Eliminating Mother-to-Child
Transmission of HIV/AIDS
Current Situation
Advanced efforts have been made by several African countries to eliminate mother to child transmission of HIV with many southern African countries achieving over 80% coverage of antiretroviral (ARV) prophylaxis.
By contrast, West and Central Africa continue to lag at 16%-44% coverage. Nigeria alone accounts for 32% of the countries under 80% coverage, the Democratic Republic of Congo a far second at 7%. Though there has been notable progress in the incidence of pediatric HIV in the country, Nigeria presently carries the highest burden of new infections among the global priority countries in 2013 – nearly 51,000.
Priority Public Health Programs
Our Approach
HSDF collaborated with some states in Nigeria (Akwa Ibom, Bayelsa, Cross River FCT, Kano, Nasarawa, Plateau, and Rivers) to scale up Elimination of Mother to Child Transmission (eMTCT) sites and improve service provision across private healthcare facilities. This was done to increase the potential for Early Infant Diagnosis (EID) by eliminating unnecessary steps and ensuring early initiation on pediatric antiretroviral therapy.
Unreliable reporting of service-utilization data in private facilities is a major impediment to successful program execution and hinders the availability of data for decision-making. HSDF piloted an EMR tool in 20 high-volume private facilities and demonstrated the potential of streamlining multiple manual reporting forms into a single electronically generated report.
Diagnose
Establish a fact base with quantitative examination of patient needs and service delivery, as well as the gaps between them
Design
Support operational planning by developing simple, concrete, specific, state-led plans and focus on levers that need improvement to achieve rapid scale-up of Elimination of Mother-to-Child Transmission (eMTCT) services
Deliver
Execute the scale-up plan by tracking implementation progress against clear targets through reporting and tracking of performance, trouble-shooting of emerging bottlenecks, and stakeholder alignment and collaboration
Results
We executed the scale up of the Prevention of Mother-to-Child Transmission (PMTCT) of HIV in Nigeria by collaborating with key stakeholders at national and state levels to provide strategic planning, implementation and operational change to the program. We worked in seven of the 12+1 states with the highest burden of HIV in Nigeria to improve access to Early Infant Diagnosis (EID) services as well as to improve the quality of PMTCT data at the state level.
Our educational approach and intervention led to the activation of more elimination of mother-to-child transmission (eMTCT) sites by the state governments and an increase in eMTCT services across private healthcare facilities.
HSDF created a regular forum for partners and state officials, during which progress made and challenges faced in the execution of eMTCT services are discussed. Such fora have now been institutionalized in Akwa-Ibom, Cross River, Rivers, and Bayelsa.
HSDF’s interventions resulted in the listing of more private healthcare facilities on the District Health Information System (DHIS) platform and subsequent improvement in eMTCT data availability for monitoring, evaluation and application for effective decision making