Barriers to the management of children under five exposed to HIV in the rural areas of South Africa.
Sibusiso F Buthelezi, Regis R M Modeste, Deliwe R Phetlhu
PMID 33764130WHAT IT FOUND
Barriers to HIV-exposed child care in rural South Africa include clinic staff shortages, long travel distances, and stigma.
Nurses sometimes lacked PMTCT knowledge or showed negative attitudes, causing mothers to avoid testing or skip follow-up visits.
Key findings
01Healthcare providers, including nurses and midwives, were reported to have inadequate knowledge of PMTCT protocols and displayed negative attitudes that discouraged women from attending clinics.
02Structural barriers such as severe staff shortages, long waiting times, and stock-outs of HIV test kits and antiretrovirals contributed to missed opportunities for early infant diagnosis and treatment.
03Patient-related barriers, specifically fear of stigma and cultural beliefs, led to late antenatal bookings, non-disclosure of HIV status, and failure to bring children for confirmatory testing.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review only included peer-reviewed studies published in English, potentially excluding relevant local reports or grey literature. Findings are limited to rural areas in South Africa and may not generalise to urban settings or other countries. The included studies varied in design and quality, with some quantitative studies showing low generalisability scores in the appraisal checklist. The review synthesises reported barriers but does not measure the relative impact or frequency of these barriers across the population.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not interpret these barriers as evidence that specific interventions work or fail. This review describes the context of care delivery and patient experiences but does not test any clinical treatment or management strategy.