Department of Paediatrics and Child Health, College of Health Sciences, Makerere University, Kampala, Uganda.
BMC Health Serv Res. 2012 Jan 5;12:3. doi: 10.1186/1472-6963-12-3.
The implementation and utilization of programmes for the prevention of mother-to-child transmission (PMTCT) of HIV in most low income countries has been described as sub-optimal. As planners and service providers, the views of health workers are important in generating priorities to improve the effectiveness of the PMTCT programme in Uganda. We explored the lessons learnt by health workers involved in the provision of PMTCT services in eastern Uganda to better understand what more needs to be done to strengthen the PMTCT programme.
A qualitative study was conducted at Mbale Regional Referral Hospital, The AIDS Support Organisation (TASO) Mbale and at eight neighbouring health centres in eastern Uganda, between January and May 2010. Data were collected through 24 individual interviews with the health workers involved in the PMTCT programme and four key informants (2 district officials and 2 officials from TASO). Data were analyzed using the content thematic approach. Study themes and sub-themes were identified following multiple reading of interview transcripts. Relevant quotations have been used in the presentation of study findings.
The key lessons for programme improvement were: ensuring constant availability of critical PMTCT supplies, such as HIV testing kits, antiretroviral drugs (ARVs) for mothers and their babies, regular in-service training of health workers to keep them abreast with the rapidly changing knowledge and guidelines for PMTCT, ensuring that lower level health centres provide maternity services and ARVs for women in the PMTCT programme and provision of adequate facilities for effective follow-up and support for mothers.
The voices of health workers in this study revealed that it is imperative for government, civil society organizations and donors that the PMTCT programme addresses the challenges of shortage of critical PMTCT supplies, continuous health worker training and follow-up and support for mothers as urgent needs to strengthen the PMTCT programme.
在大多数低收入国家，预防母婴传播（PMTCT）艾滋病毒方案的实施和利用被描述为不尽如人意。作为规划者和服务提供者，卫生工作者的意见对于确定优先事项以提高乌干达 PMTCT 方案的有效性非常重要。我们探讨了参与乌干达东部 PMTCT 服务的卫生工作者所吸取的经验教训，以更好地了解需要做些什么来加强 PMTCT 方案。
2010 年 1 月至 5 月，在 Mbale 地区转诊医院、AIDS 支持组织（TASO）Mbale 以及乌干达东部的八个邻近卫生中心进行了一项定性研究。通过对参与 PMTCT 方案的 24 名卫生工作者和 4 名关键信息提供者（2 名地区官员和 2 名 TASO 官员）进行的 24 次单独访谈收集数据。使用内容主题方法分析数据。通过多次阅读访谈记录，确定了研究主题和子主题。在呈现研究结果时，使用了相关引述。
改善方案的关键经验教训包括：确保关键 PMTCT 用品（如艾滋病毒检测试剂盒、母亲及其婴儿用抗逆转录病毒药物）的持续供应，定期对卫生工作者进行在职培训，以使其掌握不断变化的 PMTCT 知识和指南，确保较低级别的卫生中心为参与 PMTCT 方案的妇女提供产科服务和抗逆转录病毒药物，并为有效随访和支持母亲提供足够的设施。
这项研究中的卫生工作者的声音表明，政府、民间社会组织和捐助者必须将 PMTCT 方案作为当务之急，解决关键 PMTCT 用品短缺、持续的卫生工作者培训以及对母亲的后续支持和支持等挑战，以加强 PMTCT 方案。
