Pre- and post-intervention assessment of a PMTCT-programme strengthening initiative in a rural area of the Eastern Cape, South Africa

  • Nancy Phaswana-Mafuya
  • Karl Peltzer
  • Rendani Ladzani
  • Gladys Mlambo
  • Adlai Davids
  • Khanyisa Phaweni
  • Pelisa Dana
  • Mandisa Ndabula

Abstract

The research assesses prevention-of-mother-to-child-transmission-of-HIV (PMTCT) services following implementation of programme-strengthening activities in a municipality in the Eastern Cape Province, South Africa. A pre-intervention and post-intervention design was used to conduct facility assessments and client exit interviews at baseline and after 28 months. For the facility assessments, unstructured interviews were conducted with the heads of maternity wards at each delivery facility (n = 4), nurses (n = 9) and lay counsellors (n = 18). District Health Information System (DHIS) records were used to assess changes on PMTCT-programme indicators. Observations were conducted at the fixed clinics and hospitals to determine compliance to the national criteria for PMTCT-services delivery. For the exit interviews with clients, the pre- and post-assessment samples, respectively, included women attending for antenatal care (n = 296; n = 239) as well as HIV-positive women attending for postnatal care (n = 70; n= 142). The personnel generally perceived the PMTCT services as having been strengthened as a result of the initiative and the DHIS records showed positive changes. Client exit interviews revealed significant increases in the numbers of women who: were aware of the PMTCT programme; were tested for HIV during their pregnancy; were aware of VCT before coming to the facility; knew their HIV-test result; and, had helpful pre-HIV-test and/or post-HIV-test counselling experiences. The long waiting periods at the facilities and the relatively short length of the counselling sessions remained a serious concern. Lessons learnt may help with designing strategies to expand the national programme in South Africa as well as PMTCT programmes elsewhere. 

Keywords: antenatal care, health service delivery, HIV/AIDS, maternal health services, postnatal care, programme evaluation, quantitative research, women

African Journal of AIDS Research 2011, 10(1): 83–93

Author Biographies

Nancy Phaswana-Mafuya
Human Sciences Research Council, Social Aspects of HIV/AIDS Research Alliance, PO Box 35115, Newton Park, Port Elizabeth 6055, South Africa; Nelson Mandela Metropolitan University, Office of the Deputy Vice Chancellor, PO Box 77000, Port Elizabeth, South Africa
Karl Peltzer
Human Sciences Research Council (HSRC), Private Bag x41, Pretoria 0001, South Africa; University of Limpopo, Department of Psychology, Private Bag 1100, Sovenga 0727, South Africa
Rendani Ladzani
Human Sciences Research Council (HSRC), Private Bag x41, Pretoria 0001, South Africa; University of Limpopo, Department of Psychology, Private Bag 1100, Sovenga 0727, South Africa
Gladys Mlambo
Human Sciences Research Council (HSRC), Private Bag x41, Pretoria 0001, South Africa; University of Limpopo, Department of Psychology, Private Bag 1100, Sovenga 0727, South Africa
Adlai Davids
Human Sciences Research Council, Social Aspects of HIV/AIDS Research Alliance, PO Box 35115, Newton Park, Port Elizabeth 6055, South Africa
Khanyisa Phaweni
Human Sciences Research Council (HSRC), Private Bag x41, Pretoria 0001, South Africa; University of Limpopo, Department of Psychology, Private Bag 1100, Sovenga 0727, South Africa
Pelisa Dana
Human Sciences Research Council (HSRC), Private Bag x41, Pretoria 0001, South Africa; University of Limpopo, Department of Psychology, Private Bag 1100, Sovenga 0727, South Africa
Mandisa Ndabula
Human Sciences Research Council (HSRC), Private Bag x41, Pretoria 0001, South Africa; University of Limpopo, Department of Psychology, Private Bag 1100, Sovenga 0727, South Africa
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Articles

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eISSN: 1608-5906
print ISSN: 1727-9445