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

Background: There is increasing debate about the impact of scaled-up HIV/AIDS programmes on fragile healthcare systems in low-income countries.

Objectives: 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.

Search strategy: Publications describing the effect of PMTCT programmes on maternal healthcare services were sought through computerised searches in five electronic databases.

Selection criteria: Abstracts of publications were evaluated for appropriateness for inclusion based on whether they met the inclusion criteria.

Data collection and analysis: Copies of all selected publications were obtained. A classification system was developed to group the relevant publications.

Main results: 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.

Authors' conclusions: It appears that PMTCT programmes miss the opportunity to have an overall positive effect on maternal health care because of their verticality.