Option B+ Program for the Prevention of Vertical Transmission of HIV: A Case Study in Johannesburg, South Africa

Bisnauth, Melanie A.; Coovadia, Ashraf; Mbuagbaw, Lawrence; Wilson, Michael G.; Birch, Stephen

doi:10.3389/fpubh.2020.533534

Cited by 7 publications

(21 citation statements)

References 8 publications

(4 reference statements)

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“…Accessibility is a component of utilization that refers to the equality and equity of care in the healthcare facilities in which these women utilize PMTCT, no matter their nationality and legal status. 18 , 20 Availability dissects the factors such as the range of maternal, newborn child health services (MNCH)/PMTCT services relative to the need that is, hours of operation, ARV supply, willingness of service provider, and information provision. 18 , 20 Affordability refers to costs of PMTCT services and opportunity costs (time a woman can afford to take time from work to get to the hospital), including transport costs, medicine charges, diagnostic tests, special diets, and childcare costs.…”

Section: Methodsmentioning

confidence: 99%

“… 18 , 20 Availability dissects the factors such as the range of maternal, newborn child health services (MNCH)/PMTCT services relative to the need that is, hours of operation, ARV supply, willingness of service provider, and information provision. 18 , 20 Affordability refers to costs of PMTCT services and opportunity costs (time a woman can afford to take time from work to get to the hospital), including transport costs, medicine charges, diagnostic tests, special diets, and childcare costs. 18 , 20 Acceptability refers to whether the expectations of the women are met, which includes age, gender, race, ethnicity of provider, decision making, and whether culturally appropriate service are offered.…”

Section: Methodsmentioning

confidence: 99%

“… 18 , 20 Affordability refers to costs of PMTCT services and opportunity costs (time a woman can afford to take time from work to get to the hospital), including transport costs, medicine charges, diagnostic tests, special diets, and childcare costs. 18 , 20 Acceptability refers to whether the expectations of the women are met, which includes age, gender, race, ethnicity of provider, decision making, and whether culturally appropriate service are offered. 18 , 20 Acceptability also includes the individuals’ non-medical expectations of healthcare providers’ treatment of dignity and respect of their culture.…”

Section: Methodsmentioning

confidence: 99%

“… 18 , 20 Acceptability refers to whether the expectations of the women are met, which includes age, gender, race, ethnicity of provider, decision making, and whether culturally appropriate service are offered. 18 , 20 Acceptability also includes the individuals’ non-medical expectations of healthcare providers’ treatment of dignity and respect of their culture. 18 , 20 Adaptability , however, refers to the sustainability and scalability for the PMTCT program for all women, no matter nationality and legal status.…”

Section: Methodsmentioning

confidence: 99%

“… 17 A vital component that was not traditionally part of the PMTCT program but was later added was the provision of lifelong ART services for women by the World Health Organization (WHO) consolidated guidelines. 18 Thus, the PMTCT cascade of care does not end at delivery of the baby as there is a need for long term follow-up. PMTCT using ART is a proven, efficacious intervention, and can reduce vertical HIV transmission to less than 2%.…”

Section: Introductionmentioning

confidence: 99%

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Providing HIV Prevention of Mother to Child Transmission (PMTCT) Services to Migrants During the COVID-19 Pandemic in South Africa: Insights of Healthcare Providers

Bisnauth

Coovadia

Kawonga

et al. 2022

Health�Serv�Insights

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Background: In March 2020, COVID-19 entered South Africa, resulting in 2.9 million cases, the country took preventative and precautionary measures to control the spread of COVID-19 infection. These measures limited population mobility especially for migrant women living with HIV (WLWH) and the provision of PMTCT services. The purpose of this research was to explore the challenges of the COVID-19 pandemic on PMTCT provision by healthcare providers and understand what strategies could be implemented with lifelong antiretroviral therapy (ART) for migrants to better manage the program. Methods: Twelve in-depth interviews were conducted with healthcare providers across city and provincial levels on how the changes to the healthcare system with COVID-19 affected highly mobile patients’ adherence and utilization of PMTCT services. A thematic content analysis was used for emerging themes and guided by The Utilization of PMTCT Services conceptual framework. Results: Five main themes emerged: (1) Facilitators and barriers to adherence, which included the need for multi-month dispensing for the long term supply of antiretrovirals (ARVs) and the fear of contracting COVID-19 at the hospital that disrupted patients’ continuum of care; (2) Healthcare providers work environment, where participants felt overwhelmed with the high patient demand and the lack of infrastructural resources to follow social distancing protocols; (3) Financial challenges and opportunity costs, PMTCT proved difficult for migrants due to border closures and documentation required to receive care, this resulted in treatment interruption and left many unable to receive support at the facility due to capacity restrictions; (4) Interpersonal interactions, mistreatment, and xenophobic attitudes existed toward the migrant HIV population; and (5) “Program sustainability” revealed three key areas for strengthening: longer duration of time allocated with counseling for same-day initiation, the increased use of technology, and translation services for migrants. Conclusions: It is important to take what was learned during the pandemic and integrate it into routine service delivery, which includes long-term medication supply to reduce risk with multiple visits to collect medication, and the use of technology to alleviate the high-burden of patient demand. Healthcare policies that work toward inclusion and sustainability for migrants are needed to improve the integration of safer and practical methods of PMTCT provision into health systems.

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