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.

Abstract

There is increasing debate about the impact of scaled-up HIV/AIDS programmes on fragile healthcare systems in low-income countries. 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. Publications describing the effect of PMTCT programmes on maternal healthcare services were sought through computerised searches in five electronic databases. Abstracts of publications were evaluated for appropriateness for inclusion based on whether they met the inclusion criteria. Copies of all selected publications were obtained. A classification system was developed to group the relevant publications. 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. It appears that PMTCT programmes miss the opportunity to have an overall positive effect on maternal health care because of their verticality.