Implementation and experiences of integrated prevention of mother-to-child transmission services in Tanzania, Malawi and South Africa: A mixed methods study
| Autor: | Eveline Geubbels, Deborah Kajoka, Thokozani Kalua, Estelle McLean, Alison Wringe, Janet Seeley, Rujeko Samanthia Chimukuche, Mosa Moshabela, Jenny Renju, Farida Hassan, John Songo, Lameck B. Luwanda |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Malawi Referral Art initiation HIV Infections Hiv testing Tanzania 03 medical and health sciences South Africa 0302 clinical medicine Pregnancy Medicine Humans Service user Maternal health 030212 general & internal medicine 030505 public health biology business.industry Public Health Environmental and Occupational Health Prevention of mother to child transmission Prenatal Care biology.organism_classification Infectious Disease Transmission Vertical Family medicine Female Hiv status 0305 other medical science business |
| Zdroj: | Global public health. 16(2) |
| ISSN: | 1744-1706 1744-1692 |
| Popis: | Although integration of HIV and maternal health services is recommended by the World Health Organization, evidence to guide implementation is limited. We describe facility-level implementation of policies for integrating HIV care within maternal health services and explore experiences of service users and providers in rural Tanzania (Ifakara), South Africa (uMkhanyakude) and Malawi (Karonga). Policy in all countries included HIV testing during antenatal care (ANC), same-day antiretroviral therapy (ART) initiation for HIV-positive pregnant women, and postpartum referral to ART clinics, between six weeks (Malawi, South Africa) and two years after delivery (Tanzania). All facilities offered HIV testing within ANC, most commonly during the first visit. Although most women were comfortable with HIV testing, some felt that opting out would lead to sub-standard services. Some facilities conducted group post-test counselling for HIV-negative women, raising concerns of unintended HIV status disclosure. ART initiation was offered on the same day, the same room as an HIV diagnosis in >90% of facilities. Women's worries around postpartum referral included having unknown providers, insufficient privacy and queues. Adoption and implementation of policies on integrated HIV and maternal health services varied across settings. Patients' experiences of these policies may influence uptake and retention in care. |
| Databáze: | OpenAIRE |
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