The study identified gaps in prevention of mother-to-child transmission (PMTCT) knowledge and infant feeding policy which seem to affect appropriate infant feeding. Various determinants of mixed feeding and exclusive formula feeding in the context of PMTCT were identified that can guide infant feeding counselling and support services of PMTCT programmes.

Adherence to maternal and infant ARV prophylaxis was found to be sub-optimal. Health services delivery factors, male involvement, communication and social support contribute to adherence to ARV prophylaxis in this largely rural setting in South Africa.

To conduct a rapid assessment of the prevention-of-mother-to-child-transmission-of-HIV (PMTCT) programme in two of the three local service areas in Cacadu district, Eastern Cape province, South Africa, we designed an exploratory study using a mixed-methods approach. Quantitative and qualitative data on PMTCT programme implementation were collected in 2008 through a structured assessment at the 44 health facilities implementing the programme in the province. This included in-depth interviews with 11 clinic supervisors, 31 clinic programme coordinators, and 8 hospital/maternity staff members in order to examine their perceived problems and suggestions regarding PMTCT programme implementation; an assessment of the clinic registers and recording systems; a meeting with stakeholders; and one feedback meeting with clinic managers, sub-district management and other stakeholders in regard to the results of the rapid assessment. Overall, most of the national criteria for PMTCT programme implementation were fulfilled across the health facilities. However, shortcomings were found relating to health policy, health services delivery and clients' health-seeking behaviour. The findings show the need for a well-functioning health system with adequate and trained staff, a reduced staff workload, proper case recording, an improved patient follow-up system, better support for staff, the empowerment of PMTCT clients, strong leadership, and coordination and collaboration between partners.

The research assesses prevention-of-mother-to-child-transmission-of-HIV (PMTCT) services following implementation of programme-strengthening activities in a municipality in the Eastern Cape Province, South Africa. A pre-intervention and post-intervention design was used to conduct facility assessments and client exit interviews at baseline and after 28 months. For the facility assessments, unstructured interviews were conducted with the heads of maternity wards at each delivery facility (n = 4), nurses (n = 9) and lay counsellors (n = 18). District Health Information System (DHIS) records were used to assess changes on PMTCT-programme indicators. Observations were conducted at the fixed clinics and hospitals to determine compliance to the national criteria for PMTCT-services delivery. For the exit interviews with clients, the pre- and post-assessment samples, respectively, included women attending for antenatal care (n = 296; n = 239) as well as HIV-positive women attending for postnatal care (n = 70; n = 142). The personnel generally perceived the PMTCT services as having been strengthened as a result of the initiative and the DHIS records showed positive changes. Client exit interviews revealed significant increases in the numbers of women who: were aware of the PMTCT programme; were tested for HIV during their pregnancy; were aware of VCT before coming to the facility; knew their HIV-test result; and, had helpful pre-HIV-test and/or post-HIV-test counselling experiences. The long waiting periods at the facilities and the relatively short length of the counselling sessions remained a serious concern. Lessons learnt may help with designing strategies to expand the national programme in South Africa as well as PMTCT programmes elsewhere.

BackgroundHealth promoting schools focus on, amongst other things, preventing leading causes of death such as Sexually Transmitted Infections (STI's), Human Immune Deficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS), a sedentary lifestyle and creating conditions that are conducive to health through health education.AimThis study explored the perceptions of educators regarding implementation of the health promotion programme manuals in selected schools of the Makapanstad community.MethodA qualitative, exploratory, descriptive and contextual design was utilised in this study. Four schools were selected to participate in the study. Purposive sampling was used to select educators from these schools who were actively involved in the health promotion programme. Data collection was taken through focus group interviews. One focus group comprised of eight participants who were interviewed three times. The focus group interviews were conducted until data were saturated. Data were analysed using an adaptation of Tesch's method. The eight steps of Tesch's method enabled researchers to systematically analyse and organise data using colour coding to develop data into categories, sub-categories and themes.Results and conclusionThe themes that emerged during data analysis were: the perceptions of educators regarding health promotion programme manuals before implementation of manuals, and the perceptions of educators regarding health promotion programme manuals after the implementation of manuals. Introducing health promotion materials to the schools served as a point of departure for developing personal skills and creating a supportive environment for health in schools. The health promotion manual assisted the educators to attain appropriate health promotion information.