Increasing HIV-Free Survival of Infants: Reorganizing Care Using Quality Improvement for the Optimal Health and Nutrition of HIV-Positive Women and Their Exposed Infants in Uganda
| Autor: | Tamara Nsubuga-Nyombi BSc, MPHDC, Esther Karamagi MBChB, MSc, Linda Nabitaka MBChB, MCH, Samalie Namukose BSc, MSc, Jacqueline Calnan MPH, Sheila Nyakwezi BSc, MSc, Hanifa Bachou PhD, MSc, MBChB, Lazarus Oucul MCCP, Aurora Ose Amoah PhD, MPP, MPH |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: | |
| Zdroj: | Journal of the International Association of Providers of AIDS Care, Vol 18 (2019) |
| Druh dokumentu: | article |
| ISSN: | 2325-9582 23259582 |
| DOI: | 10.1177/2325958219857724 |
| Popis: | Reorganizing service delivery to integrate nutrition and infant and young child feeding (IYCF) with prevention of mother-to-child transmission (PMTCT) is important for improving outcomes of HIV-positive mothers and HIV-exposed infants (HEIs). Quality improvement (QI) strategies were implemented at 22 health facilities. The percentage of HIV-positive pregnant women and lactating mothers who received IYCF counseling at each visit improved (45%-100%; mean = 93.1%, standard deviation [SD] = 15.5). Adherence to IYCF practices improved (70%-96%; mean = 92.4%, SD = 8.5). Mother–baby pairs receiving the standard care package improved (0%-100%; mean = 98.6%, SD = 22.6). The HEIs alive at 18 months and infected decreased (mean = 6.2%, SD = 4.8). Statistical significance of change was estimated using Fisher exact test and magnitude of change over time by calculating the odds ratio. For all indicators, improvement was rapid and significant ( P < .001), especially in the first 6 months of QI implementation. Using QI to integrate nutrition and ensure consistent and comprehensive PMTCT service delivery improved IYCF adherence and decreased transmission. |
| Databáze: | Directory of Open Access Journals |
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