Abstract

Even though Prevention of Mother to Child Transmission (PMTCT) program has been running in Indonesia since 2006, the proportion of human immunodeficiency virus (HIV)-infected pregnant women remains high in some districts in Indonesia. The PMTCT program aims to reduce transmission of HIV from mother to child. Thus it requires an examination of the PMTCT program implementation. The study was a qualitative study on PMTCT program implementation in South Jakarta, Indonesia, whereas the proportion of children with HIV positive in the area was quite high. The analysis used domain analysis by looking the implementation of PMTCT as a system consisting of input, process and output. PMTCT strategy is based on a comprehensive four-pronged strategy. This study found that scaling-up communication and education about PMTCT program from health provider to community was needed. In the first prong, there was no specific health provider for PMTCT program, it was still integrated with the MCH staff. PMTCT program did not disseminate information to the community. Therefore, it seemed that it was underutilized. In the second prong, implementation of HIV testing and counseling for couples of women living with HIV remained a bottleneck because women living with HIV felt fear to inform their HIV status to their partners. Thus, counseling and HIV testing for couples have not benefited at all. These women were unsatisfied with the quality of counseling, and the failure to provide antiretroviral treatments. This study found the low coverage and less responsiveness of PMTCT program to build a network of partners with various elements of government.

References

1. Mazia G, Narayanan I, Warren C, Mahdi M, Chibuye P, Walligo A, Mabuza P, Shongwe R, Hainsworth M. Integrating quality postnatal care into PMTCT in Swaziland. Global Public Health. 2009 [accessed 17 Juni 2016]; 4(3): 253-70. Available from: http://dx.doi.org/ 10.1080/ 17441690902769669.

2. Nkonki LL, Doherty TM, Hill Z, Chopra M, Schaay N, Kendall C. Missed opportunities for participation in prevention of mother to child transmission programmes: Simplicity of nevirapine does not necessarily lead to optimal uptake, a qualitative study. AIDS Research and Therapy. 2007 [accessed 20 Juni 2016]; 4:27. Available from: http://www.ncbi. nlm.nih.gov/pmc/articles/PMC2211501/.

3. Townsend CL1, Cortina-Borja M, Peckham CS, de Ruiter A, Lyall H, Tookey PA. Low rates of mother-to-child transmission of HIV following effective pregnancy interventions in the United Kingdom and Ireland, 2000–2006. AIDS. 2008 [accessed 17 Juni 2016]; 22(8): 973-81. Available from: http://journals.lww.com/aidsonline/Fulltext/ 2008/05110/Low_rates_of_mother_to_child_transmission_of_HIV.8.as px.

4. United Nations Programme on HIV/AIDS. Global report: UNAIDS report on the global AIDS epidemic 2013. Geneva: UNAIDS; 2013 [accessed 17 Juni 2016]. Available from: http://kff.org/global-health-policy/fact-sheet/the-global-hivaids-epidemic/.

5. National AIDS Commission Secretary. National HIV and AIDS Strategy and Action Plan 2010-2014 [Internet]. Coordinating Minister for People’s Welfare Indonesia; 2012. Available from: http://www.ilo.org/ wcmsp5/groups/public/—-ed_protect/—-protrav/—-ilo_aids/documents/legaldocument/wcms_173075.pdf.

6. Mentri Kesehatan Republik Indonesia. Statistik Kasus HIV/AIDS di Indonesia sampai Desember 2013. Jakarta. Direktorat Jendral Penyakit Menular dan Kesehatan Lingkungan. Departemen Kesehatan Republik Indonesia, 2013.

7. Komisi Nasional Penanggulangan AIDS; Strategi Nasional dan Perencanaan Aksi Pencegahan HIV dan AIDS 2010-2014. Jakarta. Komisi Penanggulangan AIDS Nasional; 2014.

8. Badriah F, Alkaff R. Metodologi Penelitian Kualitatif. Universitas Islam Negeri Syarif Hidayatullah Jakarta (UIN) Punlisher; Buku, 2013.

9. Luo C, Akwara P, Ngongo N, Doughty P, Gass R, Ekpini R, Crowley S, Hayashi C. Global progress in PMTCT and paediatric HIV care and treatment in low-and middle-income countries in 2004–2005. Reproductive Health Matters. 2007 [accessed 16 Juni 2016]; 15(30): 179-89. Available from: http://www.sciencedirect.com/science/article/pii/S0968808007303273.

10. Thorne C, Malyuta R, Ferencic N, Mimica J, Eramova I. Towards the elimination of mother-to-child transmission of HIV in low-prevalence and concentrated epidemic settings in Eastern Europe and Central Asia. Europe: World Health Organization and United Nations Children’s Emergency Fund: 2011.

11. World Health Organization. HIV/AIDS in the South-East Asia Region: progress report towards millennium development goal 6(a). New Delhi: World Health Organization Regional Office for South-East Asia, in press.; 2012 [accessed 17 Juni 2016]. Available from: http://apps.who.int/iris/bitstream/10665/127609/1/WP%20on%20M DG%20from%20HSD.pdf.

12. Hardon AP, Oosterhoff P, Imelda JD, Anh NT, Hidayana I. Preventing mother-to-child transmission of HIV in Vietnam and Indonesia: Diverging care dynamics. Social Science & Medicine. 2009 [accessed 16 Juni 2016]; 69(6): 838-45. Available from: http://www.sciencedirect.com/science/article/pii/S0277953609003402.

13. World Health Organization. PMTCT strategic vision 2010–2015. Preventing mother-to-child transmission of HIV to reach the UNGASS and millennium development goals. Geneva: World Health Organization; 2010 [accessed 20 Juni 2016]. Available from: http://www.who.int/hiv/pub/mtct/strategic_vision.pdf.

14. United Nations Programme on HIV/AIDS. Global plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive. Geneva: Joint United Nations Programme on HIV/AIDS; 2011 [accessed 17 Juni 2016]. Available from: http://www.unaids.org/sites/default/files/media_asset/20110609_JC21 37_Global-Plan-Elimination-HIV-Children_en_1.pdf.

15. Rollins N, Little K, Mzolo S, Horwood C, Newell ML. Surveillance of mother-to-child transmission prevention programmes at immunization clinics: the case for universal screening. AIDS. 2007 [accessed 20 Juni 2016]; 21(10): 1341-7. Available from: http://journals.lww.com/aidsonline/Fulltext/2007/06190/Surveillance_of_mother_to_child_transmission.14.aspx.

16. Rollins N, Mzolo S, Moodley T, Esterhuizen T, van Rooyen H. Universal HIV testing of infants at immunization clinics: an acceptable and feasible approach for early infant diagnosis in high HIV prevalence settings. AIDS. 2009 [accessed 20 Juni 2016]; 23(14): 1851-7. Available from: http://journals.lww.com/aidsonline/Fulltext/2009/09100/Universal_HI V_testing_of_infants_at_immunization.7.aspx.

17. World Health Organization. Priority interventions: HIV/AIDS prevention, treatment and care in the health sector. Version 2.0 Geneva: World Health Organization; 2010 [accessed 16 Juni 2016]. Available from: http://apps.who.int/iris/bitstream/10665/44418/1/9789241500234_e ng.pdf.

18. Badriah F, Abe T, Baequni B, Hagihara A. Skilled versus unskilled assistance in home delivery: maternal complications, stillbirth and neonatal death in Indonesia. Journal of Nursing and Care. 2014 [accessed 2 Juni 2016]; 3: 198. Available from: http://www.omicsgroup.org/journals/ skilled-versus-unskilled-assistance-in-home-delivery-2167-1168-3- 198.php?aid=30921.

19. Trisnawati LM, Thabrany H. The role of health system to support PMTCT program implementation in Jayawijaya Regency. Journal of Indonesian Health Policy and Administration. 2015 [accessed 20 Juni 2016]; 1(1): 8-15. Available from: http://journal.ui.ac.id/index.php/ihpa/article/viewFile/4929/3386.

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