Introduction An estimated 152,000 children in Zimbabwe are living with HIV and more than 17,000 children become infected every year, the majority due to mother-to-child transmission (MTCT). Since 1999 Zimbabwe has been implementing the prevention of mother-to-child transmission (PMTCT) programme, providing pregnant women with free counselling and treatment. A large proportion of Zimbabweans live in rural areas where their only access to medical care is from rural clinics.
Methods Data were gathered during structured interviews using a self-designed questionnaire. Interviews were carried out with nurses at nine rural clinics in the Manicaland province surrounding Mutare.
Results Decentralisation of HIV testing and treatment away from the district hospital was regarded by every interviewed nurse as paramount to improving the accessibility and therefore success of the PMTCT programme. 100% expressed a strong desire to receive training on the handling and prescription of antiretroviral drugs in order to decentralise the PMTCT programme. Surprisingly, 22% of nurses were unaware of the risk of transmission during the second trimester and only 33% believed that HIV testing should be offered on an ‘opt-out’ basis, as opposed to the ‘opt-in’ system currently in place.
Conclusions This project could lead to further development of the PMTCT programme. Lack of knowledge in certain areas, as well as the monopoly of the district hospital over CD4 tests and commencement of treatment, are the main barriers to improvement.