In January 2015, the South African National Department of Health released new consolidated guidelines for the prevention of mother to child transmission (PMTCT) of HIV, in line with the World Health Organization's (WHO) PMTCT Option B+. Implementing these guidelines should make it possible to eliminate mother to child transmission (MTCT) of HIV and improve long-term maternal and infant outcomes. The present article summarises the key recommendations of the 2015 guidelines and highlights current gaps that hinder optimal implementation; these include late antenatal booking (as a result of poor staff attitudes towards 'early bookers' and foreigners, unsuitable clinic hours, lack of transport to facilities, quota systems being applied to antenatal clients and clinic staff shortages); poor compliance with rapid HIV testing protocols; weak referral systems with inadequate follow-up; inadequate numbers of laboratory staff to handle HIV-related monitoring procedures and return of results to the correct facility; and inadequate supply chain management, leading to interrupted supplies of antiretroviral drugs. Additionally, recommendations are proposed on how to address these gaps. There is a need to evaluate the implementation of the 2015 guidelines and proactively communicate with ground-level implementers to identify operational bottlenecks, test solutions to these bottlenecks, and develop realistic implementation plans.

中文翻译：

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我们的卫生系统准备好如何实施预防母婴传播的方案B +？

2015年1月，南非国家卫生部根据世界卫生组织（WHO）的PMTCT方案B +发布了新的预防艾滋病毒母婴传播的综合指南。实施这些指南应有可能消除艾滋病毒的母婴传播并改善母婴的长期结局。本文总结了2015年指南的主要建议，并强调了当前阻碍最佳实施的差距；这些包括产前预订晚（由于工作人员对“早期预订者”和外国人的态度不佳，诊所工作时间不适当，设施运输不足，对产前病人实行配额制度以及诊所工作人员短缺）；对快速艾滋病毒检测方案的依从性差；转诊系统薄弱，随访不足；实验室人员不足以处理与艾滋病毒有关的监测程序，并将结果返回给正确的设施；以及供应链管理不足，导致抗逆转录病毒药物的供应中断。此外，提出了有关如何解决这些差距的建议。有必要评估2015年指南的实施情况，并与地面实施者进行积极沟通，以识别运营瓶颈，测试这些瓶颈的解决方案并制定切实可行的实施计划。导致抗逆转录病毒药物的供应中断。此外，提出了有关如何解决这些差距的建议。有必要评估2015年指南的实施情况，并与地面实施者进行积极沟通，以识别运营瓶颈，测试这些瓶颈的解决方案并制定切实可行的实施计划。导致抗逆转录病毒药物的供应中断。此外，提出了有关如何解决这些差距的建议。有必要评估2015年指南的实施情况，并与地面实施者进行积极沟通，以识别运营瓶颈，测试这些瓶颈的解决方案并制定切实可行的实施计划。