The Prevention of Mother-to-Child HIV Transmission - Costing the Service in Four Sites in South Africa

Desmond, Chris
Other Authors: 
Franklin L Steinberg M
Published by: 
Health Systems Trust

The maturity of the HIV/AIDS epidemic in South Africa has brought competing agendas for prevention and impact mitigation to the table. Given the countrys resource constraints it is imperative that any interventions are thoroughly assessed for their efficacy, costs and benefits.

The challenge to succeed with primary prevention of new infections remains the key long-term solution to the epidemic. Many also believe that a PMTCT programme provides a boost to other HIV/AIDS prevention and care and support programmes. For example, PMTCT programmes help identify HIV-positive women, their partners and their HIV infected children for care and support interventions. By promoting VCT and disclosure of HIV status, they can act as a vanguard for the destigmatisation of the disease.

Ensuring the availability of resources for delivering this intervention in a cost-effective and sustained manner remains a challenge. This report contributes to this by providing an assessment of the cost side of this equation. This research is part of a larger evaluation of the pilot PMTCT programme in South Africa, and has been commissioned by the Health Systems Trust on behalf of the Department of Health.

The specific objectives of the research were to:

  • Undertake a costing exercise of the national PMTCT protocol in four purposively selected national PMTCT pilot sites
  • Assess sources of funding for the PMTCT intervention
  • Provide a range of costing data for informing the funding requirements of a national roll out of the PMTCT programme
  • Provide a range of costing data that can be used for policy, planning and management purposes.


Data from this research were fed back to the Directorates of Financing and HIV/AIDS as soon as they became available at the end of 2002. Some of these data have already been used to inform government plans and budgets. This report is now being released to the broader public in order to help raise general awareness about the value and limitations of costing studies, and also because some of the findings have on-going relevance to current PMTCT services and provision of antiretroviral therapy (ART) on a large scale.

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