Peer-reviewed article
Managers perspectives on the implementation of the Prevention of Mother-to-Child Transmission policy in South Africa.
Dyeshana H, Zuma S ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study explores the views of 11 Prevention of Mother-to-Child Transmission (PMTCT) managers across South Africa's nine provinces about challenges in implementing HIV prevention policy. Managers identified four main barriers: policy design and change management issues, system and service delivery constraints, provider-level problems, and client-level factors. The research finds that PMTCT policy is only partially implemented in South Africa, which may prevent the country from achieving elimination of mother-to-child transmission by 2030. The study recommends guidelines to support full implementation across all health service platforms.
Key points
- Four themes of implementation challenges were identified: policy design and change management, system and service delivery constraints, provider-level determinants, and client-level determinants
- PMTCT policy is currently only partially implemented across South Africa
- Study involved managers at national (1), provincial (7), and district (3) levels
- Challenges remain despite significant progress in reducing mother-to-child transmission of HIV
- Full implementation is needed to achieve elimination of mother-to-child transmission (eMTCT) by 2030
Limitations
This is a qualitative study based on manager perspectives only, capturing views from 11 respondents. It does not present quantitative data on transmission rates, client outcomes, or systematic comparison of implementation across provinces, and does not examine the impact of identified barriers on actual PMTCT effectiveness or child health outcomes.
Abstract
Background Despite significant progress in South Africa in reducing mother-to-child transmission of human immunodeficiency virus (HIV) infection, challenges remain. This is evident by the incidence and prevalence of HIV in pregnancy and transmission during breastfeeding. This study is aimed at ascertaining the perceptions of prevention of mother-to-child transmission (PMTCT) managers regarding the challenges experienced during the implementation of the PMTCT policy at public health service delivery platforms across all provinces of South Africa. Aim To examine the perceptions and views of PMTCT managers regarding the challenges experienced during implementation of the policy. Setting The study was conducted in all nine provinces of South Africa. Methods An exploratory-qualitative descriptive research design was utilised. The study population was the PMTCT managers. Data were collected from a sample of 11 PMTCT managers, seven at the provincial level, three at the district level, and one at the national level, using in-depth semi-structured interviews from April 2021 to July 2022. The participants were purposefully selected based on their expertise and experiences related to the study topic. Results The participants shared the views, experiences and challenges encountered during the PMTCT policy implementation. Four themes were generated: policy design and change management, system and service delivery constraints, provider-level determinants and client-level determinants. It is imperative that recommendations shared be implemented to support the full implementation of the PMTCT policy, enabling the country to achieve the elimination of mother-to-child transmission by 2030 and an HIV-free generation. Conclusion The article confirmed that the Prevention of Mother-to-Child Transmission policy is partially implemented in South Africa which may derail the country to achieve eMTCT by 2030. Contribution The article propose guidelines towards full implementation of the Prevention of Mother-to-Child Transmission policy across all service delivery platforms across South Africa.