Implementation of Prevention of Mother-to-Child Transmission of HIV Programme through Private Hospitals of Delhi—Policy Implications

September 2015 - Biomedical Prevention

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Gupta, A.K., Garg, C.R., Joshi, B.C, et al. AIDS Care (July 2015), E-publication ahead of print.

This study examined the implementation status of prevention of mother-to-child transmission (PMTCT) programs in private hospitals in India. Between March and September 2013, the authors interviewed directors of obstetrics and gynecology and pediatrics at 29 large corporate hospitals, 42 medium-sized hospitals, and 10 small nursing homes. Interviews covered HIV testing and counselling, PMTCT programs, the type of care provided to HIV-positive pregnant women, access by HIV-positive women to CD4-count services, and other relevant questions. The study found that private hospitals routinely performed HIV testing for all antenatal clients, but did not obtain women's consent, and did not offer pre- or post-test counseling. Medical termination of pregnancy was undertaken in more than 90 percent of HIV-positive pregnant women. The hospitals did not follow any PMTCT protocol and did not provide delivery services to HIV-positive women. Only 8 percent of HIV-positive women were referred to public health facilities for antenatal care, delivery, and HIV care. CD4 cell-count facilities were available in 41 percent of the hospitals, but HIV-positive clients were not given CD4 testing. Antiretroviral therapy was not available in any participating hospital. The authors concluded that policymakers urgently need to make the private health sector more accountable for PMTCT programming and to assume a greater regulatory role to improve technical standards of care in the private hospitals.

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