Prevention-of-Mother-To-Child-Transmission of HIV Services in Sub-Saharan Africa: A Qualitative Analysis of Healthcare Providers and Clients Challenges in Ghana.
BACKGROUND
Developed by the World Health Organization (WHO) and partners, the correct adaptation and implementation of the global guidelines on prevention of mother-to-child transmission (PMTCT) of HIV is critical. This study explored the challenges that health workers face implementing WHO's PMTCT guidelines, and the experiences of HIV-positive clients receiving these services.


METHODS
We interacted with 14 health professionals, and 16 PMTCT clients through in-depth interviews. Four of seven PMTCT sites within the Accra Metropolis were purposively included. Interviews were tape-recorded, transcribed, analyzed, and then sorted into themes.


RESULTS
Health workers had challenges translating PMTCT guidelines into useful messages for their clients. Their counselling was often prescriptive. Counselors identified inadequate in-service training as a key reason for their out-dated and inconsistent messages. HIV-positive clients exhibited general knowledge about the importance of doing exclusive breast-feeding for the first six months of life. Clients had confidence in antiretroviral for PMTCT. However, deeply rooted socio-cultural practices and the attitudes of counselors remain challenges to clients.
Counselors require refresher training which addresses, among other things, long-held socio-cultural practices. Publicizing these challenges will prod policy makers and program implementers to develop strategies that address the challenges both locally and globally.
Department of Population, Family, and Reproductive Health, School of Public Health, Legon, GHANA.
Amos Kankponang
AK
Laar
Formerly of West African AIDS Foundation, Accra, GHANA.
Belynda
B
Amankwa
Tema General Hospital, Tema, GHANA.
Charlotte
C
Asiedu
Challenges; Clients; HIV; PMTCT; Service providers