Background: The prevalence of cases of HIV among children below the ages of 15 years continues to increase and majority of these children acquired the infection through mother-to-child transmission. Methodology: The main objectives of the study were to explore the perceptions of local women regarding the PMTCT program, to evaluate the strength of these perceptions and to make recommendations. A qualitative method was used involving a number of focus group discussions among antenatal clinic attendees in the 27 primary health care clinics in Qwa-Qwa, Free State province of South Africa. Findings: The findings were organised under eight major themes: (1) Knowledge of the program -where the participants expressed high knowledge about the PMTCT program as they knew how MTCT of HIV occurs and how it can be prevented, (2) Perceived concerns about the program- which were mainly fear of resistance to ARVs, fear of stopping the treatment after delivery, potential for high numbers of orphans, depression and suicide when HIV result is positive, the fear of the family neglecting the baby if the mothers dies, the perception that the program cares for only the babies and not their mother, (3)Readiness to do HIV test- where majority of the participants said it was difficult doing the HIV test due to fear of positive result, (4) Ease of taking ARVs- Difficulty in taking the ARVs due to fear of resistance and harmful side effects, (5) Relationship with clinic staff- a majority of the participants were happy with their relationship with the clinic staff, (6) Reactions expected from family members when program advice is followed- more than half of the participants expected negative reactions from family members if the program advice is followed because of the negative attitudes of their male partners and the elders’ of the resistance to change from their cultural beliefs, (7) Advantages of the program- according to the focus group participants, the advantages of the program include the knowledge gained about HIV, modes of MTCT of HIV and how to prevent MTCT of HIV. Other advantages mentioned were prevention of MTCT of HIV, pre-test counselling reducing the fear of doing HIV test, knowing one’s HIV status as well as the potential of the program to have positive change on the cultural beliefs of the people, and lastly (8)How they felt being part of the program- where all the participants said they were excited . Conclusions: The findings were similar to those of other studies in many respects. Recommendations: The recommendations were community and family HIV/AIDS education and their involvement in the PMTCT program in other to reduce misconceptions about the disease, and stigmatization against the women in the program. Other recommendations include: the concept of PMTCT-plus which provides ongoing support and treatment for the mothers, babies and infected family members; integration of innovative health education and culturally appropriate interventions into the program; provision of adequate maternity leaves to women in the PMTCT program as well as full integration of the PMTCT program into the District Health System (DHS) as part of the “horizontal” delivered package.

An estimated 33.0 million people are currently living with HIV/AIDS worldwide. Of these, 15.5 million are women, and 2.2 million children under the age of 5 years who have mainly been infected through mother-to-child transmission. Mothers and babies are increasingly infected and about 90% of these are in sub-Saharan Africa. The same trend can be identified in South Africa, which has one of the highest incidences and prevalence rates of HIV/AIDS in the world with 5-6 million people living with HIV/AIDS. Women of childbearing age constitute 55% of all HIV positive adults and a quarter of pregnant women (28%) in South Africa are HIV positive. The HIV/AIDS epidemic is overburdening hospital systems and it will continue to grow within the context of already massively overstretched public resources. This increase also impacts on health services in the North West Province which are facing an alarming increase in mothers and babies living with HIV/AIDS. One of the strategies that are implemented to reduce maternal deaths is the Prevention-of-Mother-to-Child Transmission (PMTCT) Programme and massive roll out of Antiretrovirals during puerperium. One of the goals of the PMTCT programme is to prevent transmission of HIV/AIDS from mothers to babies and reduce child, perinatal and neonatal morbidity and mortality. This strategy is integrated with Non-Governmental Organizations (NGOs) and community-based organizations (CBOs) in care of mothers and babies living with HIV/AIDS during puerperium. Successful implementation of this programme requires social support and community involvement because of short hospitalization during the postnatal period. Caregivers are trained to perform various tasks and fulfil certain roles due to lack of human resources. Caregivers implementing the PMTCT programme experience problems which lead to stress and one of the causes of this stress manifests in feelings of inadequacy and isolation. They are faced with problems pertaining to mothers not adhering to treatment, and poverty is an additional source of stress as it negatively affects the quality of the PMTCT services they need to provide. This research was conducted in the Bojanala region, Rustenburg Sub-District of the North West Province in South Africa. A descriptive, exploratory, qualitative research design was utilized to explore and describe the lived experiences of caregivers while implementing the PMTCT programme as well as perceptions of health workers coordinating the PMTCT programme in order to gain a more thorough understanding of the support needed by caregivers during puerperium. Two populations were used. In population one, purposive sampling was used to select caregivers. In population two inclusive sampling was used to select health workers. In-depth interviews were conducted with both populations with the aim to collect data. From the research findings similarities were identified between the two populations regarding support, namely: (a) Caregivers need personal support in the form of counselling as well as support networks to enable them to deal with the problems they are faced with. (b) Caregivers need financial support to afford basic essentials and better remuneration to meet their financial needs. (c) Caregivers need to be trained in areas in which they lack knowledge -continued development and empowerment is essential. They also need to be trained specifically in PMTCT and they need a PMTCT consultant to always be available to support them. (d) Improvement of the PMTCT services by providing transport to follow up mothers, protective resources to protect themselves against infections as they are at risk of infections, water is essential as a basic human right, provision with food parcels to mothers who are poverty stricken and the PMTCT health services to be intensified from the antenatal period. (e) Management to establish a caring environment by displaying a caring attitude, respecting them and providing them with rewards to improve morale and performance. Recommendations were made for the fields of nursing education, nursing research and community health practice with recommendations to establish a structure of support for caregivers to enhance the PMTCT programme during puerperium. These recommendations were discussed under the five themes presented above. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2010.

An estimated 33.0 million people are currently living with HIV/AIDS worldwide. Of these, 15.5 million are women, and 2.2 million children under the age of 5 years who have mainly been infected through mother-to-child transmission. Mothers and babies are increasingly infected and about 90% of these are in sub-Saharan Africa. The same trend can be identified in South Africa, which has one of the highest incidences and prevalence rates of HIV/AIDS in the world with 5-6 million people living with HIV/AIDS. Women of childbearing age constitute 55% of all HIV positive adults and a quarter of pregnant women (28%) in South Africa are HIV positive. The HIV/AIDS epidemic is overburdening hospital systems and it will continue to grow within the context of already massively overstretched public resources. This increase also impacts on health services in the North West Province which are facing an alarming increase in mothers and babies living with HIV/AIDS. One of the strategies that are implemented to reduce maternal deaths is the Prevention-of-Mother-to-Child Transmission (PMTCT) Programme and massive roll out of Antiretrovirals during puerperium. One of the goals of the PMTCT programme is to prevent transmission of HIV/AIDS from mothers to babies and reduce child, perinatal and neonatal morbidity and mortality. This strategy is integrated with Non-Governmental Organizations (NGOs) and community-based organizations (CBOs) in care of mothers and babies living with HIV/AIDS during puerperium. Successful implementation of this programme requires social support and community involvement because of short hospitalization during the postnatal period. Caregivers are trained to perform various tasks and fulfil certain roles due to lack of human resources. Caregivers implementing the PMTCT programme experience problems which lead to stress and one of the causes of this stress manifests in feelings of inadequacy and isolation. They are faced with problems pertaining to mothers not adhering to treatment, and poverty is an additional source of stress as it negatively affects the quality of the PMTCT services they need to provide. This research was conducted in the Bojanala region, Rustenburg Sub-District of the North West Province in South Africa. A descriptive, exploratory, qualitative research design was utilized to explore and describe the lived experiences of caregivers while implementing the PMTCT programme as well as perceptions of health workers coordinating the PMTCT programme in order to gain a more thorough understanding of the support needed by caregivers during puerperium. Two populations were used. In population one, purposive sampling was used to select caregivers. In population two inclusive sampling was used to select health workers. In-depth interviews were conducted with both populations with the aim to collect data. From the research findings similarities were identified between the two populations regarding support, namely: (a) Caregivers need personal support in the form of counselling as well as support networks to enable them to deal with the problems they are faced with. (b) Caregivers need financial support to afford basic essentials and better remuneration to meet their financial needs. (c) Caregivers need to be trained in areas in which they lack knowledge -continued development and empowerment is essential. They also need to be trained specifically in PMTCT and they need a PMTCT consultant to always be available to support them. (d) Improvement of the PMTCT services by providing transport to follow up mothers, protective resources to protect themselves against infections as they are at risk of infections, water is essential as a basic human right, provision with food parcels to mothers who are poverty stricken and the PMTCT health services to be intensified from the antenatal period. (e) Management to establish a caring environment by displaying a caring attitude, respecting them and providing them with rewards to improve morale and performance. Recommendations were made for the fields of nursing education, nursing research and community health practice with recommendations to establish a structure of support for caregivers to enhance the PMTCT programme during puerperium. These recommendations were discussed under the five themes presented above. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2010.