20th International AIDS Conference - Melbourne, Australia

Abstract

TUPE436 - Poster Exhibition


Improvement of early infant HIV diagnosis in Côte d'Ivoire

K.M. N'goran1, B.C.J. Diby2, J. Essombo3, P. Fassinou4, S. Ramachandran5, G. Wilboek6, D. Aka7, A.S. Gueye8

1EGPAF Côte d'Ivoire, Monitoring and Evaluation, Abidjan, Cote D'Ivoire, 2Elizabeth Glaser Pediatric Aids Côte d'Ivoire, Monitoring and Evaluation, Abidjan, Cote D'Ivoire, 3Elizabeth Glaser Pediatric Aids Côte d'Ivoire, Country Director, Abidjan, Cote D'Ivoire, 4Elizabeth Glaser Pediatric Aids Côte d'Ivoire, Djija Project director, Abidjan, Cote D'Ivoire, 5Elizabeth Glaser Pediatric Aids Washington DC, Monitoring and Evaluation, Washington DC, United States, 6Elizabeth Glaser Pediatric Aids Washington DC, Research, Washington DC, United States, 7Côte d'Ivoire Ministry of Health, PMTCT, Abidjan, Cote D'Ivoire, 8Center for Disease Control (CDC), Research, Abidjan, Cote D'Ivoire

Background: Without treatment, approximately half of HIV-infected infants die by age 2, and 80% die before age 5. Early identification of infants provides opportunities for life-saving interventions. In Côte d''Ivoire, 87.3% of children born to HIV-infected mothers were not tested for HIV within 2 months post-natal. Recognizing these challenges, the Elizabeth Glaser Pediatric Aids Foundation, an implementing partner of Côte d''Ivoire''s Ministry of Health adopted a series of interventions to improve EID performance
Description: EGPAF''s approaches to improve EID performance included implementation of a combination of four targeted strategies in July 2011: The first strategy was focused on improvement of the quality of care in 125 EGPAF-supported antenatal (ANC) and the post-natal care (PNC) sites through training health care providers, redefining patient flow at site, recommending infant testing at all health service entry points (PNC, immunization, consultation, nutrition) and expanding PMTCT services to more health facilities . Quarterly meetings were held between EGPAF staff and health district staff as well as facility-level staff to discuss progress and challenges. The second strategy focused on improvement of community engagement through sensitization and outreach activities such as home visits, awareness campaigns in the communities around all 125 EGPAF-supported sites. The third was work with the MOH to revise and implement policies around PMTCT and EID. The last strategy was implementation of system improvements; EGPAF established networks with health districts and community-based organizations for blood sample transportation and implemented a new mechanism for quickly conveying the PCR results through e-mail, SMS and telephone calls to ensure timely availability of DNA-PCR results at facility level
Lessons learned: Repeat measurement of the percentage of HIV-exposed infants tested for HIV over eight quarters from October 2011 to September 2013 - shows an increase in HIV-exposed infant testing from 56% (241/430) in October-December 2011 to 88% (388/442) in July-September 2013
Conclusions/Next steps: The combination of several targeted interventions addressing low EID coverage from the policy, facility, lab system, and community levels was associated with an increase in rate of EID testing in Côte d''ivoire. However national efforts are key to ensure accountability and leadership for sustained improvement efforts


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