Tynan Anna, Vallely Lisa, Kupul Martha, Neo Ruthy, Fiya Voletta, Worth Heather, Kariwiga Grace, Mola Glen D L, Kaldor John, Kelly-Hanku Angela
The School of Public Health, The University of Queensland, Brisbane, Australia.
Sexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands Province, Papua New Guinea.
Int J Health Plann Manage. 2018 Jan;33(1):e367-e377. doi: 10.1002/hpm.2450. Epub 2017 Sep 27.
Prevention of parent-to-child transmission (PPTCT) of HIV is a highly complex package of interventions, which spans services in both maternal and child health programmes. In Papua New Guinea (PNG), a commitment to ensure that all pregnant women and their partners have access to the full range of PPTCT interventions exists; however, efforts to increase access and utilisation of PPTCT remain far from optimal. The aim of this paper is to examine health care worker (HCW) perception of health system factors impacting on the performance of PPTCT programmes.
Sixteen interviews were undertaken with HCWs involved in the PPTCT programme. Application of the WHO 6 building blocks of a health system was applied, and further thematic analysis was conducted on the data with assistance from the analysis software NVivo.
Broken equipment, problems with access to medication and supplies, and poorly supported workforce were reported as barriers for implementing a successful PPTCT programme. The absence of central coordination of this complex, multistaged programme was also recognised as a key issue.
The study findings highlight an important need for investment in appropriately trained and supported HCWs and integration of services at each stage of the PPTCT programme. Lessons from the PPTCT experience in PNG may inform policy discussions and considerations in other similar contexts.
预防艾滋病毒母婴传播(PPTCT)是一套高度复杂的干预措施,涵盖了孕产妇和儿童健康项目中的各项服务。在巴布亚新几内亚(PNG),政府承诺确保所有孕妇及其伴侣都能获得全面的PPTCT干预措施;然而,在增加PPTCT服务的可及性和利用率方面,所做的努力仍远未达到最佳状态。本文旨在探讨医护人员(HCW)对影响PPTCT项目实施的卫生系统因素的看法。
对参与PPTCT项目的医护人员进行了16次访谈。应用了世界卫生组织卫生系统的6个组成部分,并在分析软件NVivo的协助下对数据进行了进一步的主题分析。
设备损坏、药品和物资获取问题以及医护人员支持不足被报告为实施成功的PPTCT项目的障碍。该复杂的多阶段项目缺乏中央协调也被认为是一个关键问题。
研究结果凸显了对经过适当培训和获得支持的医护人员进行投资以及在PPTCT项目的每个阶段整合服务的重要需求。巴布亚新几内亚PPTCT经验的教训可能为其他类似情况下的政策讨论和考量提供参考。