Despite impressive health system-related achievements in the prevention of mother-to-child transmission of HIV (PMTCT) in the last decade, Nigeria contributes the greatest number of infants infected with HIV worldwide. Elimination of mother-to-child transmission of HIV in Nigeria requires the implementation of feasible, culturally acceptable and sustainable interventions and policies addressing a series of health system-related challenges, according to a review published in International Health.
An estimated 159,000 of the 180,000 new infections among children worldwide were in sub-Saharan Africa, with Nigeria alone accounting for 23% of the region’s total. Between 2009 and 2015, new infections among Nigerian children only fell by 21%. In 2017 only 32% of pregnant women living with HIV in Nigeria got antiretrovirals.
Identifying and addressing health system-related challenges to PMTCT is critical to implementing effective PMTCT programmes. The authors aimed to identify achievements and challenges in the elimination of mother-to-child transmission of HIV in Nigeria from a health system perspective. They drew on their experiences of implementing PMTCT programmes in Nigeria and reviewed policy documents and research papers.
The authors analysed progress and challenges using the World Health Organization’s (WHO) health system framework. This includes six essential building blocks (service delivery, health workforce, health information, medical products, health financing, and leadership and government) that make up a health system and are needed to improve health outcomes.