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Title:Barriers to accessing PMTCT services in a rural area of South Africa
Author:Skinner, Donald
Periodical:African Journal of AIDS Research
Geographic term:South Africa
Subjects:maternal and child health care
External link:https://www.tandfonline.com/doi/pdf/10.2989/16085900509490350
Abstract:Prevention-of-mother-to-child-transmission of HIV (PMTCT) services can be difficult for pregnant women to access, despite the provision of free health services for women and children. Based on interviews and focus group discussions held in November 2002, as well as situational observations, the authors examine the introduction of PMTCT services in Flagstaff, a town in a poor rural area of the Eastern Cape, South Africa, to assess the context's impact on the provision of this service. Their goal was to suggest how access to PMTCT services at the clinics may be improved. Poor roads, an underdeveloped transport system and poor telecommunications typify the pervasive poverty in the study area. Families have few resources for travel and most live a long distance from a clinic. Accessing emergency transport is especially difficult and expensive. Poor infrastructure also means that many families do not have access to clean water, which complicates the use of infant formula. PMTCT services have been recently added to several clinics that provide general services to the local population, but that were already understaffed and over-pressured. Since the PMTCT services were new, some elements of the intervention and staff training were delayed, thus inhibiting full implementation. New staff had not been added to ease accumulated pressures. Thus, socioeconomic context can present a formidable barrier to the provision of PMTCT services. Improvement in services to rural areas will require creative thinking, perhaps including the use of mobile services and the development of community structures, such as contributions to community health education by traditional birth attendants and local volunteer groups. Bibliogr., sum. [Journal abstract]