Understanding the Health System Barriers to the Prevention of Mother-to-Child Transmission (PMTCT) of HIV Services in Fiji

Abstract

Abstract Introduction: Mother-to-child transmission (MTCT) is the leading cause of HIV in children, yet it is largely preventable with timely care. In low- and middle-income countries, limited infrastructure hinders effective PMTCT programs, leading to avoidable HIV infections.

Objectives: This research examines health system barriers faced by healthcare workers in delivering PMTCT of HIV services in three Fijian divisional hospitals and associated clinics, and their impact on service provision.

Methods: I used both qualitative and 1uantitative approach to examine health system barriers to PMTCT of HIV services. Qualitative data were collected through 58 in-depth interviews with purposively selected healthcare workers from three divisional hospitals and analysed inductively. Quantitative analysis used secondary data from Fiji’s 2021 MICS to assess HIV transmission knowledge among women of reproductive age, employing univariate and logistic regression analyses in STATA/BE 17.

Results: I found that staff shortages, limited training and supplies, workplace tensions, lack of cooperation, and fear of HIV infection hindered PMTCT service quality. Quantitative analysis showed low knowledge of HIV transmission among reproductive-aged women in Fiji. These findings are detailed in separate chapters of the dissertation.

Conclusion: The findings of this thesis underscore the need to address health system barriers to preventing mother-to-child transmission (PMTCT) of HIV in Fiji. Regular monitoring of HIV test supplies and PPE, standardized PMTCT training for all healthcare workers, and improved collaboration between NGO and government staff are essential. Targeted educational campaigns for young women (15–24) in the Western region can also enhance awareness. These insights can guide policymakers and stakeholders in strengthening PMTCT services in Fiji and similar contexts.