Prevention of mother-to-child transmission (PMTCT) implementation in rural community health centres in Mpumalanga province, South Africa

Abstract

This study explores organisational and individual provider influences on prevention of mother-to-child transmission (PMTCT) implementation at 12 community health centres (CHCs) in a rural South African setting. Clinic staff members (N = 103; females = 86%, nurse managers = 9.7%, nurses = 54.4%, lay health workers = 35.9%) were surveyed on PMTCT implementation acceptability and skills. The data were analysed using descriptive statistics comparing PMTCT protocol implementation achievements and clinic-level PMTCT indicators. Results indicate that staff were very positive about the frequency at which each element of the PMTCT protocol was achieved. Several areas where gaps in conformity to the PMTCT protocol were identified including delivery at the clinic, HIV retesting, provision of anti-retroviral treatment (ART) and six-week polymerase chain reaction (PCR) testing. It was unclear what organisational or individual characteristics contributed to this variation. Overall, providers’ perception of barriers to care and human resource capacity were unrelated to performance and fidelity of protocol implementation.

Keywords:

• organisational factors
• barriers
• adaptation
• PMTCT implementation
• South Africa

Acknowledgements

This study was funded by a collaborative grant from the NIH/PEPFAR, R01HD078187-S.