{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T23:02:27Z","timestamp":1781046147044,"version":"3.54.1"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2012,12,26]],"date-time":"2012-12-26T00:00:00Z","timestamp":1356480000000},"content-version":"vor","delay-in-days":269,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"funder":[{"DOI":"10.13039\/100006641","name":"UNICEF","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006641","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of the International AIDS Society"],"published-print":{"date-parts":[[2012,4]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Mother\u2010to\u2010child transmission of HIV can be reduced to&lt;5% with appropriate antiretroviral medications. Such reductions depend on multiple health system encounters during antenatal care (ANC), delivery and breastfeeding; in countries with limited access to care, transmission remains high. In Lesotho, where 28% of women attending ANC are HIV positive but where geographic and other factors limit access to ANC and facility deliveries, a Minimum PMTCT Package was launched in 2007 as an alternative to the existing facility\u2010based approach. Distributed at the first ANC visit, it packaged together all necessary pregnancy, delivery and early postnatal antiretroviral medications for mother and infant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>To examine the availability, feasibility, acceptability and possible negative consequences of the Minimum PMTCT Package, data from a 2009 qualitative and quantitative study and a 2010 facility assessment were used. To examine the effects on ANC and facility\u2010based delivery rates, a difference\u2010in\u2010differences analytic approach was applied to 2009 Demographic and Health Survey data for HIV\u2010tested women who gave birth before and after Minimum PMTCT Package implementation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The Minimum PMTCT Package was feasible and acceptable to providers and clients. Problems with test kit and medicine stock\u2010outs occurred, and 46% of women did not receive the Minimum PMTCT Package until at least their second ANC visit. Providing adequate instruction on the use of multiple medications represented a challenge. The proportion of HIV\u2010positive women delivering in facilities declined after Minimum PMTCT Package implementation, although it increased among HIV\u2010negative women (difference\u2010in\u2010differences=14.5%, <jats:italic>p<\/jats:italic>=0.05). The mean number of ANC visits declined more among HIV\u2010positive women than among HIV\u2010negative women after implementation, though the difference was not statistically significant (<jats:italic>p<\/jats:italic>=0.09). Changes in the percentage of women receiving\u22654 ANC visits did not differ between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>If supply issues can be resolved and adequate client educational materials provided, take\u2010away co\u2010packages have the potential to increase access to PMTCT commodities in countries where women have limited access to health services. However, efforts must be made to carefully monitor potential changes in ANC visits and facility deliveries, and further evaluation of adherence, safety and effectiveness are needed.<\/jats:p><\/jats:sec>","DOI":"10.7448\/ias.15.2.17326","type":"journal-article","created":{"date-parts":[[2012,12,27]],"date-time":"2012-12-27T09:22:23Z","timestamp":1356600143000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Lesotho's Minimum PMTCT Package: lessons learned for combating vertical HIV transmission using co\u2010packaged medicines"],"prefix":"10.1002","volume":"15","author":[{"given":"Lotus","family":"McDougal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mpolai M","family":"Moteetee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence","family":"Mohai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malisebo","family":"Mphale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binod","family":"Mahanty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blandinah","family":"Motaung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Ankrah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makaria","family":"Reynolds","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Legins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Appolinaire","family":"Tiam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chewe","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig","family":"McClure","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Binkin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,12,26]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Antiretroviral drugs for treating pregnant women and preventing HIV infection in infants: towards universal access: recommendations for a public health approach\u20142006 version","author":"World Health Organization","year":"2006"},{"key":"e_1_2_9_3_1","volume-title":"Antiretroviral drugs for treating pregnant women and preventing HIV infection in infants: recommendations for a public health approach\u20142010 version","author":"World Health Organization","year":"2010"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/1478-7547-9-3"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2010.02733.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000180102.88511.7d"},{"issue":"4","key":"e_1_2_9_7_1","first-page":"1","article-title":"Community strategies that improve care and retention along the prevention of mother\u2010to\u2010child transmission of HIV cascade: a review","volume":"15","author":"Marcos Y","year":"2012","journal-title":"J Int AIDS Soc"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.3402\/gha.v2i0.1883"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1099-1050(199607)5:4<333::AID-HEC202>3.0.CO;2-K"},{"issue":"4","key":"e_1_2_9_10_1","first-page":"438","article-title":"Overcoming access barriers for facility\u2010based delivery in low\u2010income settings: insights from Bangladesh and Uganda","volume":"24","author":"Parkhurst JO","year":"2006","journal-title":"J Health Popul Nutr"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1526-9523(02)00421-X"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/1742-6405-8-10"},{"key":"e_1_2_9_13_1","unstructured":"AIDSInfo [database on the Internet].UNAIDS.2011[cited 2011 Dec 30]. 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