Externalities of prevention of mother-to-child transmission programs: a systematic review.
There has been considerable debate about the effects of targeted global health assistance in low- and middle-income countries on health systems, specifically HIV/AIDS funding. Recently, a handful of studies have emerged that describe the implementation of PMTCT programs, which have many theoretical links to maternal and child health. Through a systematic review of research published between January 2000 and March 2011, this paper synthesizes evidence evaluating the impact of these programs. We assessed 5,855 papers, reviewed 154, and included 21 articles. They offer evidence of beneficial synergies between PMTCT programs and both STI prevention and early childhood immunization. Other data, including information about antenatal and delivery care, family planning, and nutrition supplementation varied considerably across studies demonstrating both positive and negative effects of PMTCT. More research is needed to allow countries and funders to make informed decisions regarding allocation of limited funds to targeted versus broad categories of health care.
College of Arts and Sciences, Yale University, New Haven, CT, USA.
Sarah
S
Nutman
Douglas
D
McKee
Kaveh
K
Khoshnood
D017954:Africa South of the Sahara / Q000453:epidemiology; D018791:CD4 Lymphocyte Count; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration* / Q000592:standards; D005193:Family Planning Services; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control*; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008297:Male; D008430:Maternal-Child Health Centers / Q000458:organization & administration* / Q000592:standards; D009035:Mothers; D011247:Pregnancy; D019562:Viral Load