Managers perspectives on the implementation of the Prevention of Mother-to-Child Transmission policy in South Africa.

The Southern African Journal of HIV Medicine is focused on HIV/AIDS treatment, prevention and related topics relevant to clinical and public health practice. The purpose of the journal is to disseminate original research results and support high-level learning related to HIV Medicine. It publishes original research articles, editorials, case reports/case series, reviews of state-of-the-art clinical practice and correspondence.

BackgroundImplementation of the programmes for the Prevention of Mother to Child Transmission (PMTCT) of Human Immunodeficiency Virus (HIV) into antenatal care over the last three decades could inform implementation of interventions for other health challenges such as gestational diabetes mellitus (GDM). This study assessed PMTCT outcomes, and how GDM screening, care, and type 2 diabetes (T2DM) prevention were integrated into PMTCT in Western Cape (WC), South Africa.MethodsA convergent mixed methods and triangulation design were used. Content and thematic analysis of PMTCT-related policy documents and of 30 semi-structured interviews with HIV/PMTCT experts, health care workers and women under PMTC diagnosed with GDM complement quantitative longitudinal analysis of PMTCT implementation indicators across the WC for 2012–2017.ResultsProvincial PMTCT and Post Natal Care (PNC) documents emphasized the importance of PMTCT, but GDM screening and T2DM prevention were not covered. Data on women with both HIV and GDM were not available and GDM screening was not integrated into PMTCT. Women who attended HIV counselling and testing annually increased at 17.8% (95% CI: 12.9% - 22.0%), while women who delivered under PMTCT increased at 3.1% (95% CI: 0.6% - 5.9%) annually in the WC. All 30 respondents favour integrating GDM screening and T2DM prevention initiatives into PMTCT.ConclusionPMTCT programmes have not yet integrated GDM care. However, Western Cape PMTCT integration experience suggests that antenatal GDM screening and post-partum initiatives for preventing or delaying T2DM can be successfully integrated into PMTCT and primary care.

Despite global efforts to prevent mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV), important gaps remain, particularly in low-resource countries. Community-based health systems strengthening (HSS) interventions are emerging as a strategy towards effective prevention of mother-to-child transmission (PMTCT) of HIV services. However, the nexus between interventions and impact indicators remains unclear. This systematic review aims to assess all available evidence on the impact of community-driven HSS interventions on PMTCT. We will develop a search of studies published between 2015 and 2025 from databases such as PubMed/Medline, Scopus, Web of Science, Google Scholar and African Journals. We will use a combination of search terms such as 'participatory action research', 'health systems strengthening', 'PMTCT of HIV', 'childhood HIV', 'MTCT of HIV' and 'under-five mortality'. Studies aimed at community-based participatory health system intervention on PMTCT of HIV published in English will be used. Experimental, quasi-experimental and observational (including cohort and case-control) studies will be included. Data will be analysed using narrative and meta-analysis approaches. The risk of bias will be assessed using Cochrane Handbook guidelines. The primary outcome measure will cover PMTCT of HIV and secondary outcome measures are HIV prevalence and under-five mortality. Finally, the quality of evidence will be assessed using Grades of Recommendation, Assessment, Development and Evaluation technique. As no original data will be collected, ethical approval is not applicable for this study. The results will be disseminated through peer-reviewed publication and presentations at health summits and conferences. The review would inform context-sensitive HIV policies and interventions in developing countries, particularly for women and children. CRD420251131511.

Background: Despite the availability of prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) services, many factors and reasons prevent mothers from accessing these services. HIV prevalence is still high among South African women of reproductive age and mother-to-child-transmission (MTCT) is a concern. This study ascertained the perspectives of healthcare workers regarding availability and accessibility of the PMTCT programme.Objective: To explore and describe the perspectives of healthcare workers regarding availability and accessibility of the PMTCT programme.Method: Qualitative research with exploratory-descriptive design was utilised. Data were collected from 21 healthcare workers using three focus-group discussions. The participants were selected based on rendering the PMTCT programme services for more than two years. Moreover, the participants had undergone training, formal education and continuous support on the PMTCT programme. Three large clinics were selected as the main clusters of the sub-district. Tesch’s method was used to analyse the qualitative data.Results: Healthcare workers indicated ineffective utilisation of the PMTCT programme services by HIV-positive pregnant women. Most women had challenges with child feeding owing to limited knowledge. Another challenge indicated by healthcare workers was lack of resources. It is important that recommendations be implemented to assist with availability and accessibility of the PMTCT programme.Conclusion: Availability and accessibility of PMTCT programme services are still problematic. The study has the potential to inform development of strategies that may facilitate access to care for PMTCT programme clients.

Male partners’ involvement in human immunodeficiency virus (HIV) intervention programmes is crucial in the prevention of mother-to-child transmission (PMTCT) of HIV. However, male partner involvement in PMTCT is low in most countries in Sub-Saharan Africa. Therefore, this study aimed at exploring the major factors associated with male partner involvement in PMTCT of HIV programmes in the Gokwe North District of Zimbabwe. The study utilised qualitative methods. Data was collected using a pretested interview guide. Purposive sampling methods were used to select participants of focus group discussions and key informant interviews. Interviews were conducted from May to September 2015. Thematic analysis was used for data analysis. The study revealed that local traditional leaders played a role in mobilising men in communities. Awareness campaigns enhanced communities’ knowledge about PMTCT. Couple communication proved to be vital in promoting male involvement. However, stigmatisation against men utilising antenatal-care services, fear of HIV results and a lack of knowledge of the practices surrounding PMTCT of HIV programmes were hindrances to male partner involvement. Collaboration and engagement amongst stakeholders especially with traditional leadership can be essential in increasing male partner participation in PMTCT. Education has proved to be a catalyst in the de-stigmatisation of men in PMTCT programmes. Moreover, HIV counselling can illuminate an understanding on the implications of HIV test results. The significant contribution of this article is its demonstration of the role of African traditional leadership and belief systems in curbing HIV infections, particularly in terms of male partners’ involvement in PMTCT initiatives.Contribution: The significant contribution of this article is its demonstration of the role of African traditional leadership and belief systems in curbing HIV infections, particularly in terms of male partners’ involvement in PMTCT initiatives.

Introduction: Despite communication on Human immunodeficiency virus (HIV), close to 5.9 million people didn’t know they were living with HIV. One of the modes of transmission of HIV is vertical transmission. It remains the principal way of transmission of HIV for children below 15 years, with over 90% of them being infected. In Cameroon, the mother and child transmission of HIV is still a problem with 5.5% of infection of exposed infant at the early infant diagnosis in 2019. Awareness on prevention of mother to child transmission (PMTCT) is an important component for the fight against HIV. We therefore aimed at gauging the level of knowledge of a group of adult clients on HIV and PMTCT. Methodology: We conducted a cross sectional and analytical study at the Yaoundé Gyneco-Obstetric and Pediatric hospital for a period of one month. Were included, adults who visited the hospital for a free screening campaign on HIV. Data were collected using a questionnaire on their characteristics and knowledge of HIV and PMTCT. Data were entered using CSPro and analysed using IBM SPSS. Results: There was a gap in knowledge on HIV, considering satisfactory knowledge from 25 points and above, it was noted that 34.6% of our respondents had a non-satisfactory knowledge. For PMTCT, knowledge was average with the majority scoring 10 points on 18. Considering satisfactory knowledge on PMTCT was from 10 and above, 35.9% of our respondents had a non-satisfactory knowledge. Female sex was associated with satisfactory knowledge for both HIV and PMTCT. Conclusion: Concerning PMTCT, the knowledge of the mode of transmission, Antiretroviral (ARV) drugs for prevention to the babies or feedings recommendations on exposed HIV infants were poor. There is a gap in favor of women regarding knowledge between HIV and PMTCT. Therefore, men are highly encouraged to take part to health promotion activities on HIV and PMTCT.

Many countries in sub-Saharan Africa struggle with high rates of HIV incidence and, more pointedly, struggle to prevent HIV infection. This sub-Saharan region of Africa includes countries such as Guinea, Kenya, Mozambique, Somalia, and Swaziland, all of which qualify as developing countries because of their minimal and arguably insufficient healthcare infrastructure, among other influencing factors.[1] HIV steadily prevails in these countries—and Swaziland especially struggles with peak incidence of HIV. Swaziland is a country located on the southeastern tip of Africa; is landlocked by South Africa and Mozambique; and currently has the highest incidence of HIV worldwide. Swaziland has “close to a third of the country’s adult population… infected with the HIV virus.”[2] This higher prevalence is widely attributed to Swaziland’s cultural norms of polygamous and child-adult marriages.[3] Many questions thus arise in regard to the possibility that Swaziland’s peak HIV incidence rate stems directly from its cultural norms and tradition of polygamy, on the one hand, and child-adult marriage, on the other. As a result, it is reasonable to argue that the ethical principle of beneficence should inform our approach to evaluating this situation justly while continuing to respect Swaziland’s traditional customs. That is, given that HIV is a life-threatening disease and seems to propagate the adult population of Swaziland through these norms, is it ethical to advocate for, and subsequently apply, changes to these cultural practices for the purpose of both saving lives and preventing HIV transmission in the first place? Swaziland’s cultural norms operate within a patriarchal status quo. Swaziland’s King Mswati III openly admits the presence of legal polygamy.[4] In fact, King Mswati is perfectly within his rights as monarch to “choose a new wife every year from among thousands of virgins.”[5] In this vein, Swaziland hosts an annual Reed Dance Festival in late summer that publicly celebrates a woman’s chastity and purity before marriage; an unwed pregnant mother or the man she slept with, for instance, can be fined a cow for disobeying this normative cultural standard.[6] This standard indicates cultural norms that also represent enforceable laws within the country. Swaziland clearly seems to prefer female chastity until marriage—a status that suggests favoritism towards heteronormative relationships due to clear societal standards that clearly value a woman’s chastity, polygamous unions challenge the value of one woman by prioritizing the significance of one man. As a standard cultural practice, polygamy is unproblematic insofar as it does not promote disease. However, HIV infection is significantly higher among newly married adolescent girls since the men they marry tend to be older, HIV positive, and active participants in polygamous relationships. That is, polygamous marriages perpetuate sexual infection among people who were previously HIV negative.[7] Consequently, Swaziland’s cultural norms have significant potential to operate at odds with measures to lower HIV incidence. Polygamous Swazi unions are commonly acknowledged as a central factor driving Swaziland’s considerable rate of HIV incidence. In 2012, Swaziland’s government officials enacted a Child Protection and Welfare Act that criminalized child marriages and classified any sexual activity that occurred within these marriages as being equivalent to statutory rape with the intention of decreasing rates of HIV infection.[8] This official declaration recognizes that children—realistically, adolescent teenagers below the age of consent—should not be forced into a marriage that is potentially life-threatening as a result of consummating a marriage. Therefore, Swazi officials seem to acknowledge that allowing marriages with potentially HIV-positive men is inherently problematic, even though they clearly stay bound by traditional customs. The inclusion criteria for clinical trials in Swaziland focus on pregnant women who are HIV positive and remain untreated, with no reference to whether they are in a non-polygamous marriage, or perhaps unwed. Simply, the purpose of these clinical trials is to “understand how best to provide care and treatment services to human immunodeficiency virus (HIV)-positive pregnant women and their babies in Swaziland,” and to “evaluate a new approach for Preventing Mother-to-Child Transmission (PMTCT) where all HIV-positive pregnant women initiate lifelong triple antiretroviral (ARV) therapy regardless of their disease stage.”[9] Trial participants must either be (i) women eighteen years or older and pregnant, or (ii) the babies born to these women, who must also be concurrently enrolled in the study. These clinical trials are often funded by grants from American universities approved by Swaziland’s Ministry of Health, which has been called in to evaluate specific aspects of HIV transmission. This is of seminal importance because, as recently as 2013, Swaziland’s population growth rate was estimated to be 1.5 percent annually.[10] Heavy prevalence of HIV in a country with minimal population growth limits the options for Swaziland’s livelihood as a country. Clinical trials are only the tip of the iceberg. With a sole focus on pregnant, positive women and their babies, these trials exclude testing possible treatments for women who are HIV positive but not pregnant. Even so, when clinical trials seek to prevent and treat HIV in pregnant women, the potential arises for stigma and discrimination to occur between women who seek treatment and those who abstain—and who may, perhaps, be the other wives of the same husband. These clinical trials have the potential to greatly benefit Swaziland by reducing the transmission of HIV from mother to child and allowing for the Swaziland population to grow. However, they offer limited resources in terms of longer-term treatment for those who are HIV positive. Treatment options also raise further ethical issues related to justice. Given Swaziland’s polygamous culture, HIV transmission is not limited to occurring solely between a mother and her child; polygamous men are also responsible for transmitting HIV. From a pro-patriarchal standpoint, it is reasonable to conclude that Swazi men uphold the Swazi tradition by seeking honor and status in alignment with their cultural norms. This perspective favors the preservation of the husband’s autonomy in his pursuit of polygamous relations and, by implication, the continued infection of others through intercourse—assuming that he is HIV positive. Inherently, polygamy is not necessarily morally wrong; however, this social custom acquires risk when transmission of a life-threatening disease such as HIV persists. Given the approximately 1:1 population growth ratio, this custom warrants reevaluation because it neglects to account for the wellbeing of the Swazi people whose average life expectancy, coincidentally, is just more than fifty years.[11] Many international researchers posit that judging other cultures for their traditional customs is equivalent to imposing other normative standards and cultural values on another society. However, Swaziland’s problem with HIV and the fact that clinical trials targeting this issue exist—though, notably, are no longer recruiting participants—to examine its transmission indicates an overall desire to decrease the incidence of HIV in the population.[12] This earnestness suggests that Swaziland’s cultural norms are shifting in favor of preventing HIV transmission in the future, and illustrates how the Swazi people are now adapting to address these pressing healthcare issues. Polygamy may very continue, but the Swazi people must continue to find ways to minimize—and hopefully eradicate—transmission of HIV by promoting widespread use of condoms; using antiretroviral treatments; implementing countrywide HIV testing and treatment options for anyone, regardless of who is sexually active or gets married.

The aim of this study was to estimate the field efficacy of the first routine programme for the prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) initiated in South Africa, in the subdistrict of Khayelitsha. A consecutive sample of 658 mother-infant pairs, identified from the PMTCT register from 1 March to 30 November 2003, were identified for enrolment in this study. Details of the regimen received were established and HIV status of the infants at between 6 and 10 weeks of age was determined by qualitative DNA polymerase chain reaction. Zidovudine (AZT) was provided antenatally from week 34 of gestation and during labour. Infant formula milk was-offered to mothers who chose not to breastfeed. The protocol was amended in July 2003 such that women who had received < 2 weeks of treatment with AZT were given a single dose of nevirapine (NVP) at the onset of labour, and the infant received a weight-adjusted dose of NVP within 72 h of delivery. Of the 535 mother-infant pairs (81%) eventually included in the study, 410 (77%) received an effective PMTCT intervention according to the protocol. The rate of transmission of HIV from mother to child was 8.8% (95% confidence interval (CI), 6.2-10.9). A maternal age of > 25 years was the only significant independent risk factor for transmission (odds ratio, 2.12; 95% CI, 1.14-4.07). The results of this study demonstrate the feasibility and effectiveness of a large-scale PMTCT programme in an urban public-sector setting.

BackgroundVertical transmission of Human Immunodeficiency Virus (HIV) is the primary route of infection among children. Ethiopia is among the top ten countries in the world with the highest burden of HIV infections among children. Therefore we aimed to assess mother to child transmission (MTCT) of HIV and associated factors among HIV exposed infants (HEIs).MethodsA cross-sectional study was conducted using retrospective data collected from HEIs paired with their mothers who had received the services in prevention of mother to child transmission (PMTCT) programs from January 2014 to December 2017 in public health facilities in Dessie town. Data of a total of 313 HEIs paired with their mothers were obtained by using semi-structured data extraction proforma from their medical records. The data were processed in Epi-info version 7.1.2.0 and analyzed using SPSS version 22. Crude and adjusted odds ratios with their 95% confidence intervals and p-value were used to identify significant factors.ResultsThe prevalence of HIV among exposed infants was 3.8%. Absence of maternal antenatal care visit (AOR = 4.6, 95% CI: 1.17–17.99), home delivery (AOR = 4.2, 95% CI: 1.04 −16.76), absence of antiretroviral intervention to the mother (AOR= 5.7, 95% CI: 1.10–29.36), and failure to initiate nevirapine prophylaxis for the infant (AOR = 5.3, 95% CI: 1.11 −25.44) were significant factors of MTCT of HIV.ConclusionPrevalence of MTCT of HIV was low (3.8%) in Dessie town public health facilities. Having ANC visit, delivery at health facility, maternal ARV drug intake, and infant ARV prophylaxis were the significant protective factors against MTCT of HIV. Promoting ANC service utilization among pregnant women and providing counseling as well as setting up linkage with PMTCT and giving ARV intervention to all HIV positive pregnant women and timely initiation of NVP prophylaxis to all HEIs should be recommended by the minister of health and health facilities.

ABSTRACTBackground: Over 90% of infant acquired immunodeficiency syndrome (AIDS) cases have been through mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV). Consequent to this, prevention of mother-to-child transmission (PMTCT) programs have instituted as dual purposes for prevention of HIV transmission from mother to child and enrollment of infected pregnant women and their families into antiretroviral treatment (ART) program. However, there are still some breakthrough infections and challenges. Therefore, this study was designed to assess risk of HIV transmission among HIV-exposed infants on follow-up at a PMTCT clinic in an antiretroviral (ARV) referral health facility in southwest Nigeria.Methods: A cohort of 60 purposively recruited consenting pregnant women referred to PMTCT HIV clinic in Ibadan, southwest Nigeria were enrolled and followed up for 1 year (2015–2016). A well-structured epidemiological questionnaire was used to capture all relevant information. Data were then analyzed by SPSS version 21 (St. Louis, MO, USA), while bivariate and multivariate analyses were used to identify associations.Results: A total of 44 mothers and their infants were available for the analysis with an attrition rate of 26.7%. The mean age of mothers at enrollment to follow-up was 32.9 years (SD = 4.2 years). Two (4.5%, 95% CI: 7.2–12.3%) of the infants were HIV positive by DNA PCR test. There was no linear relationship between age of the mothers with CD4 count or viral load both before and after delivery but there was a significant positive relationship with year on ARV (r = 0.318, 95% CI: 0.024–0.562). Infants of rural dwelling mothers were at 3.39 (adjusted odds ratio (AOR) = 3.39, 95% CI: 1.32, 2.29) times higher risk of vertical HIV transmission compared to those of urban dwelling mothers. Infants delivered at home had 2.61(AOR = 2.61, 95% CI: 1.59, 7.91) times higher risk of MTCT compared to those delivered at health institution. Mixed feeding was also another important predictor in which the risk of MTCT was about two (AOR = 2.21, 95% CI: 0.68, 9.97) times higher compared to exclusive breastfeeding.Conclusions: There was a high risk of MTCT of HIV among exposed infants on follow-up at the PMTCT clinic of Adeoyo Maternity Teaching referral hospital. Our findings will assist health policy makers in providing important information capable of enhancing assurance HIV control in such population and in raising the standard of PMTCT program in Nigeria.

Coverage and acceptance of prevention of mother-to-child transmission services amongst pregnant women attending ante-natal clinics - Oyo state, South-Western Nigeria, 2010

BackgroundIntegrating Prevention of Mother-to-Child Transmission (PMTCT) programmes into routine health services under complex socio-political and health system conditions is a priority and a challenge. The successful rollout of PMTCT in sub-Saharan Africa has decreased Human Immunodeficiency Virus (HIV), reduced child mortality and improved maternal health. In South Africa, PMTCT is now integrated into existing primary health care (PHC) services and this experience could serve as a relevant example for integrating other programmes into comprehensive primary care. This study explored the perspectives of both experts or key informants and frontline health workers (FHCWs) in South Africa on PMTCT integration into PHC in the context of post-AIDS denialism using a Complex Adaptive Systems framework.MethodsA total of 20 in-depth semi-structured interviews were conducted; 10 with experts including national and international health systems and HIV/PMTCT policy makers and researchers, and 10 FHCWs including clinic managers, nurses and midwives. All interviews were conducted in person, audio-recorded and transcribed. Three investigators collaborated in coding transcripts and used an iterative approach for thematic analysis.ResultsExperts and FHCWs agreed on the importance of integrated PMTCT services. Experts reported a slow and partial integration of PMTCT programmes into PHC following its initial rollout as a stand-alone programme in the aftermath of the AIDS denialism period. Experts and FHCWs diverged on the challenges associated with integration of PMTCT. Experts highlighted bureaucracy, HIV stigma and discrimination and a shortage of training for staff as major barriers to PMTCT integration. In comparison, FHCWs emphasized high workloads, staff turnover and infrastructural issues (e.g., lack of rooms, small spaces) as their main challenges to integration. Both experts and FHCWs suggested that working with community health workers, particularly in the post-partum period, helped to address cases of loss to follow-up of women and their babies and to improve linkages to polymerase-chain reaction (PCR) testing and immunisation.ConclusionsDespite organised efforts in South Africa, experts and FHCWs reported multiple barriers for the full integration of PMTCT in PHC, especially postpartum. The results suggest opportunities to address operational challenges towards more integrated PMTCT and other health services in order to improve maternal and child health.

PMTCT (Prevention of Mother to Child Human Immunodeficiency Virus Transmission) is an effort to facilitate, accelerate the diagnosis and management of HIV cases from mother to child. Midwives are an important component of patient health services, so they have a role to be able to implement PMTCT programs in Antenatal Care (ANC) services. Thus the purpose of this study is to analyze the role of midwives in the implementation of PMTCT programs on ANC services. This type of research is a qualitative research with case study approach. Selection of research location of Maesan Health Center with VCT service and community Health centers Sumber Wringin non VCT service in Bondowoso District. Determination of informants by purposive on health center midwife who have been working ≥ 2 years. The role of midwives in the implementation of the PMTCT program is not yet optimal socialization activities because not all midwives have conducted PMTCT related socialization activities according to the guidelines, not all midwives have received PMTCT training and lack of intensity of socialization. In addition, early HIV (Human Immunodeficiency Virus) detection, treatment of referral, and provision of support to pregnant women have been implemented by midwives and supported by the leadership in the form of monitoring and supervision. With the implementation of the PMTCT program by the midwife, it is necessary to improve the efforts that must be done for the success of the next PMTCT program. So that the expected knowledge of the community is increasing, HIV transmission in Bondowoso can be reduced so that the health status of the community, especially pregnant women getting better

BackgroundGreat strides have been made in decreasing paediatric human immunodeficiency virus (HIV) infections, especially in sub-Saharan Africa. In South Africa, new paediatric HIV infections decreased by 84% between 2009 and 2015. This achievement is a result of a strong political will and the rapid evolution of the country’s prevention of mother-to-child transmission (PMTCT) guidelines.ObjectivesIn this paper we report on the implementation of a large PMTCT programme in Soweto, South Africa.MethodsWe reviewed routinely collected PMTCT data from 13 healthcare facilities, for the period 2002–2015. Antiretroviral therapy (ART) coverage among pregnant women living with HIV (PWLHIV) and the mother-to-child transmission (MTCT) rate at early infant diagnosis were evaluated.ResultsIn total, 360 751 pregnant women attended the facilities during the review period, and the HIV prevalence remained high throughout at around 30%. The proportion of PWLHIV presenting with a known HIV status increased from 14.3% in 2009 when the indicator was first collected to 45% in 2015, p < 0.001. In 2006, less than 10% of the PWLHIV were initiated on ART, increasing to 88% by 2011. The MTCT rate decreased from 6.9% in 2007 to under 1% from 2013 to 2015, p < 0.001.ConclusionThe achievements in decreasing paediatric HIV infections have been hailed as one of the greatest public health achievements of our times. While there are inherent limitations with using routinely collected aggregate data, the Soweto data reflect progress made in the implementation of PMTCT programmes in South Africa. Progress with PMTCT has, however, not been accompanied by a decline in HIV prevalence among pregnant women.

BackgroundMale involvement (MI) in Prevention of mother to child transmission (PMTCT) of Human Immunodeficiency Virus (HIV) services remains low despite the progress registered in the implementation of the PMTCT program. Male involvement in PMTCT is a fairly new concept in Malawi that has not been fully implemented within PMTCT service provision despite its inclusion in the PMTCT guidelines. One of the reasons for the limited MI is the lack of knowledge on both its relevance and the role of men in the program. Currently, men have been encouraged to participate in PMTCT services without prior research on their understanding of the relevance and their role in PMTCT. This information is vital to the development of programs that will require MI in PMTCT. The objective of this study was to explore the views of men, pregnant women and health care providers on the importance and roles of MI in PMTCT services in Blantyre Malawi.MethodsAn exploratory descriptive qualitative study was conducted from December 2012 to January 2013 at South Lunzu Health Centre (SLHC) and its catchment area in Blantyre, Malawi. We conducted 6 key informant interviews (KIIs) with health care workers and 4 focus group discussions (FGDs) with 18 men and 17 pregnant women. Interviews and discussions were digitally recorded and simultaneously transcribed and translated into English. Data were analyzed using framework analysis approach.ResultsThe major themes that emerged on the relevance of MI in PMTCT were a) uptake of interventions along the PMTCT cascade b) support mechanism and c) education strategy. Lack of MI in PMTCT was reported to result into non-disclosure of HIV test results and non-compliance with PMTCT interventions.ConclusionsMale involvement is paramount for the uptake of interventions at the different cascades of PMTCT. The absence of male involvement may compromise compliance with PMTCT interventions.