Field Evaluation of Point of Care Technologies in Maternal and Child Health (MCH) Services and in the Prevention of Mother-to-Child Transmission of HIV (PMTCT) Program Project Period

Overview

Provision of optimal maternal child health services requires the availability of laboratory diagnostic capacity to identify maternal conditions that may negatively impact health without intervention. In Mozambique, most pregnant women will visit the antenatal clinics at least once, but many do not return for further visits. It is thus imperative to provide as many of the necessary laboratory services as possible during that initial visit. The development of point-of-care (POC) technologies for various laboratory tests provides the opportunity to conduct testing during the time of the visit, permitting implementation of necessary interventions during the patient’s visit.

Three POC laboratory tests that may significantly impact maternal child health include tests that screen for maternal anemia, syphilis, and CD4+ T-lymphocyte enumeration. Implementation of interventions based on abnormalities identified using these three tests can dramatically improve the health of the pregnant woman, as well as decrease the risk of morbidity and mortality to the infant, including the prevention of vertical transmission of HIV from mother to infant.

This study evaluated the feasibility and acceptability of introduction of three POC technologies for diagnosis of syphilis, hemoglobin, and CD4+ T-lymphocyte enumeration within the mother-to-child services. In addition, the study will assess the impact of the availability of test results on implementation of appropriate clinical responses to abnormal results, such as provision of supportive treatments for women identified with anemia, appropriate administration of antibiotics for syphilis infection, and initiation of antiretroviral therapy among HIV-positive pregnant women identified as eligible for treatment. Study findings will be used to guide optimal placement and usage of POC instruments to support maternal child health and PMTCT service delivery.