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Table 1 Avoidable health personnel and systems barriers to ART and PMTCT in four facilities in South Africa: the maternal-child care continuum
| Antenatal Care | |
|---|---|
| HEALTH PERSONNEL | |
| HIV Testing & Counselling | In Which Facilities? |
| HIV counsellor unavailable for testing | All four |
| Repeat testing unavailable for patients who had earlier declined | All four |
| Counsellor unavailable at time of HIV test | All four |
| ART Eligibility/Initiation | In Which Facilities? |
| Health staff miss ART eligibility in patient's file | All four |
| HEALTH SYSTEM | |
| HIV Testing & Counselling | In Which Facilities? |
| No HIV test kit available | Eastern Cape clinic only |
| ART Eligibility/Initiation | In Which Facilities? |
| Patient file does not have CD4 cell result | All four |
| Labour Ward | |
| HEALTH PERSONNEL | |
| HIV Testing & Counselling | In which Facilities? |
| No counselling for HIV positive woman on infant testing at six weeks; ART for woman and infant; immunization; cotrimoxazole; nutrition; family planning; safer sex; partner testing | All three hospitals |
| HIV Prevention | In which Facilities? |
| No ARV prophylaxis given to HIV positive woman in labour | All three hospitals |
| Infant not given ARV prophylaxis when mother's HIV positive status is clear | Johannesburg hospital |
| HEALTH SYSTEM | In which Facilities? |
| HIV Testing & Counselling | |
| Woman with unknown HIV status not tested | All three hospitals |
| Woman's HIV status unclear from file | All three hospitals |
| Postnatal Care (after patient is discharged and returns for follow up care) | In which Facilities? |
| HEALTH PERSONNEL | |
| HIV Testing & Counselling | |
| Woman with unknown HIV status not tested | All three hospitals |
| HIV positive woman fails to take child for PCR test | Johannesburg and Eastern Cape academic hospitals (only these facilities offer PCR testing) |
| HEALTH SYSTEM | |
| ART Eligibility/Initiation | In which Facilities? |
| Woman with HIV does not receive CD4 cell test | All three hospitals |
| Paediatric Ward (only pertains to Eastern Cape Academic Hospital and Johannesburg Hospital) | |
| HEALTH PERSONNEL | In which Facilities? |
| HIV Testing & Counselling | |
| HIV-exposed child admitted for TB not tested for HIV | Johannesburg hospital |
| HIV positive child's mother with status unknown not referred for HIV testing | Johannesburg and Eastern Cape academic hospitals |
| ART Eligibility/Initiation | In which Facilities? |
| ART eligibility of mother (with HIV positive child unknown) | Johannesburg and Eastern Cape Academic hospitals |
