Department of Occupational and Environmental Health, School of Public Health, University of Nevada, Las Vegas, 4505 S Maryland Pkwy, Las Vegas, NV, USA.
National Agency for the Control of AIDS, Plot 823, Ralph Shodeinde Street, Central Business District, Abuja, Nigeria.
Int Health. 2019 Jul 1;11(4):240-249. doi: 10.1093/inthealth/ihz018.
Despite its scaled-up response for prevention of mother-to-child transmission of HIV (PMTCT), Nigeria still contributes the greatest number of infants infected with HIV worldwide. Drawing on our knowledge, and review of policy documents and research papers, we explored the achievements and challenges in the elimination of mother-to-child transmission of HIV in Nigeria using the WHO's health systems framework. We found that Nigeria has increased the number of PMTCT sites, decentralized and integrated PMTCT care for expanded service delivery, adopted task-shifting to address the shortage of skilled healthcare providers, explored alternative sources of domestic funding to bridge the funding gap and harmonized the health management information system to improve data quality. Some of the challenges we identified included: difficulty in identifying HIV-infected pregnant women because of low uptake of antenatal care; interrupted supplies of medical commodities; knowledge gaps among healthcare workers; and lack of a national unique identifying system to enhance data quality. While there have been some achievements in the PMTCT program, gaps still exist in the different blocks of the health system. Elimination of mother-to-child transmission of HIV in Nigeria will require the implementation of feasible, culturally acceptable and sustainable interventions to address the health system-related challenges.
尽管尼日利亚已经扩大了预防母婴传播艾滋病毒（PMTCT）的规模，但它仍然是全球感染艾滋病毒的婴儿数量最多的国家。我们利用专业知识以及对政策文件和研究论文的回顾，利用世界卫生组织的卫生系统框架，探讨了尼日利亚消除母婴传播艾滋病毒方面的成就和挑战。我们发现，尼日利亚已经增加了 PMTCT 服务点，将 PMTCT 护理去中心化和整合，以扩大服务提供范围，采用任务转移策略来解决熟练医疗保健提供者短缺的问题，探索了国内资金的替代来源以弥补资金缺口，并协调了卫生管理信息系统以提高数据质量。我们确定的一些挑战包括：由于接受产前保健的人数较少，难以发现感染艾滋病毒的孕妇；医疗用品供应中断；医疗保健工作者知识差距；以及缺乏国家唯一的识别系统以提高数据质量。尽管 PMTCT 方案取得了一些成就，但卫生系统的不同部分仍然存在差距。要在尼日利亚消除母婴传播艾滋病毒，需要实施可行、文化上可接受和可持续的干预措施，以解决与卫生系统相关的挑战。
