PMTCT programme--partial assessments can build the picture.

Abstract

Delva and Temmerman state that ideally a prevention of mother-to-child transmission (PMTCT) programmes success should be measured by its effectiveness in the community that our study of the Coronation Women and Childrens Hospital (CWCH) PMTCT programme partially fails to envelop the entire reality of the programme and that it is difficult to extrapolate results from a research to a routine service setting. We agree. Our study was undertaken at a time when virtually no information was available regarding the efficacy of the newly instituted national PMTCT programmes or the 18 government pilot PMTCT sites. Political controversy shrouded PMTCT programmes and doubt was cast on the efficacy of nevirapine (NVP) the ability of South African women to exclusively formula-feed (EFF) and the need to diagnose the HIV status of vertically exposed infants. We did not intend the findings of our hospital-based study to be extrapolated to the community did we suggest that the study population was representative of all women participating in the CWCH PMTCT programme. The study enrolled 297 (24%) of the total 1 234 HIV-positive women registered with the PMTCT service therefore despite any bias introduced by the inclusion criteria and study design the sample represents a significant proportion of patient outcomes in the routine service. We simply used the opportunity provided by a research study to document certain parameters of the routine PMTCT programme at CWCH. (excerpt)