study was however effectively supported the research hypothesis of the authors. References Curtise K.C & White P. 2005. Qualitative research design and approaches in heath sciences. healthsciences,(11), 217-225. Desai, M. & Dikshit, RK 2012. Antiretroviral Drugs: Critical Issues and Recent Advances, Indian Journal of pharmacology, vol. 44, no. 3, pp. 288-298. Ferguson, CJ & Brannick, MT 2012. 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Wainberg, M.A & Brenner, B.G 2010. Role of HIV subtype Diversity in the Development of Resistance to Antiviral Drugs, Viruses, Vol. 2, no. 11, pp. 2493-2508. Read More