ABSTRACT
To conduct a rapid assessment of the prevention-of-mother-to-child-transmission-of-HIV (PMTCT) programme in two of the three local service areas in Cacadu district; Eastern Cape province; South Africa; we designed an exploratory study using a mixed-methods approach. Quantitative and qualitative data on PMTCT programme implementation were collected in 2008 through a structured assessment at the 44 health facilities implementing the programme in the province. This included in-depth interviews with 11 clinic supervisors; 31 clinic programme coordinators; and 8 hospital/maternity staff members in order to examine their perceived problems and suggestions regarding PMTCT programme implementation; an assessment of the clinic registers and recording systems; a meeting with stakeholders; and one feedback meeting with clinic managers; sub-district management and other stakeholders in regard to the results of the rapid assessment. Overall; most of the national criteria for PMTCT programme implementation were fulfilled across the health facilities. However; shortcomings were found relating to health policy; health services delivery and clients' health-seeking behaviour. The findings show the need for a well-functioning health system with adequate and trained staff; a reduced staff workload; proper case recording; an improved patient follow-up system; better support for staff; the empowerment of PMTCT clients; strong leadership; and coordination and collaboration between partners