Barriers to implementation of pmtct program in the Eastern Cape of South Africa

This study examined barriers to the implementation of PMTCT program in the Eastern Cape, South Africa. Indepth interviews were conducted with 3 provincial PMTCT officials and 22 PMTCT co-ordinators. Four focus group discussions were conducted with 21 LSA officials and another four with 71 PMTCT clients. The results show that there are barriers to implementation of PMTCT services at all levels. Provincial: inadequate human/physical resources, poor management systems, multiple competing demands, lack of co-ordination/integration. District: inadequate human resources, limited geographical coverage, poor program receptiveness, lack of proper monitoring, lack of integration, co-ordination/communication. Facility: limited PMTCT trained nurses, poor infrastructure, poor management system, lack of support/supervision, negative attitude by some of the nurses, poor health care organisation and inability to access health facility. Household: lack of support/cooperation, stigma/discrimination and traditional beliefs. Community: stigma/discrimination. Lessons learned in this study should be considered when identifying best practices for expanding and providing PMTCT services.