Barriers to the Management of Children Under Five Exposed to HIV in the Rural Areas of South Africa

Overview

Journal Curationis

Specialty Nursing

Date 2021 Mar 25

PMID 33764130

Authors

Sibusiso F Buthelezi

Regis R M Modeste

Deliwe R Phetlhu

Affiliations

Soon will be listed here.

Abstract

Background: South Africa has made enormous progress in reducing mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV), however, MTCT and AIDS related death persist among children particularly in the rural areas. Lack of adherence to health policies and guidelines implementation remain one of the contributory factors to poor management of HIV-exposed children. Hence, the need to deeply explore the complexity of the problems and understand the barriers to the management of HIV exposed children in the rural areas.

Objectives: To explore and synthesise the barriers to the management of children under 5 years old exposed to HIV in rural areas in South Africa.

Method: An integrative literature review was conducted. An electronic search was conducted on several databases. The researchers applied the Boolean ' AND'/'OR' in combination with phrases such as 'HIV infection*', 'HIV transmission', 'HIV-exposed infant*, child*, and neonate*' and 'South Africa*'. Included studies were limited to South Africa, and articles were written in English and published in peer-reviewed journals from 2005 to 2018. Both qualitative and quantitative studies between 2005 and 2018 were utilised.

Results: The findings highlighted that healthcare institution-related barriers, healthcare provider-related barriers, patient-related barriers and Socio-economic-related barriers were the significant barriers to the management of HIV-exposed children in the rural areas.

Conclusion: Continuous engagement with all relevant stakeholders should remain a priority in protecting HIV-exposed children. It is evident that there exist gaps in the current implementation of prevention of mother-to-child transmission (PMTCT), especially in rural areas. Therefore, intervention strategies that could improve implementation of PMTCT policy guidelines for HIV-exposed children in rural areas are needed.

References

Pitt V, Powis D, Levett-Jones T, Hunter S . Factors influencing nursing students' academic and clinical performance and attrition: an integrative literature review. Nurse Educ Today. 2012; 32(8):903-13. DOI: 10.1016/j.nedt.2012.04.011. View

Sprague C, Chersich M, Black V . Health system weaknesses constrain access to PMTCT and maternal HIV services in South Africa: a qualitative enquiry. AIDS Res Ther. 2011; 8:10. PMC: 3058008. DOI: 10.1186/1742-6405-8-10. View

Barron P, Pillay Y, Doherty T, Sherman G, Jackson D, Bhardwaj S . Eliminating mother-to-child HIV transmission in South Africa. Bull World Health Organ. 2013; 91(1):70-4. PMC: 3537246. DOI: 10.2471/BLT.12.106807. View

Adeniyi V, Thomson E, Ter Goon D, Ajayi I . Disclosure, stigma of HIV positive child and access to early infant diagnosis in the rural communities of OR Tambo District, South Africa: a qualitative exploration of maternal perspective. BMC Pediatr. 2015; 15:98. PMC: 4549931. DOI: 10.1186/s12887-015-0414-8. View

Kendall C, Claessens L, Dorward J, Mfeka G, Gate K . Reasons for failure of prevention of mother-to-child HIV transmission in a rural South African district hospital. South Afr J HIV Med. 2018; 16(1):365. PMC: 5843254. DOI: 10.4102/sajhivmed.v16i1.365. View

Akal C, Afework D . Status of Prevention of Mother-to-Child Transmission (PMTCT) Services Utilization and Factors Affecting PMTCT Service Uptake by Pregnant Women Attending Antenatal Care Clinic in Selected Health Facilities of Afar Regional State, Ethiopia. J Environ Public Health. 2019; 2018:5127090. PMC: 6311780. DOI: 10.1155/2018/5127090. View

Rodriguez V, LaCabe R, Privette C, Douglass K, Peltzer K, Matseke G . The Achilles' heel of prevention to mother-to-child transmission of HIV: Protocol implementation, uptake, and sustainability. SAHARA J. 2017; 14(1):38-52. PMC: 5638135. DOI: 10.1080/17290376.2017.1375425. View

Sandelowski M, Voils C, Barroso J . Defining and Designing Mixed Research Synthesis Studies. Res Sch. 2010; 13(1):29. PMC: 2809982. View

Nkomo P, Davies N, Sherman G, Bhardwaj S, Ramokolo V, Ngandu N . How ready are our health systems to implement prevention of mother to child transmission Option B+?. South Afr J HIV Med. 2018; 16(1):386. PMC: 5843177. DOI: 10.4102/sajhivmed.v16i1.386. View

10.

Suryavanshi N, Mave V, Kadam A, Kanade S, Sivalenka S, Kumar V . Challenges and opportunities for outreach workers in the Prevention of Mother to Child Transmission of HIV (PMTCT) program in India. PLoS One. 2018; 13(9):e0203425. PMC: 6122806. DOI: 10.1371/journal.pone.0203425. View

11.

Egbujie B, Grimwood A, Mothibi-Wabafor E, Fatti G, Tshabalala A, Allie S . Impact of 'Ideal Clinic' implementation on patient waiting time in primary healthcare clinics in KwaZulu-Natal Province, South Africa: A before-and-after evaluation. S Afr Med J. 2018; 108(4):311-318. DOI: 10.7196/SAMJ.2017.v108i4.12583. View

12.

Whittemore R, Knafl K . The integrative review: updated methodology. J Adv Nurs. 2005; 52(5):546-53. DOI: 10.1111/j.1365-2648.2005.03621.x. View

13.

Wilford A, Phakathi S, Haskins L, Jama N, Mntambo N, Horwood C . Exploring the care provided to mothers and children by community health workers in South Africa: missed opportunities to provide comprehensive care. BMC Public Health. 2018; 18(1):171. PMC: 5781263. DOI: 10.1186/s12889-018-5056-y. View

14.

Cataldo F, Chiwaula L, Nkhata M, van Lettow M, Kasende F, Rosenberg N . Exploring the Experiences of Women and Health Care Workers in the Context of PMTCT Option B Plus in Malawi. J Acquir Immune Defic Syndr. 2017; 74(5):517-522. PMC: 5340586. DOI: 10.1097/QAI.0000000000001273. View

15.

Ashaba S, Kaida A, Coleman J, Burns B, Dunkley E, ONeil K . Psychosocial challenges facing women living with HIV during the perinatal period in rural Uganda. PLoS One. 2017; 12(5):e0176256. PMC: 5411062. DOI: 10.1371/journal.pone.0176256. View

16.

Fords G, Crowley T, van der Merwe A . The lived experiences of rural women diagnosed with the human immunodeficiency virus in the antenatal period. SAHARA J. 2017; 14(1):85-92. PMC: 5639609. DOI: 10.1080/17290376.2017.1379430. View

17.

Koye D, Zeleke B . Mother-to-child transmission of HIV and its predictors among HIV-exposed infants at a PMTCT clinic in northwest Ethiopia. BMC Public Health. 2013; 13:398. PMC: 3639796. DOI: 10.1186/1471-2458-13-398. View

18.

Doherty T, Chopra M, Nsibande D, Mngoma D . Improving the coverage of the PMTCT programme through a participatory quality improvement intervention in South Africa. BMC Public Health. 2009; 9:406. PMC: 2777166. DOI: 10.1186/1471-2458-9-406. View

19.

Sandelowski M . Combining qualitative and quantitative sampling, data collection, and analysis techniques in mixed-method studies. Res Nurs Health. 2000; 23(3):246-55. DOI: 10.1002/1098-240x(200006)23:3<246::aid-nur9>3.0.co;2-h. View

20.

Meehan S, Leon N, Naidoo P, Jennings K, Burger R, Beyers N . Availability and acceptability of HIV counselling and testing services. A qualitative study comparing clients' experiences of accessing HIV testing at public sector primary health care facilities or non-governmental mobile services in Cape Town,.... BMC Public Health. 2015; 15:845. PMC: 4557635. DOI: 10.1186/s12889-015-2173-8. View