ABSTRACT
Swaziland's prevention of mother-to-child transmission (PMTCT) programme is linked to maternal and newborn health (MNH) services, but is mainly focussed on HIV/AIDS. Existing MNH services are inadequate, especially postnatal care (PNC) of mothers and babies, with delayed postnatal visits occurring at 4-6 weeks after delivery. Fifty-seven percent of staff in seven Swazi health facilities were trained in promoting and providing early PNC. A final evaluation showed a 20-fold increase in the number of visits coming for an early postnatal visit (within the first three days after birth). A direct observation of the client-provider interaction showed a significant increase in the competence of the health workers related to postnatal examinations, and care of mothers and babies (p<0.05- < 0.01). The percentage of women breastfeeding within one hour of delivery increased by 41% in HIV-positive mothers and 52% in HIV-negative mothers. Cotrimoxazole prophylaxis for HIV-exposed infants increased by 24%. Although, health workers were observed providing counselling, maternal recall of messages was deficient, suggesting the need for additional strategies for promoting healthy behaviours. High-quality integrated PMTCT programmes and MNH postnatal services are feasible and acceptable, and can result in promoting early postnatal visits and improved care of both HIV-positive and HIV-negative mothers and their babies.
Subject(s)
HIV Infections/transmission , Health Personnel/education , Infectious Disease Transmission, Vertical/prevention & control , Maternal Health Services/organization & administration , Postnatal Care/organization & administration , Adolescent , Adult , Counseling , Eswatini , Female , HIV-1 , Health Knowledge, Attitudes, Practice , Humans , Infant, Newborn , Maternal Health Services/statistics & numerical data , Mothers , Observation , Postnatal Care/methods , Pregnancy , Pregnancy Complications, Infectious/prevention & control , Program Evaluation , Quality Assurance, Health Care , Young AdultSubject(s)
Assertiveness , Nursing Staff/psychology , Humans , Interprofessional Relations , PhysiciansABSTRACT
The study investigated the planning and management of primary health care in Zambia. The overall objective was to explore how far planning and management facilitated an integrated approach to primary health care
