title: Prevention of mother-to-child transmission (PMTCT) implementation in rural community health centres in Mpumalanga province, South Africa.
abstract: This study explores organisational and individual provider influences on prevention of mother-to-child transmission (PMTCT) implementation at 12 community health centres (CHCs) in a rural South African setting. Clinic staff members (N= 103; females = 86%, nurse managers = 9.7%, nurses = 54.4%, lay health workers = 35.9%) were surveyed on PMTCT implementation acceptability and skills. The data were analysed using descriptive statistics comparing PMTCT protocol implementation achievements and clinic-level PMTCT indicators. Results indicate that staff were very positive about the frequency at which each element of the PMTCT protocol was achieved. Several areas where gaps in conformity to the PMTCT protocol were identified including delivery at the clinic, HIV retesting, provision of anti-retroviral treatment (ART) and six-week polymerase chain reaction (PCR) testing. It was unclear what organisational or individual characteristics contributed to this variation. Overall, providers' perception of barriers to care and human resource capacity were unrelated to performance and fidelity of protocol implementation.
authors.affiliation: HIV/AIDS/STIs and TB (HAST) Research Programme, Human Sciences Research Council, Pretoria, South Africa; Department of Research and Innovation, University of Limpopo, Turfloop, South Africa; ASEAN Institute for Health Development, Madidol University, Salaya, Thailand.
authors.forename: Karl
authors.initials: K
authors.lastname: Peltzer
authors.affiliation: Center for Prevention Implementation Methodology (CePIM) for Drug Abuse and Sexual Risk Behavior, University of Miami, Miami, USA; Florida Node Alliance of the National Drug Abuse Treatment Clinical Trials Network, University of Miami, Miami, USA.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Prado
authors.affiliation: Florida Node Alliance of the National Drug Abuse Treatment Clinical Trials Network, University of Miami, Miami, USA.
authors.forename: Viviana
authors.initials: V
authors.lastname: Horigian
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Weiss
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, USA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Cook
authors.affiliation: HIV/AIDS/STIs and TB (HAST) Research Programme, Human Sciences Research Council, Pretoria, South Africa.
authors.forename: Sibusiso
authors.initials: S
authors.lastname: Sifunda
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Jones
keywords: PMTCT implementation; South Africa; adaptation; barriers; organisational factors