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Understanding the constraints and facilitators in the Fijian health system to the prevention of mother-to-child transmission of HIV (PMTCT) services in Suva, Fiji

Understanding the constraints and facilitators in the Fijian health system to the prevention of mother-to-child transmission of HIV (PMTCT) services in Suva, Fiji

Introduction: Prevention of mother-to-child transmission of HIV (PMTCT ) remains a challenge for developing countries. Research indicates that health-system related barriers have a negative impact on PMTCT programs. This study explores barriers and facilitators in the implementation of PMTCT program in Suva, Fiji.

Methods: The study utilised a qualitative approach. Data were collected via individual,in-depth, interviews held in a single hospital in May 2013. A total of seventeen healthcare providers were interviewed. The selection of respondents was based on their involvement with provision PMTCT services. The data were analysed using thematic analysis. results: Preliminary results indicate facilitators for the PMTCT program include improvements in the availability of resources. The supply of anti-retroviral medications is currently adequate for both mothers and babies, with the exception of protease inhibitor for babies. The availability of HIV testing kits has improved in recent years due to improvements in forecasting demand for materials.Resource barriers include: shortages of personal protective equipment; lack of hospital laboratory facility to perform confirmatory HIV tests; and delays in receiving tests results due to shortage of reagents in the reference laboratory. Workforce barriers include: shortages of healthcare workers in the antenatal clinic to cater for pregnant women; limited access to PMTCT training for nurses and midwives; and tensions between the hospital PMTCT staff (who perceive a lack of PMTCT knowledge in counsellors) and external providers of patient counseling services (who identified a lack of referrals to their service by PMTCT staff ). Conclusion: The results indicate that hospital has made significant progress in provision of PMTCT services since the program commenced in 2005. Resource and workforce barriers, though improving, remain a concern. Cultural tensions between public and private providers require a more detailed examination, and will be considered once the full results are analysed. Disclosure of Interest Statement: One-year study scholarship has been provided by the Human Resources for Health Knowledge Hub, University of New South Wales, No other grant was received in the development of this study.

Speakers: Amina Razzaq
Conference: ASHM 2013

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