Tailored Approaches to Improve Early Infant Diagnosis Coverage and Outcomes in Tanzania
Despite global progress in the reduction of new pediatric HIV infections, the substantial risk of infection during the antenatal and postnatal periods remains. ART coverage, particularly in infants and young children is low, largely stemming from poor identification through inadequate coverage and utilization of early infant diagnosis (EID) services among other approaches to identify HIV infected infants and children. Challenges in follow-up of HIV exposed infants (HEI) during the postpartum period, until final diagnosis, also persist. Timely uptake of virological testing among HIV exposed infants (HEI) allows for early and appropriate linkage to care and initiation of treatment, reducing HIV related morbidity and mortality.
The United States Agency for International Development (USAID) Boresha Afya North/Central Zone project in Tanzania implemented tailored strategies aimed at supporting mother and infant pairs focused on retention and addressing identified gaps in the HEI cascade.
Using quality improvement methodologies, an adapted package of PMTCT services was developed, focusing on:
- Increasing the coverage and uptake of ARVs and viral load testing among HIV-positive pregnant women and breastfeeding mothers and their infants attending post-natal care (PNC)
- Increasing the proportion of mother-infant pairs retained in PNC
- Increasing the proportion of HIV-exposed infants under two yearsof age with a confirmed HIV status through DNA/PCR or antibody testing
- Increasing uptake of the nutrition assessment, counseling, and support (NACS) package through provision of NACS tools and trainings for health care workers on NACS and system strengthening
Varied strategies were implemented to support improvement in coverage and outcomes for mothers and infants. These strategies were complementary to the adapted package and were multi-faceted in focusing not only on the programmatic implementation but also on the monitoring, data, and human resources elements.
Tanzania
Maternal & Child Health; Pediatric HIV Diagnosis, Care & Treatment
