An early assessment of Uganda's roll-out of Option B+: Service capacity and infant outcomes

Autor: Baryamutuma, Rose, Kansiime , Edgar, Nuwagaba, Charity Kyomugisha, Nabitaka , Linda, Muhumuza , Simon, Akello , Evelyn, Musinguzi, Joshua, Bazeyo , William, Celentano, Jessica, Lindan, Christina
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: East African Journal of Applied Health Monitoring and Evaluation ; Vol. 1 No. 1 (2017)
ISSN: 2591-6769
2953-2663
Popis: Background: Uganda was one of the first countries in sub-Saharan Africa to implement Option B+ as its national strategy for prevention-of-mother-to- child transmission (PMTCT) of HIV, doing so in 2013. We report on two evaluations designed to assess the capacity of the health care system to implement Option B+, and to obtain preliminary information on the maternal-to-child-transmission rate of HIV. Methods: We performed: 1) a cross-sectional assessment in 2014 of 505 health care facilities (49 district hospitals, 83 Health Center [HC] IVs, and 373 HCIIIs) in 62 of Uganda’s 112 districts to evaluate whether services and commodities required for Option B+ were being provided; and 2) a retrospective record review of 283 HIV-exposed infants enrolled in post-natal care in 2013 in the Central Region to evaluate infant outcomes at 18-months of age. Results: Less than 50% of HCIIIs performed routine diagnostics, including syphilis, hemoglobin, and urinalysis testing, required at all ante-natal clinics; almost all facilities performed a baseline CD4 cell count, but only 44.5% of HCIIIs and 60.2% of HCIVs performed follow-up testing. The proportion of facilities monitoring antiretroviral therapy (ART) (47.2-69.4%) and clinic adherence (50.0-67.3%) was low. Many facilities (20.4-45.8%) reported stock-outs of ART and HIV test kits in the prior month. At 18 months, 53.7% of HIV-exposed infants were lost to follow-up (LTFU). Among those retained, 6.5% were HIV infected. Conclusion: Significant shortcomings in service provision and high LTFU of HIV-exposed infants are barriers to Uganda’s ability to implement Option B+ successfully.
Databáze: OpenAIRE
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