Health system barriers to implementation of collaborative TB and HIV activities including prevention of mother to child transmission in South Africa.

摘要: In South Africa, the control of TB and HIV co-infection remains a major challenge despite availability international national guidelines for integration services. This study was undertaken in KwaZulu-Natal, one provinces most affected by both HIV, to identify understand managers' community care workers' (CCWs) perceptions health systems barriers related implementation collaborative TB/HIV activities, including prevention mother child transmission (PMTCT). We conducted 29 in-depth interviews with managers at provincial, district facility level NGOs involved care, as well six focus group discussions CCWs. Thematic analysis transcripts revealed convergence perspectives on process policy directives activities across all categories respondents (i.e. province-, district-, facility- community- based organizations). The majority participants felt that insufficiently consultative leadership political will were lacking. predominant themes include challenges structure organisational culture; management, planning power issues; unequal financing; human resource capacity regulatory problems notably relating scope practice nurses Accelerated PMTCT require address these barriers.