Preventing Mother-to-Child Transmission of HIV in Western Kenya

Anna H van??t Hoog, Dorothy A Mbori-Ngacha, Lawrence H Marum, Juliana A Otieno, Ambrose O Misore, Lucy W Nganga, Kevin M DeCock
2005 Journal of Acquired Immune Deficiency Syndromes  
Objectives: To improve uptake in a program to prevent mother-tochild HIV transmission and describe lessons relevant for prevention of mother-to-child transmission programs in resource-poor settings. Methods: Implementation of a pilot project that evaluates approaches to increase program uptake at health facility level at New Nyanza Provincial General Hospital, a public hospital in western Kenya, an area with high HIV prevalence. Client flow was revised to integrate counseling, HIV testing, and
more » ... ispensing of single-dose nevirapine into routine antenatal services. The number of facilities providing PMCT services was expanded to increase district-wide coverage. Main outcome measures were uptake of counseling, HIV testing, nevirapine, and estimated program impact. Results: Uptake of counseling and testing improved from 55 to 68% (P , 0.001), nevirapine uptake from 57% to 70% (P , 0.001), and estimated program impact from 15% to 23% (P = 0.03). Aggregate reports compare well with computer-entered data. Conclusion: Addressing institutional factors can improve uptake, but expected program impact remains low for several reasons, including relatively low efficacy of the intervention and missed opportunities in the labor room.
doi:10.1097/01.qai.0000160712.86580.ff pmid:16249710 fatcat:6bm2ile3nnbfzct6i7hamkyq7e