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首页> 外文期刊>Bulletin of the World Health Organization >Implementing prevention policies for mother-to-child transmission of HIV in rural Malawi, South Africa and United Republic of Tanzania, 2013–2016
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Implementing prevention policies for mother-to-child transmission of HIV in rural Malawi, South Africa and United Republic of Tanzania, 2013–2016

机译：2013-2016年在马拉维农村地区，南非和坦桑尼亚联合共和国实施预防艾滋病毒母婴传播的预防政策

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Objective To assess adoption of World Health Organization (WHO) guidance into national policies for prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) and to monitor implementation of guidelines at facility level in rural Malawi, South Africa and the United Republic of Tanzania. Methods We summarized national PMTCT policies and WHO guidance for 15 indicators across the cascades of maternal and infant care over 2013–2016. Two survey rounds were conducted (2013–2015 and 2015–2016) in 46 health facilities serving five health and demographic surveillance system populations. We administered structured questionnaires to facility managers to describe service delivery. We report the proportions of facilities implementing each indicator and the frequency and durations of stock-outs of supplies, by site and survey round. Findings In all countries, national policies influencing the maternal and infant PMTCT cascade of care aligned with WHO guidelines by 2016; most inter-country policy variations concerned linkage to routine HIV care. The proportion of facilities delivering post-test counselling, same-day antiretroviral therapy (ART) initiation, antenatal care and ART provision in the same building, and Option B+ increased or remained at 100% in all sites. Progress in implementing policies on infant diagnosis and treatment varied across sites. Stock-outs of HIV test kits or antiretroviral drugs in the past year declined overall, but were reported by at least one facility per site in both rounds. Conclusion Progress has been made in implementing PMTCT policy in these settings. However, persistent gaps across the infant cascade of care and supply-chain challenges, risk undermining infant HIV elimination goals.
机译：目的评估世界卫生组织（WHO）指南在预防人类免疫缺陷病毒（HIV）母婴传播（PMTCT）的国家政策中的采用情况，并监测马拉维，南非和坦桑尼亚联合共和国。方法我们总结了2013-2016年期间全国母婴保健政策中的15个指标的国家PMTCT政策和WHO指南。在为五个卫生和人口监测系统人群提供服务的46个卫生机构中进行了两轮调查（2013-2015年和2015-2016年）。我们向设施经理发放了结构化问卷，以描述服务交付情况。我们按地点和调查周期报告实施每个指标的设施所占比例，以及缺货的频率和持续时间。调查结果在所有国家中，到2016年，影响母婴PMTCT护理级联的国家政策均与WHO准则保持一致;多数国家间政策差异都与常规艾滋病毒护理的联系有关。在所有场所中，在同一建筑物中提供测试后咨询，当日抗逆转录病毒治疗（ART）启动，产前护理和ART设施以及Option B +的设施比例增加或保持在100％。各地实施婴儿诊断和治疗政策的进展各不相同。过去一年中，HIV检测试剂盒或抗逆转录病毒药物的库存总体下降，但是在两轮中每个站点至少有一个机构报告了这一情况。结论在这些环境中实施PMTCT策略方面已经取得了进展。然而，婴儿护理和供应链挑战之间持续存在差距，有可能破坏消除婴儿艾滋病毒的目标。

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