H4+ Ethiopia: Mother-Baby Cohort PMTCT Register (#H4plus)

A comprehensive prevention of mother-to-child transmission (PMTCT) programme includes continued follow up and treatment for HIV positive mothers and their children to ensure timely initiation of interventions at every step of the PMTCT cascade, avoid postpartum HIV- 1 transmission and improve overall maternal and infant health outcomes. A successful PMTCT programme plays a critical role in the achievement of the 90-90-90 targets, which aim that by 2020, 90% of all people living with HIV will know their HIV status; 90% of all people diagnosed with HIV infection will receive sustained antiretroviral therapy; and 90% of all people receiving antiretroviral therapy will have viral suppression.

Photo PMTCT
Integrated MNCH/PMTCT Register (mother-baby cohort).* 

This had been a challenge to implement as mothers are registered in the maternal clinic under antenatal and postnatal care, and babies are registered in the pediatrics unit at birth and postpartum. With this modality, appropriate implementation, follow up, monitoring and evaluation (M&E) of PMTCT was difficult.

In 2014, the Government of Ethiopia, with the technical and financial support of H4+ and other partners, developed and rolled out a new Mother-Baby cohort PMTCT register. For the first time, mothers are linked with their babies in a single register, allowing health facilities to track the interventions the mother and child receive. This enables systematic monitoring and follow up of the mother throughout pregnancy, and both mother and child during delivery and post-partum until the HIV status of the baby is confirmed. This will help address the challenge of poor M&E and the resultant poor follow-up rates previously faced by the program.

This had been a challenge to implement as mothers are registered in the maternal clinic under antenatal and postnatal care, and babies are registered in the pediatrics unit at birth and postpartum. With this modality, appropriate implementation, follow up, monitoring and evaluation (M&E) of PMTCT was difficult.

PMTCT coverage & programme miletstonesIn 2014, the Government of Ethiopia, with the technical and financial support of H4+ and other partners, developed and rolled out a new Mother-Baby cohort PMTCT register. For the first time, mothers are linked with their babies in a single register, allowing health facilities to track the interventions the mother and child receive. This enables systematic monitoring and follow up of the mother throughout pregnancy, and both mother and child during delivery and post-partum until the HIV status of the baby is confirmed. This will help address the challenge of poor M&E and the resultant poor follow-up rates previously faced by the program.
Training workshops were conducted in two rounds in August 2014 where 76 MNCH/PMTCT focal points from the government and universities were trained as trainers for their respective regions with technical support by H4+/Sida-supported PMTCT M&E consultants and technical staff from H4+ agencies and other partners. Following this, 226 individuals were trained in national ToTs as trainers, using H4+-produced training manuals, including an electronic training package produced with the technical and financial support of H4+. This training package–part of the Mother-Baby Cohort follow up tool–-has been distributed to 1,000 PMTCT sites across the country as part of capacity building for PMTCT M&E.

The Mother-Baby Cohort PMTCT Register is a promising practice that should be scaled up and strengthened throughout the country. This register represents an important tool to enable the assessment of the quality and effectiveness of PMTCT services by monitoring
the number of mother-child pairs receiving PMTCT interventions and on consistent follow up, and ultimately the number of confirmed HIV-1-negative children born to HIV-1-positive women.

 

 

The H4+ Ethiopia partnership is generously funded by the 
Swedish International Development Cooperation Agency @Sida.

SIDACMYK

 

 

*Photo: WHO Ethiopia/ Loza Mesfin