PMID- 29568595
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 2078-6751 (Electronic)
IS  - 1608-9693 (Print)
IS  - 1608-9693 (Linking)
VI  - 16
IP  - 1
DP  - 2015
TI  - How ready are our health systems to implement prevention of mother to child 
      transmission Option B+?
PG  - 386
LID - 10.4102/sajhivmed.v16i1.386 [doi]
LID - 386
AB  - In January 2015, the South African National Department of Health released new 
      consolidated guidelines for the prevention of mother to child transmission 
      (PMTCT) of HIV, in line with the World Health Organization's (WHO) PMTCT Option 
      B+. Implementing these guidelines should make it possible to eliminate mother to 
      child transmission (MTCT) of HIV and improve long-term maternal and infant 
      outcomes. The present article summarises the key recommendations of the 2015 
      guidelines and highlights current gaps that hinder optimal implementation; these 
      include late antenatal booking (as a result of poor staff attitudes towards 
      'early bookers' and foreigners, unsuitable clinic hours, lack of transport to 
      facilities, quota systems being applied to antenatal clients and clinic staff 
      shortages); poor compliance with rapid HIV testing protocols; weak referral 
      systems with inadequate follow-up; inadequate numbers of laboratory staff to 
      handle HIV-related monitoring procedures and return of results to the correct 
      facility; and inadequate supply chain management, leading to interrupted supplies 
      of antiretroviral drugs. Additionally, recommendations are proposed on how to 
      address these gaps. There is a need to evaluate the implementation of the 2015 
      guidelines and proactively communicate with ground-level implementers to identify 
      operational bottlenecks, test solutions to these bottlenecks, and develop 
      realistic implementation plans.
FAU - Nkomo, Palesa
AU  - Nkomo P
AD  - Health Systems Research Unit, South African Medical Research Council, South 
      Africa.
FAU - Davies, Natasha
AU  - Davies N
AD  - Wits Reproductive Health and HIV Institute, University of the Witwatersrand, 
      South Africa.
FAU - Sherman, Gayle
AU  - Sherman G
AD  - National Institute for Communicable Diseases, Johannesburg, South Africa.
AD  - Department of Paediatrics and Child Health, University of the Witwatersrand, 
      South Africa.
FAU - Bhardwaj, Sanjana
AU  - Bhardwaj S
AD  - The United Nations Children's Fund, Pretoria, South Africa.
FAU - Ramokolo, Vundli
AU  - Ramokolo V
AD  - Health Systems Research Unit, South African Medical Research Council, South 
      Africa.
FAU - Ngandu, Nobubelo K
AU  - Ngandu NK
AD  - Health Systems Research Unit, South African Medical Research Council, South 
      Africa.
FAU - Noveve, Nobuntu
AU  - Noveve N
AD  - Health Systems Research Unit, South African Medical Research Council, South 
      Africa.
FAU - Ramraj, Trisha
AU  - Ramraj T
AD  - Health Systems Research Unit, South African Medical Research Council, South 
      Africa.
FAU - Magasana, Vuyolwethu
AU  - Magasana V
AD  - Health Systems Research Unit, South African Medical Research Council, South 
      Africa.
FAU - Singh, Yages
AU  - Singh Y
AD  - Health Systems Research Unit, South African Medical Research Council, South 
      Africa.
FAU - Nsibande, Duduzile
AU  - Nsibande D
AD  - Health Systems Research Unit, South African Medical Research Council, South 
      Africa.
FAU - Goga, Ameena E
AU  - Goga AE
AD  - Health Systems Research Unit, South African Medical Research Council, South 
      Africa.
AD  - Department of Paediatrics, University of Pretoria, South Africa.
LA  - eng
PT  - Journal Article
DEP - 20151007
PL  - South Africa
TA  - South Afr J HIV Med
JT  - Southern African journal of HIV medicine
JID - 100965417
PMC - PMC5843177
COIS- The authors declare that they have no financial or personal relationships which 
      may have inappropriately influenced them in writing this article.
EDAT- 2015/10/07 00:00
MHDA- 2015/10/07 00:01
PMCR- 2015/10/07
CRDT- 2018/03/24 06:00
PHST- 2015/04/15 00:00 [received]
PHST- 2015/08/06 00:00 [accepted]
PHST- 2018/03/24 06:00 [entrez]
PHST- 2015/10/07 00:00 [pubmed]
PHST- 2015/10/07 00:01 [medline]
PHST- 2015/10/07 00:00 [pmc-release]
AID - sajhivmed.v16i1.386 [pii]
AID - 10.4102/sajhivmed.v16i1.386 [doi]
PST - epublish
SO  - South Afr J HIV Med. 2015 Oct 7;16(1):386. doi: 10.4102/sajhivmed.v16i1.386. 
      eCollection 2015.