Towards health in all policies to prevent mother-to-child transmission of HIV in Nigeria: A systematic Review

Background: Nigeria is one of 22 priority countries that collectively account for 90 percent of all new HIV infections among children.  A policy on the prevention-of-mother-to-child-transmission of HIV (PMTCT) exists in Nigeria, but it remains to be seen whether it will achieve its full potential impact.

Objective: A systematic review was undertaken to examine the effectiveness of the PMTCT policy in Nigeria.

Methods: We searched electronic databases for articles that addressed one of the four national targets for PMTCT: 1) primary prevention of HIV infection in women of reproductive age group and their partners; 2) prevention of unintended pregnancies among HIV positive women; 3) prevention of HIV from HIV infected mothers to their infants; 4) care and support for HIV infected mothers, their infants and family members.

Results: 52 studies met the inclusion criteria. Majority focused on target 3 (n=37, 71%), followed by target 4 (n=8, 15%), target 2 (n=5, 10%), and target 1 (n=2, 4%). Results showed that women of reproductive age are moderately aware and receptive of PMTCT services. The most pertinent barrier to the effectiveness of PMTCT policy is the lack of available, accessible and acceptable PMTCT resources. Other barriers to the effectiveness of PMTCT are health workers maintenance of confidentiality and HIV-related stigma associated with counselling.

Conclusion: Our findings revealed that significant reduction of new HIV infections among children in Nigeria are likely to be achieved when efforts are made to take into account the health and health systems implications of the National PMTCT policy.