Antiretroviral initiation of pregnant women and antenatal care booking practices in eThekwini District, KwaZulu-Natal, South Africa.

BACKGROUND

The introduction of antiretroviral therapy (ART) in South Africa began as part of the prevention of mother-to-child transmission programme. For significant reduction of vertical transmission, early antenatal care booking and ART initiation are necessary.

AIM

This study aimed to evaluate ART initiation and booking practices of women attending antenatal care in eThekwini district during financial years (FY) 2010/2011 and 2013/2014.

METHODS

An observational study used a retrospective chart review at four eThekwini district community health centres (CHC). From these CHCs, records of women that initiated ART in FY10/11 and FY13/14 were reviewed and compared for ART initiation delays and booking practices.

RESULTS

A total of 2749 pregnant women who attended antenatal care (ANC) at the study sites were found eligible for ART; of these, 49% (n = 1334) attended ANC in FY10/11 while 51% (n = 1414) attended in FY13/14. In FY10/11, 46% (n = 610) and 60 % (n = 855) of the womenwere initiated on ART during pregnancy. The mean gestational age at booking for FY10/11 was 20.88 (standard deviation [s.d.] = 5.6) and 18.40 (s.d. = 6.2) in FY13/14. The mean gestational age at ART initiation for women who initiated ART in FY10/11 was 26.30 (s.d. = 6.02) and in FY13/14 it was 19.06 (s.d. = 6.86).

CONCLUSION

In FY13/14 ART initiations occurred within 4 days after booking. ANC booking before 20 weeks was found to have improved between the two years from 39% to 58%;however, on average, in both years women booked during the second trimester.