Integration of Preventing Mother-To-Child Transmission of HIV and Syphilis Testing and Treatment in Antenatal Care Services in the Northern Cape and Gauteng Provinces, South Africa

Dinh, Thu–Ha; Kamb, Mary L.; Msimang, Veerle; Likibi, Muptal; Molebatsi, Thabo; Goldman, T. R.; Lewis, David A.

doi:10.1097/olq.0000000000000042

Cited by 36 publications

(34 citation statements)

References 9 publications

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“…The included reports cover programmes from Africa (Botswana, Cameroon, Cote d'Ivoire, Ethiopia, Kenya, Malawi, Mozambique, Rwanda, South Africa, Swaziland, Tanzania, Uganda, Zambia, Zimbabwe and Sub‐Saharan Africa in general), Asia (China, Mongolia, Thailand), Europe (Ukraine) and the Pacific (Fiji). The majority of the emerging evidence relates to integration of HIV services, mainly prevention of mother‐to‐child transmission (PMTCT) of HIV, one study is on the integration of PMTCT and TB services, one on malaria, five on syphilis and two on integration of nutrition services . We also include guidance from the Global Fund to Fight AIDS, Tuberculosis and Malaria on how to integrate maternal, newborn and child health interventions with HIV, tuberculosis and malaria programmes…”

Section: Resultsmentioning

confidence: 99%

Barriers and enablers to integrating maternal and child health services to antenatal care in low and middle income countries

Jongh¹,

Gurol‐Urganci

Allen

et al. 2016

BJOG

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Antenatal care (ANC) represents a delivery platform for a broad range of health services; however, these opportunities are insufficiently utilised. This review explores key barriers and enablers for successful integration of health s"ervices with ANC in different contexts. Data from peer‐reviewed and grey literature were organised using the SURE checklist. We identified 46 reports focusing on integration of HIV, tuberculosis, malaria, syphilis or nutrition services with ANC from Asia, Africa and the Pacific. Perspectives of service users and providers, social and political factors, and health system characteristics (such as resource availability and organisational structures) affected ease of integration.Tweetable abstractHealth system factors, context and stakeholders must be considered for integrated antenatal care services.

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Section: Resultsmentioning

confidence: 99%

Barriers and enablers to integrating maternal and child health services to antenatal care in low and middle income countries

Jongh¹,

Gurol‐Urganci

Allen

et al. 2016

BJOG

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“…To achieve effective integration of HIV, TB and malaria interventions into ANC services, implementation must be accompanied by improved physical and technical infrastructure; services provided at different locations (e.g. consulting rooms and laboratories in different facilities) or those not provided on the same day pose a significant challenge to integrated HIV services (reviewed in [11, 26, 43]) and have impacted on the integration of malaria treatment into ANC [44, 45]. While IPTp is given presumptively in ANC, thus removing the need for testing, women are often required to purchase the drug elsewhere or are not directly observed taking therapy having been given the drug to take home, both of which have been identified as a significant barrier to IPTp coverage [45–47].…”

Section: Introductionmentioning

confidence: 99%

Achieving development goals for HIV, tuberculosis and malaria in sub-Saharan Africa through integrated antenatal care: barriers and challenges

Fowkes

Draper

Hellard

et al. 2016

BMC Med

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BackgroundThe global health community is currently transitioning from the Millennium Development Goals (MDGs) to the Sustainable Development Goals (SDGs). Unfortunately, progress towards maternal, newborn and infant health MDGs has lagged significantly behind other key health goals, demanding a renewed global effort in this key health area. The World Health Organization and other institutions heralded integrated antenatal care (ANC) as the best way to address the inter-related health issues of HIV, tuberculosis (TB) and malaria in the high risk groups of pregnant women and infants; integrated ANC services also offer a mechanism to address slow progress towards improved maternal health.DiscussionThere is remarkably limited evidence on best practice approaches of program implementation, acceptability and effectiveness for integrated ANC models targeting multiple diseases. Here, we discuss current integrated ANC global guidelines and the limited literature describing integrated ANC implementation and evidence for their role in addressing HIV, malaria and TB during pregnancy in sub-Saharan Africa. We highlight the paucity of data on the effectiveness of integrated ANC models and identify significant structural barriers in the health system (funding, infrastructure, distribution, human resources), the adoption system (limited buy-in from implementers, leadership, governance) and, in the broader context, patient-centred barriers (fear, stigma, personal burdens) and barriers in funding structures. We highlight recommendations for action and discuss avenues for the global health community to develop systems to integrate multiple disease programs into ANC models of care that better address these three priority infectious diseases.SummaryWith the current transition to the SDGs and concerns regarding the failure to meet maternal health MDGs, the global health community, researchers, implementers and funding bodies must work together to ensure the establishment of quality operational and implementation research to inform integrated ANC models. It is imperative that the global health community engages in a timely discussion about such implementation innovations and instigates appropriate actions to ensure advances in maternal health are sufficient to meet applicable SDGs.

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“…Further, the interventions necessary to diagnose HIV and syphilis in pregnancy (testing, ideally at first pregnancy visit) are similar and can be performed onsite in ANC clinics with limited equipment. The integration of PMTCT of HIV services with maternal syphilis screening services is cost-efficient, saving providers' and clients' time [14]. Thus, the integration of services has the potential to increase uptake of each individual intervention and to lead to improved maternal and reproductive health [6,11].…”

Section: Introductionmentioning

confidence: 99%

The need for further integration of services to prevent mother‐to‐child transmission of HIV and syphilis in Mwanza City, Tanzania

Balira

Mabey

Weiss

et al. 2015

Intl J Gynecology & Obste

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a b s t r a c t a r t i c l e i n f oKeywords: HIV Integration PMTCT Pregnancy SyphilisObjective: To assess the operational integration of maternal HIV testing and syphilis screening in Mwanza, Tanzania. Methods: Interviews were conducted with 76 health workers (HW) from three antenatal clinics (ANC) and three maternity wards in 2008-2009 and 1137 consecutive women admitted for delivery. Nine ANC health education sessions and client flow observations were observed. Results: Only 25.0% of HWs reported they had received training in both prevention of mother-to-child transmission (PMTCT) and syphilis screening. HIV and syphilis tests were sometimes performed in different rooms and results recorded in separate registers with different formats and the results were not always given by the same person. At delivery, most women had been tested for both HIV (79.4%) and syphilis (88.1%) during pregnancy. Of those not tested antenatally for each infection, 70.1% were tested for HIV at delivery but none for syphilis. Conclusion: Integration of maternal HIV and syphilis screening was limited. Integrated care guidelines and related health worker training should address this gap.

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Integration of Preventing Mother-To-Child Transmission of HIV and Syphilis Testing and Treatment in Antenatal Care Services in the Northern Cape and Gauteng Provinces, South Africa

Cited by 36 publications

References 9 publications

Barriers and enablers to integrating maternal and child health services to antenatal care in low and middle income countries

Barriers and enablers to integrating maternal and child health services to antenatal care in low and middle income countries

Achieving development goals for HIV, tuberculosis and malaria in sub-Saharan Africa through integrated antenatal care: barriers and challenges

The need for further integration of services to prevent mother‐to‐child transmission of HIV and syphilis in Mwanza City, Tanzania

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