A clinical trial conducted in Uganda proved that a single $4 dose of nevirapine (NVP) is highly effective in preventing the vertical transmission of HIV. A program to implement the delivery of NVP to HIV-positive pregnant women attending the antenatal clinic at Mulago Hospital (the only public hospital in Uganda) has received support from the Ministry of Health and donor agencies. It is now expanding to include multiple rural and urban sites throughout the country. In the first 6 months of activity at Mulago, 4712 women have been offered VCT, 4289(91%) have received pre-test counseling, and 2688(63%) accepted and received rapid HIV testing. All positive women (15% of those tested) have received NVP treatment. Delivery at Mulago hospital is a requirement of the program in order to ensure provision of NVP to the newborn and a 6-week postnatal visit is required to test the infant in order to determine transmission rates. A small percentage (61%) of women have returned for delivery and an even smaller number have returned for postnatal follow-up (58%). As an integral part of the program, we designed and conducted an evaluation of the process used to implement this service. At quarterly intervals we have conducted 30-minute structured interviews with the professionals (midwives, counselors, physicians) involved with carrying out this program within a resource-constrained public hospital. Results of this evaluation highlight program aspects that are working well (e.g., patient/provider satisfaction) and those needing improvement (counseling space, compensation for extra duties, public awareness campaigns).
Learning Objectives: This session shall expose participants to the experiences of counselors and health care providers working on a novel service delivery program designed to reduce perinatal transmission of HIV. By applying the lessons learned from this program, participants will be better able to design, implement and monitor a similar maternal-child health service program.
Keywords: Evaluation, HIV/AIDS
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.