Mapping evidence of interventions and strategies to bridge the gap in the implementation of the prevention of mother-to-child transmission of HIV programme policy in sub-Saharan countries: A scoping review.

Abstract

BackgroundPrevention of mother-to-child transmission (PMTCT) of HIV is a life-saving public health intervention. Sub-Saharan African (SSA) countries have made significant progress in the programme, but little is known about the strategies used by them to eliminate mother-to-child transmission of HIV.AimTo map evidence of strategies and interventions employed by SSA in bridging the implementation gap in the rapidly changing PMTCT of HIV programme policy.MethodsElectronic search of the databases MEDLINE, PubMed and SABINET for articles published in English between 2001 and August 2016. Key words included ‘Sub-Saharan African countries’, ‘implementation strategies’, ‘interventions to bridge implementation gap’, ‘prevention of mother-to-child transmission of HIV’ and ‘closing implementation gap’.ResultsOf a total of 743 articles, 25 articles that met the inclusion criteria were included in the study. Manual content analysis resulted in the identification of three categories of strategies: (1) health system (referral systems, integration of services, supportive leadership, systematic quality-improvement approaches that vigorously monitors programme performance); (2) health service delivery (task shifting, networking, shared platform for learning, local capacity building, supportive supervision); as well as (3) community-level strategies (community health workers, technology use – mHealth, family-centred approaches, male involvement, culturally appropriate interventions).ConclusionThere are strategies that exist in SSA countries. Future research should examine multifaceted scientific models to prioritise the highest impact and be evaluated for effectiveness and efficiency.