TY - JOUR TI - Implementing prevention policies for mother-to-child transmission of HIV in rural Malawi, South Africa and United Republic of Tanzania, 2013-2016 AU - Jones, H. AU - Wringe, A. AU - Todd, J. AU - Songo, J. AU - Gomez-Olive, F. X. AU - Moshabela, M. AU - Geubbels, E. AU - Nyamhagatta, M. AU - Kalua, T. AU - Urassa, M. AU - Zaba, B. AU - Renju, J. T2 - Bull World Health Organ AB - OBJECTIVE: To assess adoption of World Health Organization (WHO) guidance into national policies for prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) and to monitor implementation of guidelines at facility level in rural Malawi, South Africa and the United Republic of Tanzania. METHODS: We summarized national PMTCT policies and WHO guidance for 15 indicators across the cascades of maternal and infant care over 2013-2016. Two survey rounds were conducted (2013-2015 and 2015-2016) in 46 health facilities serving five health and demographic surveillance system populations. We administered structured questionnaires to facility managers to describe service delivery. We report the proportions of facilities implementing each indicator and the frequency and durations of stock-outs of supplies, by site and survey round. FINDINGS: In all countries, national policies influencing the maternal and infant PMTCT cascade of care aligned with WHO guidelines by 2016; most inter-country policy variations concerned linkage to routine HIV care. The proportion of facilities delivering post-test counselling, same-day antiretroviral therapy (ART) initiation, antenatal care and ART provision in the same building, and Option B+ increased or remained at 100% in all sites. Progress in implementing policies on infant diagnosis and treatment varied across sites. Stock-outs of HIV test kits or antiretroviral drugs in the past year declined overall, but were reported by at least one facility per site in both rounds. CONCLUSION: Progress has been made in implementing PMTCT policy in these settings. However, persistent gaps across the infant cascade of care and supply-chain challenges, risk undermining infant HIV elimination goals. DA - 2019/03/01/ PY - 2019 DO - 10.2471/BLT.18.217471 VL - 97 IS - 3 SP - 200 EP - 212 SN - 1564-0604 (Electronic) 0042-9686 (Linking) UR - https://www.ncbi.nlm.nih.gov/pubmed/30992633 AN - 30992633 KW - *World Health Organization KW - Africa South of the Sahara/epidemiology KW - Anti-Retroviral Agents/*administration & dosage KW - Counseling/*organization & administration KW - Female KW - Global Health KW - Guidelines as Topic KW - HIV Infections/*transmission KW - Humans KW - Infant KW - Infant Care/methods KW - Infant, Newborn KW - Infectious Disease Transmission, Vertical/*prevention & control KW - Prenatal Care/organization & administration KW - Public Health Surveillance KW - Socioeconomic Factors ER -