Challenges faced by health workers in implementing the prevention of mother-to-child HIV transmission (PMTCT) programme in Uganda

ABSTRACTBackground To report the experience of health workers who had played key roles in the early stages of implementing the prevention of mother-to-child HIV transmission services (PMTCT) in Uganda. Methods Interviews were conducted with 15 key informants including counsellors, obstetricians and...

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Bibliographic Details
Published in:Journal of public health (Oxford, England) England), 2007-09, Vol.29 (3), p.269-274
Main Authors: Nuwagaba-Biribonwoha, H., Mayon-White, R. T., Okong, P., Carpenter, L. M.
Format: Article
Language:English
Subjects:
Awareness
Challenges
Children
Counseling
Female
Health impact assessment
Health Personnel - education
Health services
HIV
HIV Infections - drug therapy
HIV Infections - prevention & control
HIV Infections - transmission
Humans
Infectious Disease Transmission, Vertical - prevention & control
Inservice Training
Male
Pilot Projects
Pregnancy
Pregnancy Complications, Infectious - drug therapy
Pregnancy Complications, Infectious - prevention & control
Pregnancy Complications, Infectious - virology
Prenatal Care
Preventive programmes
Program Development
Program Evaluation
Qualitative Research
Tape Recording
Uganda
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Summary:ABSTRACTBackground To report the experience of health workers who had played key roles in the early stages of implementing the prevention of mother-to-child HIV transmission services (PMTCT) in Uganda. Methods Interviews were conducted with 15 key informants including counsellors, obstetricians and PMTCT coordinators at the five PMTCT test sites in Uganda to investigate the benefits, challenges and sustainability of the PMTCT programme. Audio-taped interviews were held with each informant between January and June 2003. These were transcribed verbatim and manually analysed using the framework approach. Results The perceived benefits reported by informants were improvement of general obstetric care, provision of antiretroviral prophylaxis for HIV-positive mothers, staff training and community awareness. The main challenges lay in the reluctance of women to be tested for HIV, incomplete follow-up of participants, non-disclosure of HIV status and difficulties with infant feeding for HIV-positive mothers. Key informants thought that the programme's sustainability depended on maintaining staff morale and numbers, on improving services and providing more resources, particularly antiretroviral therapy for the HIV-positive women and their families. Conclusion Uganda's experience in piloting the PMTCT programme reflected the many challenges faced by health workers. Potentially resource-sparing strategies such as the ‘opt-out’ approach to HIV testing required further evaluation.
ISSN:1741-3842
1741-3850
DOI:10.1093/pubmed/fdm025