Sociocultural, Health System, and Structural Barriers to Scale-up Community PMTCT in Nigeria: A Qualitative Study

My research is a qualitative study that examines why community-based prevention of mother-to-child transmission (PMTCT) services have been difficult to implement and scale in Nigeria, despite expanded policies and donor investment. Using focus group discussions with pregnant women, mentor mothers, traditional birth attendants, and community health workers in Akwa Ibom and Taraba states, our study explores how sociocultural and religious norms, individual knowledge and household dynamics, health system capacity, community–facility integration, and economic and governance constraints interact to shape HIV and syphilis testing, treatment initiation, and retention in care. By situating these experiences within the RISE community PMTCT model, the research provides context-rich evidence on why implementation gaps persist and identifies system-level and community-informed priorities for achieving elimination of mother-to-child transmission in high-burden, resource-constrained settings.