An Audit of PMTCT Services at a Regional Hospital in South Africa

Abstract

Background Prevention of mother-to-child transmission (PMTC) is a major intervention world-wide in the fight against the HIV pandemic, and has resulted in markedly reduced rates of mother-to-child transmission rates in well-resourced countries However, our impression is that barriers to implementation of the programme exist at all levels of health care at all facilities providing maternal care. Aim To conduct a clinical audit of the PMTCT programme at a regional hospital. Methods Data was collected from an analysis of antenatal and medical records of women who attended antenatal care and delivered at a regional hospital from January-December 2007. Results Of the 499 records analysed, 479 women (96%) were offered testing, 473 accepted. Of those tested, 227 (48%) were HIV positive. Only 15 (6.1%) of the 246 who tested negative, were re-tested. CD4 counts were only done in 159 (70%) of the 227 HIV-positive women. More importantly, only 134 (84.3%) received their results. Of the 227 HIV positive women, only 131 were given 200mg Nevirapine at > 28 weeks gestation; 185 (81.5%) took Nevirapine before delivery; 143 took Nevirapine > 2 hours before delivery and 84 (37%) took Nevirapine < 2 hours before delivery. 208 (91.6%) of the babies were given Nevirapine at the correct time. Discussion This audit shows that progress has been made in the implementation of PMTCT of HIV at this regional hospital by the high uptake of HIV testing; however barriers to full implementation are caused by the lack of integration of testing, counselling and obtaining CD4 count results.