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Identifying and Prioritizing Implementation Barriers, Gaps, and Strategies Through the Nigeria Implementation Science Alliance: Getting to Zero in the Prevention of Mother-to-Child Transmission of HIV
Open accessAbstract
Background: In 2013, Nigeria accounted for 15% of the 1.3 million pregnant women living with HIV in sub-Saharan Africa and 26% of new infections among children worldwide. Despite this, less than 20% of pregnant women in Nigeria received an HIV test during pregnancy, and only 23% of HIV-infected pregnant women received appropriate intervention following HIV diagnosis. This article reports findings from 2 structured group exercises conducted at the first Nigeria Implementation Science Alliance Conference to identify (1) barriers and research gaps related to prevention of mother-to-child transmission (PMTCT) and (2) potential strategies and interventions that could address PMTCT challenges. Methods: Two 1-hour structured group exercises were conducted with 10 groups of 14–15 individuals (n = 145), who were asked to brainstorm barriers and strategies and to rank their top 3 in each category. Data analysis eliminated duplicate responses and categorized each of the priorities along the HIV care continuum: HIV diagnosis, linkage to care, or retention in care. Results: Participating stakeholders identified 20 unique barriers and research gaps related to PMTCT across the HIV continuum. Twenty-five unique interventions and implementation strategies were identified. Similar to the barriers and research gaps, these interventions and strategies were distributed across the HIV care continuum. Conclusions: The barriers and strategies identified in this study represent important pathways to progress addressing MTCT. The deliberate involvement of state and federal policy makers, program implementers, and researchers helps ensure that they are relevant and actionable.
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“the rates are several times higher in practice because of the high drop-out rates of HIV-positive women along the PMTCT care cascade [1-3,6-9].”
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Powell, B. J., Waltz, T. J., Chinman, M. J., Damschroder, L. J., Smith, J. L., Matthieu, M. M., Proctor, E. K., & Kirchner, J. E. (2015) · Implementation Science · doi:10.1186/s13012-015-0209-1 · Cited by 4,963
Self-citationImplementation strategies: recommendations for specifying and reporting
Proctor, E. K., Powell, B. J., & McMillen, J. C. (2013) · Implementation Science · doi:10.1186/1748-5908-8-139 · Cited by 2,585
Self-citationFlottorp, S. A., Oxman, A. D., Krause, J., Musila, N. R., Wensing, M., Godycki-Cwirko, M., Baker, R., & Eccles, M. P. (2013) · Implementation Science · doi:10.1186/1748-5908-8-35 · Cited by 1,138
Methods to Improve the Selection and Tailoring of Implementation Strategies
Powell, B. J., Beidas, R. S., Lewis, C. C., Aarons, G. A., McMillen, J. C., Proctor, E. K., & Mandell, D. S. (2017) · The Journal of Behavioral Health Services & Research · doi:10.1007/s11414-015-9475-6 · Cited by 967
Self-citationIndividual determinants of research utilization by nurses: a systematic review update
Squires, J. E., Estabrooks, C. A., Gustavsson, P., & Wallin, L. (2011) · Implementation Science · doi:10.1186/1748-5908-6-1 · Cited by 798
Kontos, P. C., & Poland, B. D. (2009) · Implementation Science · doi:10.1186/1748-5908-4-1 · Cited by 760
An implementation research agenda
Eccles, M. P., Armstrong, D., Baker, R., Cleary, K., Davies, H., Davies, S., Glasziou, P., Ilott, I., Kinmonth, A.-L., Leng, G., et al. (2009) · Implementation Science · doi:10.1186/1748-5908-4-18 · Cited by 481
Pai, M., Lloyd, N. S., Cheng, J., Thabane, L., Spencer, F. A., Cook, D. J., Haynes, R. B., Schünemann, H. J., & Douketis, J. D. (2013) · Implementation Science · doi:10.1186/1748-5908-8-1 · Cited by 376
Tailored Implementation for Chronic Diseases (TICD): a project protocol
Wensing, M., Oxman, A., Baker, R., Godycki-Cwirko, M., Flottorp, S., Szecsenyi, J., Grimshaw, J., & Eccles, M. (2011) · Implementation Science · doi:10.1186/1748-5908-6-103 · Cited by 184
Pagoto, S., Spring, B. J., Coups, E. J., Mulvaney, S. A., Coutu, M., & Özakinci, G. (2007) · Journal of Clinical Psychology · doi:10.1002/jclp.20376 · Cited by 183
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The Lancet Nigeria Commission: investing in health and the future of the nation
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Self-citationNigeria Implementation Science Alliance, Ezeanolue, E. E., Menson, W. N. A., Patel, D. V., Aarons, G. A., Olutola, A., Obiefune, M. C., Dakum, P., Okonkwo, P., Gobir, I. B., et al. (2018) · Health Research Policy and Systems · doi:10.1186/s12961-018-0289-x · Cited by 46
Self-citationOlakunde, B. O., Adeyinka, D. A., Olawepo, J. O., Pharr, J. R., Ozigbu, C. E., Wakdok, S., Oladele, T. T., & Ezeanolue, E. E. (2019) · International Health · doi:10.1093/inthealth/ihz018 · Cited by 42
Self-citationAfolabi, B. B., Babah, O. A., Akinajo, O. R., Adaramoye, V. O., Adeyemo, T. A., Balogun, M. R., Banke-Thomas, A. O., Quao, R. A., Olorunfemi, G., Abioye, A. I., et al. (2022) · Trials · doi:10.1186/s13063-022-06690-2 · Cited by 39
Sam-Agudu, N. A., Pharr, J. R., Bruno, T., Cross, C. L., Cornelius, L. J., Okonkwo, P., Oyeledun, B., Khamofu, H., Olutola, A., Erekaha, S. C., et al. (2017) · Trials · doi:10.1186/s13063-017-2347-z · Cited by 36
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Metadata
- Authors
- Ezeanolue, E. E., Powell, B. J., Patel, D., Olutola, A., Obiefune, M., Dakum, P., Okonkwo, P., Gobir, B., Akinmurele, T., Nwandu, A., Torpey, K., Oyeledum, B., Aina, M., Eyo, A., Oleribe, O., Ibanga, I., Oko, J., Anyaike, C., Idoko, J., Aliyu, M. H., Sturke, R., Watts, H., Siberry, G., & the Nigeria Implementation Science Alliance
- Affiliations
- University of Nevada, Las Vegas (US)
- University of North Carolina at Chapel Hill (US)
- Center for Clinical Care and Research in Nigeria (NG)
- University of Maryland, Baltimore (US)
- Institute of Human Virology (NG)
- Harvard University (US)
- Maryland Global Initiatives Corporation, Baltimore, MD;
- Enhanced Health Access Initiatives, Abuja, Nigeria;
- Nigerian Geological Survey Agency (NG)
- Centre for Integrated Health Programs (NG)
- Solina Health, Abuja, Nigeria;
- Excellence Community Education Welfare Scheme (NG)
- Excellence and Friends Management Consult, Abuja, Nigeria;
- Pro Health International (NG)
- Caritas Nigeria (NG)
- Federal Ministry of Health (NG)
- National Agency for the Control of AIDS (NG)
- Vanderbilt University Medical Center (US)
- National Institutes of Health (US)
- United States Department of State (US)
- Corresponding author
- Ezeanolue, Echezona E.
- ORCID
- Venue
- JAIDS Journal of Acquired Immune Deficiency Syndromes
- Published
- 2016-08-01
- Volume
- 72
- Issue
- 2
- Pages
- S161-S166
- ISSN
- 1525-4135 (ISSN-L)
- PMC
- PMC5113249
- OpenAlex
- W2467095440
- Cited by
- 37
- References
- 18
- Citations by year
- 2026: 1 · 2024: 6 · 2023: 1 · 2022: 8 · 2021: 2 · 2020: 5 · 2019: 3 · 2018: 4 · 2017: 4 · 2016: 2
- FWCI
- 4.00
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- JAIDS Journal of Acquired Immune Deficiency Syndromes (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Digital Scholarship - UNLV (University of Nevada Reno) (submittedVersion, cc-by-nc-nd)
- Funders
- U.S. Department of State
- U.S. President’s Emergency Plan for AIDS Relief (R01HD075050)
- National Institutes of Health (UL1TR001111, UL1TR002489)
- National Institute of Mental Health
- National Institute of Child Health and Human Development
- National Center for Advancing Translational Sciences
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD075050, R01HD075075)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Keywords
- prevention of mother-to-child transmission of HIV, implementation barriers, research gaps, implementation strategies, HIV care continuum, linkage to care, retention in care, pregnant women living with HIV, Nigeria, stakeholder prioritization, HIV/AIDS policy
- MeSH terms
- Female, Health Priorities, Health Services Research, Humans, Infant, Newborn, Nigeria, Pregnancy, Pregnancy Complications, Infectious, HIV Infections, Infectious Disease Transmission, Vertical, Anti-HIV Agents
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