Paper short abstract:

We look at site-level deficiencies (spatiality, mobility and transportation) to understand why prevention of mother-to-child transmission (PMTCT) interventions are not increasing as fast as expected.

Paper long abstract:

Over the past few years global health initiatives have made significant financial resources available for scaling-up antiretroviral treatment (ART), including PMTCT programmes. However, the percentage of women involved in prevention of mother-to-child transmission (PMTCT) interventions is not increasing as fast as expected (UNAIDS, 2014). The problems and challenges stated since the beginning of the 2000s are still relevant. Anand, Shiraishi & al. remarked that evaluations of PMTCT programmes have focused on the role of behavioral factors whereas efforts should also investigate the role of site-level deficiencies (Anand, Shiraishi et al. 2009). That's the path we want to follow. In line with certain authors (Campbell, Cornish et al. 2012; Jewkes and Morrell 2012), we advance a position that acknowledges both the domination of the changing global policies and knowledge regarding PMTCT, and the agency of local actors in negotiating or resisting these policies. We describe PMTCT programme as a changing field; then we consider the materiality and spatiality of our study site in terms of mobility and transportation, and show how its (dis)connections from its surroundings limit the appropriation of new guidelines and constrain the provision of supplies as well as the agency of local actors in negotiating or resisting these policies in ways that fit their values or maintain their professional routines.