Table 4.

Persistent barriers to PMTCT integration

According to experts	Common to both experts and FHCWs	According to FHCWs
•Bureaucratic slowness •Lack of managerial accountability •Poor quality of care including suboptimal fidelity to algorithms •Poor training of staff •Attitudinal issues among health care workers in the facilities •Discrimination, stigma •Lack of national health information systems and issues relating to electronic records	• Loss to follow-up • Socio-economic issues for women • Women migration • Lack of unique patient identifiers • Resistance to change	•Small working spaces and other infrastructural related challenges like poor ventilation, congestion, among others •Shortage of personnel and work overload •High staff turnover •Guideline changes •Too much paperwork for managers