Progress of Preventing Mother-To-Child Transmission of HIV at Primary Healthcare Facilities and District Hospitals in Three South African Provinces (Scientific Letters) (Report)
Since the introduction of prevention of mother-to-child-transmission (PMTCT) strategies, vertical transmission of HIV has declined in low- and middle-income countries over 20 years from 20-40% to 2.8% in the best-case scenarios. (1) In wealthy countries, transmission rates are below 2%. (2,3) In South Africa, the revised clinical guidelines introduced in 2010 included starting dual zidovudine/nevirapine prophylaxis commencing from 14 weeks’ gestation or lifelong antiretroviral treatment (ART) for pregnant women with World Health Organization stage III or IV HIV disease and/or CD4 cell counts below 350 cells/[micro]l. (4) However, improving South African PMTCT outcomes has been challenging owing to inadequate coverage and sub-optimal implementation of PMTCT programmes. (5,6) Kheth’Impilo (KI) is a non-governmental organisation supporting South African Department of Health HIV care facilities. KI provides health worker and health system strengthening (including HIV and TB integration, infrastructure support and data collection systems). Nurse quality mentors (QMs), whose key role is to assist facilities to reach the HIV and AIDS National Strategic Plan PMTCT goals, have recently been introduced.