| Acceptability |
1. What have you heard about antenatal care and the PMTCT program at the antenatal clinic (ANC)?
What seems to work well in the ANC PMTCT program? What does not work well in the ANC PMTCT program? What could be changed to improve the PMTCT program? How could the ‘flow’ of services be changed to improve the program? What issues in the community affect the way PMTCT programs are provided? How could the community strengthen or improve the program? What are some other issues that affect the way PMTCT programs are provided? What have you heard about the Vikela Umndeni project? Describe what you know about the project.
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| Fidelity |
2. What have you learned about the components of the PMTCT protocol from the clinic staff? These components include testing, HIV prevention, ARV treatment, infant feeding, family planning, safer sex and involving your partner in your pregnancy.
What have you heard about the amount of time patients spend at the clinic during pregnancy? When do women come for antenatal care/pregnancy care for the first time? What kind of experiences have people had with obtaining their test results promptly? What experiences do people have in receiving their ARV treatment? How can services be improved? What else could be done in the way of new programs, like Vikela Umndeni?
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3. What have you heard about communication between patients and the health care staff at the clinic?
What have you heard about communication between patients and the health care staff at the clinic? How does communication affect receiving health care during pregnancy? What kinds of changes could improve communication?
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4. What have you heard about staff appearing fatigued (worn out, tired) or burned out (less interested in work) with patients?
How does staff fatigue or burn out affect the way provide health care? How does staff fatigue or burn out affect new programs, like Vikela Umndeni? What kinds of changes could reduce the staff burden?
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| Coverage |
5. What have you heard about staff appearing fatigued (worn out, tired) or burned out (less interested in work) with patients?
Are some clinics more popular than others? What makes them better or worse? Why did you choose this clinic for your care during pregnancy? If you attended a different clinic, why did you choose that other clinic?
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6. The following are some problems that occur in clinics. How could these problems be solved?
Many mothers come late for their first antenatal booking. Not all mothers are counseled and tested for HIV testing at their first antenatal booking. Not all HIV-positive mothers have CD4 test blood drawn. Mothers have CD4 test drawn, but do not return for results Mothers are often delayed before their receive ARV/HIV medication waiting for CD4 count results. HAART clinics are overburdened and pregnant women are delayed in starting ARV/HIV medication. Clients are referred for ARV/HIV medication but do not pitch up at ARV clinic. Clients are referred for ARV/HIV medication but no information is sent to the patient, which leads to delays and duplication. Clients are delayed for ARV/HIV medication because a treatment supporter has not been identified. The delivery of PMTCT medicines is unreliable (not always done) during labor The post-natal care clinic does not always know which babies were HIV exposed Some mothers may feel babies do not get enough nourishment only breastfeeding and may mixed feed their babies. Some women may not take their ARV medications as prescribed. It is difficult to involve the partners in PMTCT, in some cases, men are not involved.
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