PMTCT, and National's - Health Systems Trust

AIM OF THE EVALUATION
METHODOLOGY AND DESIGN
The overall aim of the evaluation was to assess the performance and uptake of the PMTCT
programme in the eighteen pilot sites and to describe the processes underway in the provinces
to expand the PMTCT programme beyond the original pilot sites.
SPECIFIC OBJECTIVES
• To assess implementation of the components of the programme in the original pilot
sites.
• To assess uptake of the programme components in the pilot sites.
• To analyse routine information collected in the 18 PMTCT pilot sites.
• To evaluate PMTCT management at the provincial and national level.
• To describe progress with the scaling up of PMTCT services in nine provinces.
• To make policy recommendations to enhance the functioning of PMTCT services.
RESEARCH DESIGN
The evaluation utilised a cross-sectional design that incorporated both qualitative and quantitative
research methods. The evaluation covers the period January to December 2002. Data was
collected at district, provincial and national levels by one HST staff member and three external
consultants. Two of the researchers were also involved in the first evaluation.
SAMPLING FRAME
In each of the nine provinces one pilot site hospital and one feeder clinic were visited. The
same hospital and clinic that were visited for the first evaluation (covering the period January
to December 2001) were selected for this repeat evaluation in order to assess progress over
time.
DATA COLLECTION METHODS
Data collection methods utilised in this evaluation included individual interviews, document
review, participant observation and review of routine monthly PMTCT data.
Two questionnaires were developed for the evaluation, one for the facility level, and the other
for the provincial level. The site questionnaire addressed management, training, counselling
and testing, antenatal care, infant feeding, monitoring and follow up, procurement of supplies
and community involvement. The provincial questionnaire addressed provincial management,
information management, plans for expansion of the programme, and expenditure.
At the facilities visited, individual interviews were conducted with health care workers (mostly
midwives) in contact with antenatal clients, lay counsellors, nutrition advisors, hospital matrons
and doctors. Individual interviews were conducted at the provincial level with the HIV director,
PMTCT co-ordinator, MCWH co-ordinator and information officers. A review of documentation
such as provincial roll-out plans, training plans, and financial reports was also undertaken.
In order to ensure standardisation amongst researchers, the same tools were used in all
provinces and the same categories of health workers were interviewed across all provinces.
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