Implementation and experiences of integrated prevention of mother-to-child transmission services in Tanzania, Malawi and South Africa

A mixed methods study

Datos Bibliográficos

ID15540619
AutoresFarida Hassan (Ifakara Health Institute, autor de correspondencia), Jenny Renju (0000-0001-5650-1902, London School of Hygiene & Tropical Medicine), John Songo (0000-0002-0126-7976, Malawi Epidemiology and Intervention Research Unit), Rujeko Samanthia Chimukuche (0000-0002-4890-2105, Africa Health Research Institute), Thokozani Kalua (0000-0001-7384-9011, Ministry of Health), Estelle Mclean (0000-0001-6079-0663, University of London), Lameck Luwanda (0000-0001-7293-3297, Ifakara Health Institute), Eveline Geubbels (0000-0002-9702-5460, Ifakara Health Institute), Janet Seeley (0000-0002-0583-5272, Africa Health Research Institute), Mosa Moshabela (0000-0002-9438-7095, University of KwaZulu-Natal), Deborah Kajoka (0000-0002-8269-2535, Ministry of Health, Community Development, Gender, Elderly and Children), Alison Wringe (0000-0001-6939-3461, University of London)
Año2020
Volumen16
Número2
Páginas201-215
Fecha de publicación2020-10-29
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaGlobal Public Health (JOURNAL)
Identificadores de la revistaISSN: 1744-1692 • E-ISSN: 1744-1706
EditorialTaylor & Francis (PUBLISHER • GB)
DOI10.1080/17441692.2020.1839927
PMID33119433
OpenAlexW3096208500
IdiomaEN
Citas recibidas1
Referencias citadas18

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

Business · Developing country · Economic growth · Environmental health · Family medicine · Health care · Health facility · Health services · Political science · Population · Program evaluation · Referral · Service (business · Service delivery framework · Service provider · Socioeconomics · Tanzania · Adolescent Sexual and Reproductive Health · Global Maternal and Child Health · HIV/AIDS Research and Interventions · Medicine · Nursing