J M C Both1, J van Roosmalen. 1. Section of Health Care and Culture, VU University Medical Centre, Amsterdam, the Netherlands. jitskeboth@hotmail.com
Abstract
BACKGROUND: There is increasing debate about the impact of scaled-up HIV/AIDS programmes on fragile healthcare systems in low-income countries. OBJECTIVES: To contribute to the understanding of the relation between HIV/AIDS programmes and healthcare systems, this systematic review focuses on the impact of Prevention of Mother to Child Transmission (PMTCT) programmes on maternal health care. SEARCH STRATEGY: Publications describing the effect of PMTCT programmes on maternal healthcare services were sought through computerised searches in five electronic databases. SELECTION CRITERIA: Abstracts of publications were evaluated for appropriateness for inclusion based on whether they met the inclusion criteria. DATA COLLECTION AND ANALYSIS: Copies of all selected publications were obtained. A classification system was developed to group the relevant publications. MAIN RESULTS: The findings show that empirical evidence of the effect of PMTCT programmes on maternal health care is scarce and further research is badly needed. Twenty-one studies that were included in the systematic review showed that PMTCT programmes are often semi-integrated in maternal health care with positive as well as negative effects on various aspects of maternal health care. AUTHORS' CONCLUSIONS: It appears that PMTCT programmes miss the opportunity to have an overall positive effect on maternal health care because of their verticality.
BACKGROUND: There is increasing debate about the impact of scaled-up HIV/AIDS programmes on fragile healthcare systems in low-income countries. OBJECTIVES: To contribute to the understanding of the relation between HIV/AIDS programmes and healthcare systems, this systematic review focuses on the impact of Prevention of Mother to Child Transmission (PMTCT) programmes on maternal health care. SEARCH STRATEGY: Publications describing the effect of PMTCT programmes on maternal healthcare services were sought through computerised searches in five electronic databases. SELECTION CRITERIA: Abstracts of publications were evaluated for appropriateness for inclusion based on whether they met the inclusion criteria. DATA COLLECTION AND ANALYSIS: Copies of all selected publications were obtained. A classification system was developed to group the relevant publications. MAIN RESULTS: The findings show that empirical evidence of the effect of PMTCT programmes on maternal health care is scarce and further research is badly needed. Twenty-one studies that were included in the systematic review showed that PMTCT programmes are often semi-integrated in maternal health care with positive as well as negative effects on various aspects of maternal health care. AUTHORS' CONCLUSIONS: It appears that PMTCT programmes miss the opportunity to have an overall positive effect on maternal health care because of their verticality.
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