Balcha Taye T, Lecerof Susanne S, Jeppsson Anders R
Social Medicine & Global Health, University Hospital Malmo, Malmo, Sweden,
J Int Assoc Physicians AIDS Care (Chic). 2011 May-Jun;10(3):187-92. doi: 10.1177/1545109710369935. Epub 2011 Apr 20.
The objective of this study is to evaluate the achievement of the prevent mother-to-child transmission (PMTCT) program and to describe the strategic challenges of its implementation in the the Oromia region, Ethiopia.
PMTCT program reports were collected over a period of 12 months from 25 zones of Oromia region. The health facilities in these zones include 28 hospitals and 84 health centers. The reports were analyzed with regard to international and national policies, guidelines, and priorities. Meanwhile, in-depth interviews were conducted with key informants from the government and an nongovernmental organization (NGO).
The reports showed that 72 277 (47%) pregnant women who attended antenatal care were tested for HIV. Although 1461 (65%) HIV-positive women walked away without intervention, 1579 (71%) babies born to HIV-positive mothers did not access prophylactic medicine. Interviews with key informants revealed that stakeholders' inertia to coordinated action, disconnect between the regional office and service providers at the grassroots, and an unclear national policy on HIV were major challenges to the program.
Addressing policy issues and setting clear purposes for all partners need a committed local leadership and program ownership at regional and federal levels.
本研究的目的是评估预防母婴传播(PMTCT)项目的成效,并描述其在埃塞俄比亚奥罗米亚地区实施过程中的战略挑战。
在12个月的时间里,从奥罗米亚地区的25个区收集了预防母婴传播项目报告。这些区的卫生设施包括28家医院和84个健康中心。对报告进行了国际和国家政策、指南及优先事项方面的分析。同时,对来自政府和一个非政府组织(NGO)的关键信息提供者进行了深入访谈。
报告显示,72277名(47%)接受产前护理的孕妇接受了艾滋病毒检测。尽管1461名(65%)艾滋病毒呈阳性的妇女未接受干预就离开了,但1579名(71%)艾滋病毒呈阳性母亲所生的婴儿未获得预防药物。对关键信息提供者的访谈表明,利益相关者在采取协调行动方面的惰性、地区办公室与基层服务提供者之间的脱节以及国家关于艾滋病毒的政策不明确是该项目的主要挑战。
解决政策问题并为所有合作伙伴设定明确目标,需要地方领导层以及地区和联邦层面坚定的项目主导权。