Community approaches to preventing mother-to-child HIV transmission: perspectives from rural Lesotho

  • Megan Towle Department of Anthropology, University of Notre Dame, 611 Flanner Hall, Notre Dame, Indiana 46556, the United States
  • Daniel H Lende Department of Anthropology, University of Notre Dame, 611 Flanner Hall, Notre Dame, Indiana 46556, the United States

Abstract

This paper examines the cultural and structural difficulties surrounding effective prevention of mother-to-child HIV transmission (PMTCT) in rural Lesotho. We argue for three strategies to improve PMTCT interventions: communitybased research and outreach, addressing cultural and structural dynamics, and working with the relevant social groups that impact HIV prevention. These conclusions are based on interviews and participant observation conducted within the rural Mokhotlong district and capital city of Maseru, involving women and men of reproductive age, grandmothers serving as primary caretakers, HIV/AIDS programme staff, and medical professionals. Qualitative analysis focused on rural women's socio-medical experience with the four measures of PMTCT (educational outreach, voluntary counselling and testing, antiretroviral interventions, and safe infant feeding). Based on these results, we conclude that intervention models must move beyond a myopic biomedical ‘best-practices' approach to address the social groups and contextual determinants impacting vertical HIV transmission. Given the complexities of effective PMTCT, our results show that it is necessary to consider the biomedical system, women and children, and the community as valuable partners in achieving positive health outcomes.

Keywords: cultural beliefs; interventions; maternal and child health services; programme planning; rural health services; social ecology; southern Africa; structural violence; task-shifting; vertical transmission

African Journal of AIDS Research 2008, 7(2): 219–228
Published
2008-08-18
Section
Articles

Journal Identifiers


eISSN: 1608-5906
print ISSN: 1727-9445