Impediments and reasons for poor management of children under five exposed to HIV in South Africa

Abstract

IntroductionDespite existing health strategies and guidelines developed to counteract the problem of mother-to-child HIV transmission, it seems that only a certain number of HIV-exposed children aged under five years are managed properly. Poor implementation of guidelines has been reported as one of the factors contributing to poor management of HIV- exposed children under five years of age. However, the complexity of the problems within the South African context and forces that drive them have not been broadly explored and documented. Material and methodsThe researchers used an integrative literature review design to explore the impediments to and reasons for poor management of children under five years of age exposed to HIV in South Africa. The review was guided by the stages of the integrative literature review, which include problem identification, literature search, data evaluation, and data analysis and presentation. The researchers conducted an electronic search of a number of databases, and applied the Boolean ‘and’ / ‘or’ in combination with phrases such as HIV infection*; HIV transmission; HIV-exposed infant*, children, neonate*; South Africa; and South African. Ancestry searching was also used. Included studies were limited to peer-reviewed articles written in English from 2005 to 2017 in South Africa, covering prevention of mother-to-child transmission (PMTCT). ResultsThe findings of this integrative literature review suggest that poor documentation, loss to follow-up, poor response to polymerase chain reaction testing and poor quality of postnatal care remain core impediments that threaten the effectiveness of the PMTCT programme. ConclusionContext-based intervention strategies are needed to tackle these weaknesses, in order to improve PMTCT implementation in South Africa. The findings of this integrative literature review could be beneficial to enable health professionals and policy makers to better understand the impediments that still exist in the PMTCT programme.