Health system response to preventing mother-to-child transmission of HIV policy changes in Zambia
A health system dynamics analysis of primary health care facilities
Bibliographic Data
| ID | 19530541 |
|---|---|
| Authors | Jonathan Mwanza (0000-0001-7877-5058, University of the Witwatersrand, corresponding author), Mary Kawonga (0000-0001-9807-7847, University of the Witwatersrand), Andrew Kumwenda (0000-0003-4624-0002, University of Zambia), Glenda E Gray (Office of the President, South Africa Medical Research Council, Cape Town, South Africa), Glenda Gray (0000-0003-4649-1477, South African Medical Research Council), W Mutale (0000-0002-4891-6750, University of Zambia), Tanya Doherty (0000-0003-1592-0080, South African Medical Research Council) |
| Year | 2022 |
| Volume | 15 |
| Issue | 1 |
| Pages | 2126269-2126269 |
| Publication date | 2022-12-31 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Global Health Action (JOURNAL) |
| Journal identifiers | ISSN: 1654-9716 • E-ISSN: 1654-9880 |
| Publisher | Informa UK Limited (PUBLISHER • GB) |
| DOI | 10.1080/16549716.2022.2126269 |
| PMID | 36239946 |
| OpenAlex | W4306178421 |
| Language | EN |
| Citations received | 4 |
| References cited | 29 |
BACKGROUND: Zambia is focusing on attaining HIV epidemic control by 2021, including eliminating Mother to Child Transmission (eMTCT) of HIV. However, there is little evidence to understand frontline healthcare workers' experience with the policy changes and the readiness of different health system elements to contribute to this goal. OBJECTIVE: To understand frontline healthcare workers' experience of preventing mother-to-child transmission (PMTCT) of human immunodeficiency (HIV) policy changes and to explore the health system readiness to respond to rapid changes in PMTCT policy by using the health system dynamic framework. METHOD: We conducted a qualitative study in which 35 frontline healthcare workers were selected and interviewed using a snowball sampling technique. All transcripts were analysed through thematic content analysis and deductive coding. Themes were derived and presented according to the health system dynamics framework. RESULTS: Among the ten elements of the health system dynamics framework, service delivery, context, and resources (i.e. infrastructure and supplies, knowledge and information, human resource, and finance) were critical in implementing the continuously evolving PMTCT policies. Furthermore, due to the fragmented primary health care platform in Zambia, non-governmental organisations (NGOs) were instrumental in ensuring that the PMTCT programme met the demand and requirements of the general population. Frontline healthcare workers who participated in the study described inequity in access to ART services due to the service delivery model employed in the selected study sites. CONCLUSION: The study highlights challenges when policies are implemented without consideration for the readiness, context, and capacity in which the policy is implemented. We offer lessons that can inform implementation of universal health coverage of antiretroviral therapy (ART), a strategy many countries have adopted, despite weak health systems
Business · Economic growth · Economics · Environmental health · Geography · Health care · Population · Public health · Qualitative research · Service delivery framework · Snowball sampling · Sociology · Thematic analysis · Adolescent Sexual and Reproductive Health · Global Maternal and Child Health · HIV/AIDS Research and Interventions · Medicine · Nursing · Health Policy · Marketing
Adolescents’ engagement with comprehensive sexuality education in Zambian schools
Patient perspective on the elimination mother-to-child transmission of HIV, syphilis, and hepatitis B in Bali, Indonesia
Cultural appropriateness of a comprehensive sexuality education programme. Implications for programme adaptation and implementation in Zambia
Using simulation modelling to transform hospital planning and management to address health inequalities
Challenges of quality improvement in the healthcare of South Africa post-apartheid
Role and outcomes of community health workers in HIV care in sub‐Saharan Africa
Mortality of infected and uninfected infants born to HIV-infected mothers in Africa
A theory of organizational readiness for change
Fostering implementation of health services research findings into practice
Diffusion of Innovations in Service Organizations
Effectiveness of Lifelong ART (Option B+) in the Prevention of Mother-to-Child Transmission of HIV Programme in Zambia
The Health System Dynamics Framework
“If donors woke up tomorrow and said we can't fund you, what would we do?” A health system dynamics analysis of implementation of PMTCT option B+ in Uganda
Innovation to improve health care provision and health systems in sub-Saharan Africa – Promoting agency in mid-level workers and district managers
Community health volunteers could help improve access to and use of essential health services by communities in LMICs
Exploring health system readiness for adopting interventions to address intimate partner violence
| Citations per year | 2 |
|---|---|
| Citation span | 2024 - 2026 (3) |
| Highly cited | No |