RED for PMTCT: An adaptation of immunization’s Reaching Every District approach increases coverage, access, and utilization of PMTCT care in Bondo District, Kenya

• Published in: International journal of gynecology and obstetrics 2015-06, Vol.130 (S2), p.S68-S73
• Main Authors: Kanyuuru, Lynn, Kabue, Mark, Ashengo, Tigistu A, Ruparelia, Chandrakant, Mokaya, Evans, Malonza, Isaac
• Format: Article
• Language: English
• Subjects: Access; Anti-HIV Agents - therapeutic use; Coverage; Female; Health Services Accessibility; HIV Infections - prevention & control; Humans; Immunization; Infectious Disease Transmission, Vertical - prevention & control; Kenya; Maternal and child health; Obstetrics and Gynecology; Pregnancy; Prenatal Care; Prevention of mother-to-child transmission (PMTCT); Reaching Every District approach; Utilization
• ISSN: 0020-7292; 1879-3479
• DOI: 10.1016/j.ijgo.2015.04.002

Abstract Gaps exist in coverage, early access, and utilization of prevention of mother-to-child transmission of HIV (PMTCT) services in Kenya. The Maternal and Child Health Integrated Program, led by Jhpiego, piloted an adaptation of immunization’s Reaching Every District (RED) approach in Bondo District as a way of improving PMTCT care. Routine district-level monthly summary service delivery pre- and post-implementation data were analyzed. Marked improvements resulted in the proportion of HIV-infected and non-infected pregnant women completing four focused prenatal care visits, from 25% to 41%, and the proportion of HIV-exposed infants (HEIs) tested at six weeks, from 27% to 78% ( P < 0.001). The proportion of HEIs tested for HIV infection at 12 months was 52%, while 77% of HEIs were issued antiretroviral prophylaxis by the end of the pilot. Implementation of RED for PMTCT demonstrated that PMTCT services can be delivered effectively in the context of the existing community strategy and resulted in increased coverage, access, and utilization of care for HIV-positive pregnant women and their children.