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Background Context-specific factors influence adherence to antiretroviral therapy (ART) among pregnant women living with HIV. Gaps exist in the understanding of the reasons for the variable outcomes of the prevention of mother-to-child transmission (PMTCT) programme at the health facility level in South Africa. This study examined adherence levels and reasons for non-adherence during pregnancy in a cohort of parturient women enrolled in the PMTCT programme in the Eastern Cape, South Africa. Methods This was a mixed-methods study involving 1709 parturient women in the Eastern Cape, South Africa. We conducted a multi-centre retrospective analysis of the mother-infant pair in the PMTCT electronic database in 2016. Semi-structured interviews of purposively selected parturient women with self-reported poor adherence ( n  = 177) were conducted to gain understanding of the main barriers to adherence. Binary logistic regression was used to determine the independent predictors of ART non-adherence. Results A high proportion (69.0%) of women reported perfect adherence. In the logistic regression analysis, after adjusting for confounding factors, marital status, cigarette smoking, alcohol use and non-disclosure to a family member were the independent predictors of non-adherence. Analysis of the qualitative data revealed that drug-related side-effects, being away from home, forgetfulness, non-disclosure, stigma and work-related demand were among the main reasons for non-adherence to ART. Conclusions Non-adherence to the antiretroviral therapy among pregnant women in this setting is associated with lifestyle behaviours, HIV-related stigma and ART side-effects. In order to eliminate mother-to-child transmission of HIV, clinicians need to screen for these factors at every antenatal clinic visit.

Aim This study assessed the contributions of the healthcare expenditure to life expectancy at birth in Nigeria for a period of 18 years (2000–2017). Subject and methods The study adopted an exp post facto research design using time series data that were sourced from the World Bank annual report on the human development indicators. Robust least squares regression was adopted to estimate the model and test the study hypotheses. Results Domestic general government health expenditure, out-of-pocket payment and external health expenditure had respective significant positive effects on life expectancy in Nigeria for the period under review. Specifically, when other variables are held constant, a $1% increase in the domestic general government health expenditure would lead to 6% increase in life expectancy at birth in Nigeria. Similarly, a $1% increase in out-of-pocket health expenditure would lead to 63% enhancement in life expectancy. Moreover, 11% improved life expectancy at birth will depend on a 1% increase in external health expenditure. Conclusions Life expectancy in Nigeria was significantly influenced by the healthcare system funding sources for the past 18 years (2000–2017). However, out-of-pocket payment had the most significant positive effect on life expectancy in the country for the period under review.