Healthcare Infrastructure and Resource Barriers to Preventing Mother-to-Child Transmission of HIV in Ghana: Insights from a Qualitative Study.

BACKGROUND

The prevention of the mother-to-child transmission (PMTCT) of HIV is a vital strategy in reducing paediatric HIV infections. However, the delivery of PMTCT services is frequently impeded by resource constraints within the healthcare systems. This study investigates the systemic barriers affecting PMTCT implementation in Ghana and examines the disconnection between health policy design, priority setting, and on-the-ground realities.

METHODS

The study employed the qualitative approach using a case study research design. The purposive sampling technique was used in selecting the health facilities, with an in-depth interview guide used to solicit views from healthcare providers and mothers participating in PMTCT services. Braun and Clarke's thematic analysis was employed in analysing the data on the perceptions of infrastructural and resource-related challenges affecting PMTCT services.

RESULTS

Participants identified several key barriers, including the absence of dedicated office spaces, a limited outpatient department (OPD) capacity, inadequate storage for antiretroviral therapy (ART) medications, and shortages of HIV-testing equipment affecting care delivery and access. These issues, alongside workforce limitations and supply chain disruptions, were found to significantly undermine the delivery and effectiveness of PMTCT services.

CONCLUSIONS

The study underscores the need for context-aware health policy development. Effective priority setting and benefits package design must be informed by frontline insights, taking into account infrastructural deficits, human resource constraints, and systemic bottlenecks. Aligning national initiatives, such as the StEPS programme, with operational realities is essential for enhancing PMTCT outcomes.