INTEGRATING PMTCT WITH MNCH SERVICES AT HEALTH FACILITIES

Transcription

1 INTEGRATING PMTCT WITH MNCH SERVICES AT HEALTH FACILITIES By: Dr. Maureen Kwikiriza Host mentors: Dr. Francis Engwau and Dr. David Serukka Academic mentor: Dr. Elizabeth Nabiwemba Roving mentors: Dr. Noerine Kaleeba, Dr. Olico Okui End of Fellowship report: 22 nd March 2013

2 Background about PREFA Local NGO formed in 2004 to contribute to Uganda s effort in enhancing access to quality PMTCT services Funded by PEPFAR through CDC PREFA support includes:- capacity building hire, train, Mentor and coach Health workers infrastructure improvement facility based PMTCT service delivery monitoring

3 Activities/implementation Uptake Inform Terms of Reference and Achievements -MNCH/HIV Quality of care improvement tool NATIONAL LEVEL: Policy/Guidelines -Document review -Rapid assessment -Consultations -Train H/W -Technical support FACILITY LEVEL: Develop and implement integration plan for PMTCT /MNCH services IPS BEST PRACTICES: Document and share -Draft roles of VHTS -Train VHTS -Form FSGs COMMUNITY LEVEL: Improve linkages

4 Best practices Participatory assessment and monitoring of integrated PMTCT and Postnatal care services Exchange learning visits for health workers Provide the data tools and orient health workers on recording Timely dissemination of the new guidelines

5 Documents developed

6 Other activities Program Officer for 3 months Participated in developing PREFA strategic plan Participated in developing protocols: PREFA M&E protocol and the BABIES surveillance protocol Coordinated events to mark 2011 World AIDS day Provided technical Support to Gender department Member of the Comm. and Advocacy subcommittee for the Paediatric HIV/AIDS conference

7 Publications News paper articles: 5/6 articles published in New Vision paper Oral presentations: Early infant diagnosis an opportunity for timely provision of effective care and treatment: PREFA experience from PMTCT-EID program, Wakiso district Manuscript: Readiness of Public Health Facilities to Implement Integrated PMTCT and postnatal care in Uganda: Results from a Facility Assessment Study (submitted to BMC-Health Services Research)

8 Programmatic activity Title: Integrating PMTCT with post natal care services in Uganda: Process Documentation and monitoring outputs Background Uptake of PMTCT services during PNC services remains low despite high immunization coverage Integrating PMTCT with PNC service will improve service delivery PREFA thus piloted integration of PMTCT and PNC in Wakiso and Nakasongola districts.

9 Objectives 1. To document the processes leading to implementation of integrated PMTCT and PNC services 2. To monitor progress of outputs following the implementation of integrated PMTCT and PNC services 3. To identify best practices for PMTCT and PNC integration

10 Steps involved in implementation of integrated PMCT/PNC services Participatory assessment phase 1. Orientation workshop on assessment framework and tools 2. Complete assessment of facilities including interviews with health workers and observation of facility functioning 3. Collection of routine PMTCT data from registers. Feedback and planning phase 1. Review of assessment results 2. Identification of areas of weakness 3. Target setting and action plans Implementation and monitoring phase 1. Planned interventions implemented 2. Monthly support visits by the task force to determine progress towards targets Implemented at four health facilities from May to August 2012

11 120% PMTCT indicator performance following integration (Nakasongola HC IV 2012) 100% 80% 60% 40% 20% <18 months done 1st PCR Infants received results PCR results HIV+ women received any FP method HIV+ mothers followed up in community 0% April May June July August September

12 Lessons learnt Rapid assessment gives insight of the challenges particular to a health facility Data driven implementation of integrated PMCT / PNC services increases uptake of PMTCT interventions.

13 Way forward Manager HIV or MNCH program Write abstracts More publications

14 Challenges Program different from research Solutions Be open and willing to learn Working with district Learn to be patient

15 Acknowledgements My Mentors Fellow Fellows PREFA staff Health workers DHO Fellowship program staff Family

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