The Achilles’ heel of prevention to mother-to-child transmission of HIV: Protocol implementation, uptake, and sustainability
The Joint United Nations Programme on HIV and AIDS proposed to reduce the vertical transmission of HIV from ∼72,200 to ∼8300 newly infected children by 2015 in South Africa (SA). However, cultural, infrastructural, and socio-economic barriers hinder the implementation of the prevention of mother-to-...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2017-01-01
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| Series: | SAHARA-J |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/17290376.2017.1375425 |
| _version_ | 1819003014113918976 |
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| author | Violeta J. Rodriguez Richard P. LaCabe C. Kyle Privette K. Marie Douglass Karl Peltzer Gladys Matseke Audrey Mathebula Shandir Ramlagan Sibusiso Sifunda Guillermo “Willy” Prado Viviana Horigian Stephen M. Weiss Deborah L. Jones |
| author_facet | Violeta J. Rodriguez Richard P. LaCabe C. Kyle Privette K. Marie Douglass Karl Peltzer Gladys Matseke Audrey Mathebula Shandir Ramlagan Sibusiso Sifunda Guillermo “Willy” Prado Viviana Horigian Stephen M. Weiss Deborah L. Jones |
| author_sort | Violeta J. Rodriguez |
| collection | DOAJ |
| description | The Joint United Nations Programme on HIV and AIDS proposed to reduce the vertical transmission of HIV from ∼72,200 to ∼8300 newly infected children by 2015 in South Africa (SA). However, cultural, infrastructural, and socio-economic barriers hinder the implementation of the prevention of mother-to-child transmission (PMTCT) protocol, and research on potential solutions to address these barriers in rural areas is particularly limited. This study sought to identify challenges and solutions to the implementation, uptake, and sustainability of the PMTCT protocol in rural SA. Forty-eight qualitative interviews, 12 focus groups discussions (n = 75), and one two-day workshop (n = 32 participants) were conducted with district directors, clinic leaders, staff, and patients from 12 rural clinics. The delivery and uptake of the PMTCT protocol was evaluated using the Consolidated Framework for Implementation Research (CFIR); 15 themes associated with challenges and solutions emerged. Intervention characteristics themes included PMTCT training and HIV serostatus disclosure. Outer-setting themes included facility space, health record management, and staff shortage; inner-setting themes included supply use and availability, staff–patient relationship, and transportation and scheduling. Themes related to characteristics of individuals included staff relationships, initial antenatal care visit, adherence, and culture and stigma. Implementation process themes included patient education, test results delivery, and male involvement. Significant gaps in care were identified in rural areas. Information obtained from participants using the CFIR framework provided valuable insights into solutions to barriers to PMTCT implementation. Continuously assessing and correcting PMTCT protocol implementation, uptake and sustainability appear merited to maximize HIV prevention. |
| first_indexed | 2024-12-20T23:14:16Z |
| format | Article |
| id | doaj.art-1182f219d87b4f14ac19644342db20d0 |
| institution | Directory Open Access Journal |
| issn | 1729-0376 1813-4424 |
| language | English |
| last_indexed | 2024-12-20T23:14:16Z |
| publishDate | 2017-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | SAHARA-J |
| spelling | doaj.art-1182f219d87b4f14ac19644342db20d02022-12-21T19:23:40ZengTaylor & Francis GroupSAHARA-J1729-03761813-44242017-01-01141385210.1080/17290376.2017.13754251375425The Achilles’ heel of prevention to mother-to-child transmission of HIV: Protocol implementation, uptake, and sustainabilityVioleta J. Rodriguez0Richard P. LaCabe1C. Kyle Privette2K. Marie Douglass3Karl Peltzer4Gladys Matseke5Audrey Mathebula6Shandir Ramlagan7Sibusiso Sifunda8Guillermo “Willy” Prado9Viviana Horigian10Stephen M. Weiss11Deborah L. Jones12University of Miami Miller School of MedicineUniversity of Miami Miller School of MedicineUniversity of Miami Miller School of MedicineUniversity of Miami Miller School of MedicineHIV/AIDS/STIs and TB (HAST) Research Programme, Human Sciences Research CouncilHIV/AIDS/STIs and TB (HAST) Research Programme, Human Sciences Research CouncilHIV/AIDS/STIs and TB (HAST) Research Programme, Human Sciences Research CouncilHIV/AIDS/STIs and TB (HAST) Research Programme, Human Sciences Research CouncilHIV/AIDS/STIs and TB (HAST) Research Programme, Human Sciences Research CouncilLeonard M. Miller Professor of Public Health SciencesUniversity of Miami, Miller School of MedicineUniversity of Miami Miller School of MedicineUniversity of Miami Miller School of MedicineThe Joint United Nations Programme on HIV and AIDS proposed to reduce the vertical transmission of HIV from ∼72,200 to ∼8300 newly infected children by 2015 in South Africa (SA). However, cultural, infrastructural, and socio-economic barriers hinder the implementation of the prevention of mother-to-child transmission (PMTCT) protocol, and research on potential solutions to address these barriers in rural areas is particularly limited. This study sought to identify challenges and solutions to the implementation, uptake, and sustainability of the PMTCT protocol in rural SA. Forty-eight qualitative interviews, 12 focus groups discussions (n = 75), and one two-day workshop (n = 32 participants) were conducted with district directors, clinic leaders, staff, and patients from 12 rural clinics. The delivery and uptake of the PMTCT protocol was evaluated using the Consolidated Framework for Implementation Research (CFIR); 15 themes associated with challenges and solutions emerged. Intervention characteristics themes included PMTCT training and HIV serostatus disclosure. Outer-setting themes included facility space, health record management, and staff shortage; inner-setting themes included supply use and availability, staff–patient relationship, and transportation and scheduling. Themes related to characteristics of individuals included staff relationships, initial antenatal care visit, adherence, and culture and stigma. Implementation process themes included patient education, test results delivery, and male involvement. Significant gaps in care were identified in rural areas. Information obtained from participants using the CFIR framework provided valuable insights into solutions to barriers to PMTCT implementation. Continuously assessing and correcting PMTCT protocol implementation, uptake and sustainability appear merited to maximize HIV prevention.http://dx.doi.org/10.1080/17290376.2017.1375425implementation sciencePMTCTHIVSouth Africa |
| spellingShingle | Violeta J. Rodriguez Richard P. LaCabe C. Kyle Privette K. Marie Douglass Karl Peltzer Gladys Matseke Audrey Mathebula Shandir Ramlagan Sibusiso Sifunda Guillermo “Willy” Prado Viviana Horigian Stephen M. Weiss Deborah L. Jones The Achilles’ heel of prevention to mother-to-child transmission of HIV: Protocol implementation, uptake, and sustainability SAHARA-J implementation science PMTCT HIV South Africa |
| title | The Achilles’ heel of prevention to mother-to-child transmission of HIV: Protocol implementation, uptake, and sustainability |
| title_full | The Achilles’ heel of prevention to mother-to-child transmission of HIV: Protocol implementation, uptake, and sustainability |
| title_fullStr | The Achilles’ heel of prevention to mother-to-child transmission of HIV: Protocol implementation, uptake, and sustainability |
| title_full_unstemmed | The Achilles’ heel of prevention to mother-to-child transmission of HIV: Protocol implementation, uptake, and sustainability |
| title_short | The Achilles’ heel of prevention to mother-to-child transmission of HIV: Protocol implementation, uptake, and sustainability |
| title_sort | achilles heel of prevention to mother to child transmission of hiv protocol implementation uptake and sustainability |
| topic | implementation science PMTCT HIV South Africa |
| url | http://dx.doi.org/10.1080/17290376.2017.1375425 |
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