Managers perspectives on the implementation of the Prevention of Mother-to-Child Transmission policy in South Africa

Background: Despite significant progress in South Africa in reducing mother-to-child transmission of human immunodeficiency virus (HIV) infection, challenges remain. This is evident by the incidence and prevalence of HIV in pregnancy and transmission during breastfeeding. This study is aimed at ascertaining the perceptions of prevention of mother-to-child transmission (PMTCT) managers regarding the challenges experienced during the implementation of the PMTCT policy at public health service delivery platforms across all provinces of South Africa. Aim: To examine the perceptions and views of PMTCT managers regarding the challenges experienced during implementation of the policy. Setting: The study was conducted in all nine provinces of South Africa. Methods: An exploratory-qualitative descriptive research design was utilised. The study population was the PMTCT managers. Data were collected from a sample of 11 PMTCT managers, seven at the provincial level, three at the district level, and one at the national level, using in-depth semi-structured interviews from April 2021 to July 2022. The participants were purposefully selected based on their expertise and experiences related to the study topic. Results: The participants shared the views, experiences and challenges encountered during the PMTCT policy implementation. Four themes were generated: policy design and change management, system and service delivery constraints, provider-level determinants and client-level determinants. It is imperative that recommendations shared be implemented to support the full implementation of the PMTCT policy, enabling the country to achieve the elimination of mother-to-child transmission by 2030 and an HIV-free generation. Conclusion: The article confirmed that the Prevention of Mother-to-Child Transmission policy is partially implemented in South Africa which may derail the country to achieve eMTCT by 2030. Contribution: The article propose guidelines towards full implementation of the Prevention of Mother-to-Child Transmission policy across all service delivery platforms across South Africa.