Eliminating MTCT (Mother to Children Transmission) at scale: A six country collaboration using performance improvement methods

Background: The Partnership for HIV Free Survival  (PHFS) is a six-country initiative in Sub-Saharan Africa which aims to accelerate the adoption and implementation of Prevention of Mother to Children Transmission (PMTCT) programs and accompanying HIV and infant feeding guidelines. Using Quality Improvement methods and the NACS framework, the initiative focuses on postnatal mother and infant care with the goal of increasing HIV-free survival. In PHFS countries, the MTCT average rate is more than 25%, while only 45% of eligible pregnant women receive transmission interventions.^[1]

Methods: Since March 2013, individual country teams have created a 2-district model for reliable eMTCT, accounting for WHO recommendations and focusing on postnatal eMTCT pathways and nutrition. Through country teams – as well as a Cross-Country Learning Platform – the project set an aim to reduce MTCT by 90% and transmission through breastfeeding from 15% to 1%, with proportionate improvement in child survival.

Results: The collaborative convened country teams for an All-Country Collaborative Kickoff, and again for two regional meetings. Additionally, teams have shared learning via the Cross-Country Learning platform comprising of an active listserv, Measurement and Evaluation calls, cross-country webinars, and social media outlets. Sharing and disseminating knowledge has been invaluable to previously siloed teams.

Discussion: We will focus on learning taking place in the field: the successes and challenges teams are facing, and the next steps in the collaborative, such as focusing our approach on data collection and measurement standards.

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[1] WHO, UNAIDS, UNICEF. Global HIV/AIDS Response, Progress Report 2011. Geneva: WHO; 2011: Annex I.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Planning of health education strategies, interventions, and programs

Learning Objectives:
Describe the development and maintenance of an effective six-country learning network. Explain quality improvement methods applicable to the rapid scale-up of eMTCT programs.

Keyword(s): Maternal and Child Health, HIV Interventions

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Sarah Olver is a Director and Improvement Advisor for The Partnership for HIV Free Survival (PHFS). PHFS is a six-country initiative, conceived by the World Health Organization (WHO) and the U.S. President�s Emergency Plan for AIDS Relief (PEPFAR) to accelerate the adoption and implementation each country�s Prevention of Mother to Children Transmission (PMTCT) program, and accompanying HIV and infant feeding guidelines.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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