TITLE

Improving the coverage of the PMTCT programme through a participatory quality improvement intervention in South Africa

AUTHOR(S)
Doherty, Tanya; Chopra, Mickey; Nsibande, Duduzile; Mngoma, Dudu
PUB. DATE
January 2009
SOURCE
BMC Public Health;2009, Vol. 9 Issue 1, p406
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Despite several years of implementation, prevention of mother-to-child transmission (PMTCT) programmes in many resource poor settings are failing to reach the majority of HIV positive women. We report on a data driven participatory quality improvement intervention implemented in a high HIV prevalence district in South Africa. Methods: A participatory quality improvement intervention was implemented consisting of an initial assessment undertaken by a team of district supervisors, workshops to assess results, identify weaknesses and set improvement targets and continuous monitoring to support changes. Results: The assessment highlighted weaknesses in training and supervision. Routine data revealed poor coverage of all programme indicators except HIV testing. Monthly support to all facilities took place including an orientation to the PMTCT protocol, review of local data and identification of bottlenecks to optimal coverage using a continuous quality improvement approach. One year following the intervention large improvements in programme indicators were observed. Coverage of CD4 testing increased from 40 to 97%, uptake of maternal nevirapine from 57 to 96%, uptake of infant nevirapine from 15 to 68% and six week PCR testing from 24 to 68%. Conclusion: It is estimated that these improvements in coverage could avert 580 new infant infections per year in this district. This relatively simple participatory assessment and intervention process has enabled programme managers to use a data driven approach to improve the coverage of this important programme.
ACCESSION #
47321917

 

Related Articles

  • Maternal 12-Month Response to Antiretroviral Therapy following Prevention of Mother-to-Child Transmission of HIV Type 1, Ivory Coast, 2003-2006. Coffie, Patrick A.; Ekouevi, Didier K.; Chaix, Marie-Laure; Tonwe-Gold, Besigin; Clarisse, Amani-Bosse; Becquet, S Renaud; Viho, Ida; N'dri-Yoman, Therese; Leroy, Valériane; Abrams, Elaine J.; Rouzioux, Christine; Dabis, François // Clinical Infectious Diseases;2/15/2008, Vol. 46 Issue 4, p611 

    Objective. Our aim was to study the response to antiretroviral treatment among women exposed to single-dose nevirapine (NVP) and/or short-course zidovudine (ZDV; with or without lamivudine [3TC]) for the prevention of mother-to-child transmission of human immunodeficiency virus (HIV) infection....

  • Safety of Agents Used to Prevent Mother-to-Child Transmission of HIV: Is There Any Cause for Concern? Thorne, Claire; Newell, Marie-Louise // Drug Safety;2007, Vol. 30 Issue 3, p203 

    Antiretroviral drugs have been used routinely to reduce the risk of mother-to-child transmission of HIV infection since 1994, following the AIDS Clinical Trials Group 076 trial, which demonstrated the efficacy of zidovudine in reducing the risk of in utero and intrapartum transmission. The use...

  • Predictors of Attrition Among High Risk HIV-Infected Participants Enrolled in a Multi-Site Prevention Trial. Johnson, Mallory O.; Dilworth, Samantha E.; Neilands, Torsten B.; Chesney, Margaret A.; Rotheram-Borus, Mary Jane; Remien, Robert H.; Weinhardt, Lance; Ehrhardt, Anke A.; Morin, Stephen F. // AIDS & Behavior;Nov2008, Vol. 12 Issue 6, p974 

    Retaining high-risk individuals is critical for HIV prevention trials. The current analyses examined predictors of trial dropout among HIV-infected men and women in a multi-site HIV prevention trial. Results indicated that dropouts ( n = 74) were more likely to be younger, depressed, and not...

  • Criminal Law and HIV Transmission/Exposure: Another Swedish Case. Elliott, Richard // Canadian HIV/AIDS Policy & Law Review;Apr2003, Vol. 8 Issue 1, p77 

    Focuses on the criminal prosecution of a Swedish woman with HIV who was found guilty of having unprotected sex with several men without disclosing her status. Sentence and fine imposed against the woman; Protest launched by Act Up-Paris against the decision.

  • Increasing Support for Contraception as HIV Prevention: Stakeholder Mapping to Identify Influential Individuals and Their Perceptions. Petruney, Tricia; Harlan, Sarah V.; Lanham, Michele; Robinson, Elizabeth T. // PLoS ONE;2010, Vol. 5 Issue 5, p1 

    Background: Voluntary contraceptive use by HIV-positive women currently prevents more HIV-positive births, at a lower cost, than anti-retroviral drug (ARV) regimens. Despite this evidence, most prevention of mother-to-child transmission (PMTCT) programs focus solely on providing ARV prophylaxis...

  • Risk Factors for In Utero or Intrapartum Mother-to-Child Transmission of Human Immunodeficiency Virus Type 1 in Thailand. Jourdain, Gonzague; Mary, Jean-Yves; Le Coeur, Sophie; Ngo-Giang-Huong, Nicole; Yuthavisuthi, Praparb; Limtrakul, Aram; Traisathit, Patrinee; McIntosh, Kenneth; Lallemant, Marc // Journal of Infectious Diseases;12/1/2007, Vol. 196 Issue 11, p1629 

    Background. The identification of risk factors for in utero and intrapartum transmission of human immunodeficiency virus type 1 (HIV-1) is crucial to the design and understanding of preventive interventions. Methods. The randomized Perinatal HIV Prevention Trial-1 enrolled 1437 pregnant women...

  • $6 million settlement in medical negligence case. Betteridge, Glenn // HIV/AIDS Policy & Law Review;May2007, Vol. 12 Issue 1, p46 

    The article presents a case of a mother against three physicians who claims that their negligence resulted in her child contracting human immunodeficiency virus (HIV) around the time of the child's birth. The mother alleged that the physicians failed to advice her to prevent HIV transmission on...

  • Babies of a pandemic. Stein, A.; Krebs, G.; Richter, L.; Tomkins, A.; Rochat, T.; Bennish, M. L. // Archives of Disease in Childhood;Feb2005, Vol. 90 Issue 2, p116 

    This article presents information on the effects of maternal HIV on infant development. With this recognition of the high prevalence of HIV in pregnant women in parts of sub-Saharan Africa, major efforts have been directed at developing and implementing interventions to prevent mother-to-child...

  • Pregnancy and Optimal Care of HIV-Infected Patients. Anderson, Brenna L.; Cu-Uvin, Susan // Clinical Infectious Diseases;2/15/2009, Vol. 48 Issue 4, p449 

    Human immunodeficiency virus (HIV) infection during pregnancy is a condition that requires multidisciplinary care. Care must be rendered that is appropriate for both the mother and the fetus. Prevention of mother-to-child transmission of HIV is of paramount concern. To prevent transmission,...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics