The impact of prevention of mother to child transmission (PMTCT) programmes on maternal health care in resource-poor settings: Looking beyond the PMTCT programme-a systematic review

摘要

Background There is increasing debate about the impact of scaled-up HIV/AIDS programmes on fragile healthcare systems in low-income countries. Objectives To contribute to the understanding of the relation between HIV/AIDS programmes and healthcare systems, this systematic review focuses on the impact of Prevention of Mother to Child Transmission (PMTCT) programmes on maternal health care. Search strategy Publications describing the effect of PMTCT programmes on maternal healthcare services were sought through computerised searches in five electronic databases. Selection criteria Abstracts of publications were evaluated for appropriateness for inclusion based on whether they met the inclusion criteria. Data collection and analysis Copies of all selected publications were obtained. A classification system was developed to group the relevant publications. Main results The findings show that empirical evidence of the effect of PMTCT programmes on maternal health care is scarce and further research is badly needed. Twenty-one studies that were included in the systematic review showed that PMTCT programmes are often semi-integrated in maternal health care with positive as well as negative effects on various aspects of maternal health care. Authors conclusions It appears that PMTCT programmes miss the opportunity to have an overall positive effect on maternal health care because of their verticality.