Community-Based Support Systems and Health System Gaps Affecting Viral Load Follow-up in Pmtct Programs in Cameroon: A Narrative Review
Abstract:
Viral load monitoring remains an essential component of Prevention of Mother-to-Child Transmission (PMTCT) programs because it supports treatment monitoring, promotes viral suppression, and reduces the risk of HIV transmission from mother to child. However, continuity of viral load follow-up among pregnant and breastfeeding women living with HIV continues to face several challenges in Cameroon. This narrative review examined community-based support systems and health system gaps affecting viral load follow-up within PMTCT programs in Cameroon. A narrative review approach was used to synthesize evidence from quantitative studies, qualitative studies, mixed-method research, technical reports, and policy documents published between 2010 and 2026. Electronic databases including PubMed, Google Scholar, Scopus, African Journals Online, and Web of Science were searched alongside reports from the World Health Organization, UNAIDS, and the Cameroon National AIDS Control Committee. The review identified delayed laboratory result turnaround time, shortage of healthcare personnel, weak patient tracking systems, stigma, transportation difficulties, poor male partner involvement, and insecurity in conflict-affected regions as barriers affecting continuity of viral load monitoring. Community-based interventions such as mentor mother programs, peer support groups, community health worker follow-up, adherence counseling, and mobile phone reminders were found to improve retention in care, adherence to antiretroviral therapy, and continuity of PMTCT follow-up services. The review concludes that strengthening healthcare systems alongside expansion of community-based support interventions may improve viral load follow-up and PMTCT outcomes in Cameroon. Further implementation research is needed to evaluate context-specific approaches for improving continuity of HIV care among pregnant and breastfeeding women.References:
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