OBJECTIVES: To evaluate prevention of mother to child transmission of HIV (PMTCT) implementation and integration of PMTCT with routine maternal and child health services in two districts of KwaZulu-Natal; to report PMTCT coverage, to compare recorded and reported information, and to describe responsibilities of nurses and lay counsellors. METHODS: Interviews were conducted with mothers in post-natal wards (PNW) and immunisation clinics; antenatal and child health records were reviewed. Interviews were conducted with nurses and lay counsellors in primary health care clinics. RESULTS: Eight hundred and eighty-two interviews were conducted with mothers: 398 in PNWs and 484 immunisation clinics. During their recent pregnancy, 98.6% women attended antenatal care (ANC); 60.8% attended their first ANC in the third trimester, and 97.3% were tested for HIV. Of 312 mothers reporting themselves HIV positive during ANC, 91.3% received nevirapine, 78.2% had a CD4 count carried out, and 33.1% had a CD4 result recorded. In the immunisation clinic, 47.6% HIV-exposed babies had a PCR test, and 47.0% received co-trimoxazole. Of HIV-positive mothers, 42.1% received follow-up care, mainly from lay counsellors. In 12/26 clinics, there was a dedicated PMTCT nurse, PCR testing was not offered in 14/26 clinics, and co-trimoxazole was unavailable in 13/26 immunisation clinics. Nurses and lay counsellors disagreed about their roles and responsibilities, particularly in the post-natal period. CONCLUSIONS: There is high coverage of PMTCT interventions during pregnancy and delivery, but follow-up of mothers and infants is poor. Poor integration of PMTCT services into routine care, lack of clarity about health worker roles and poor record keeping create barriers to accessing services post-delivery.
OBJECTIVES: To evaluate prevention of mother to child transmission of HIV (PMTCT) implementation and integration of PMTCT with routine maternal and child health services in two districts of KwaZulu-Natal; to report PMTCT coverage, to compare recorded and reported information, and to describe responsibilities of nurses and lay counsellors. METHODS: Interviews were conducted with mothers in post-natal wards (PNW) and immunisation clinics; antenatal and child health records were reviewed. Interviews were conducted with nurses and lay counsellors in primary health care clinics. RESULTS: Eight hundred and eighty-two interviews were conducted with mothers: 398 in PNWs and 484 immunisation clinics. During their recent pregnancy, 98.6% women attended antenatal care (ANC); 60.8% attended their first ANC in the third trimester, and 97.3% were tested for HIV. Of 312 mothers reporting themselves HIV positive during ANC, 91.3% received nevirapine, 78.2% had a CD4 count carried out, and 33.1% had a CD4 result recorded. In the immunisation clinic, 47.6% HIV-exposed babies had a PCR test, and 47.0% received co-trimoxazole. Of HIV-positive mothers, 42.1% received follow-up care, mainly from lay counsellors. In 12/26 clinics, there was a dedicated PMTCT nurse, PCR testing was not offered in 14/26 clinics, and co-trimoxazole was unavailable in 13/26 immunisation clinics. Nurses and lay counsellors disagreed about their roles and responsibilities, particularly in the post-natal period. CONCLUSIONS: There is high coverage of PMTCT interventions during pregnancy and delivery, but follow-up of mothers and infants is poor. Poor integration of PMTCT services into routine care, lack of clarity about health worker roles and poor record keeping create barriers to accessing services post-delivery.
Authors: Alyssa B Sharkey; Mickey Chopra; Debra Jackson; Peter J Winch; Cynthia S Minkovitz Journal: Trans R Soc Trop Med Hyg Date: 2011-12-01 Impact factor: 2.184
Authors: J Mutsvangwa; I A Beck; L Gwanzura; M T Manhanzva; L Stranix-Chibanda; T Chipato; L M Frenkel Journal: J Virol Methods Date: 2014-09-17 Impact factor: 2.014
Authors: Lena E Winestone; Elizabeth A Bukusi; Craig R Cohen; Daniel Kwaro; Nicole C Schmidt; Janet M Turan Journal: Glob Public Health Date: 2011-11-01
Authors: Janet M Turan; Maricianah Onono; Rachel L Steinfeld; Starley B Shade; Kevin Owuor; Sierra Washington; Elizabeth A Bukusi; Marta L Ackers; Jackson Kioko; Evelyn C Interis; Craig R Cohen Journal: J Acquir Immune Defic Syndr Date: 2015-08-15 Impact factor: 3.731
Authors: Sten H Vermund; José A Tique; Holly M Cassell; Megan E Pask; Philip J Ciampa; Carolyn M Audet Journal: J Acquir Immune Defic Syndr Date: 2013-06-01 Impact factor: 3.731
Authors: Sera L Young; Mduduzi N N Mbuya; Caroline J Chantry; Eveline P Geubbels; Kiersten Israel-Ballard; Deborah Cohan; Stephen A Vosti; Michael C Latham Journal: Adv Nutr Date: 2011-04-30 Impact factor: 8.701