Nuwagaba-Biribonwoha H, Mayon-White R T, Okong P, Carpenter L M
International Center for AIDS Care and Treatment Programs (ICAP), Columbia University, Dar es Salaam, United Republic of Tanzania.
J Public Health (Oxf). 2007 Sep;29(3):269-74. doi: 10.1093/pubmed/fdm025. Epub 2007 May 30.
To report the experience of health workers who had played key roles in the early stages of implementing the prevention of mother-to-child HIV transmission services (PMTCT) in Uganda.
Interviews were conducted with 15 key informants including counsellors, obstetricians and PMTCT coordinators at the five PMTCT test sites in Uganda to investigate the benefits, challenges and sustainability of the PMTCT programme. Audio-taped interviews were held with each informant between January and June 2003. These were transcribed verbatim and manually analysed using the framework approach.
The perceived benefits reported by informants were improvement of general obstetric care, provision of antiretroviral prophylaxis for HIV-positive mothers, staff training and community awareness. The main challenges lay in the reluctance of women to be tested for HIV, incomplete follow-up of participants, non-disclosure of HIV status and difficulties with infant feeding for HIV-positive mothers. Key informants thought that the programme's sustainability depended on maintaining staff morale and numbers, on improving services and providing more resources, particularly antiretroviral therapy for the HIV-positive women and their families.
Uganda's experience in piloting the PMTCT programme reflected the many challenges faced by health workers. Potentially resource-sparing strategies such as the 'opt-out' approach to HIV testing required further evaluation.
报告在乌干达实施预防母婴传播艾滋病病毒服务（PMTCT）早期阶段发挥关键作用的卫生工作者的经验。
对乌干达五个PMTCT检测点的15名关键信息提供者进行了访谈，包括咨询顾问、产科医生和PMTCT协调员，以调查PMTCT项目的益处、挑战和可持续性。2003年1月至6月期间对每位信息提供者进行了录音访谈。访谈内容逐字转录，并采用框架法进行人工分析。
信息提供者报告的可感知益处包括改善一般产科护理、为艾滋病毒呈阳性的母亲提供抗逆转录病毒预防措施、工作人员培训和社区意识。主要挑战在于女性不愿接受艾滋病毒检测、对参与者的随访不完整、艾滋病毒感染状况未公开以及艾滋病毒呈阳性的母亲在婴儿喂养方面存在困难。关键信息提供者认为该项目的可持续性取决于保持工作人员的士气和数量、改善服务并提供更多资源，特别是为艾滋病毒呈阳性的妇女及其家人提供抗逆转录病毒治疗。
乌干达在试行PMTCT项目方面的经验反映了卫生工作者面临的诸多挑战。诸如艾滋病毒检测“选择退出”方法等潜在的资源节约策略需要进一步评估。
