Bottlenecks in the implementation of essential screening tests in antenatal care: Syphilis, HIV, and anemia testing in rural Tanzania and Uganda

Baker, Ulrika; Okuga, Monica; Waiswa, Peter; Manzi, Fatuma; Peterson, Stefan; Hanson, Claudia

doi:10.1016/j.ijgo.2015.04.017

Cited by 41 publications

(60 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The main reason for concomitant use of these drugs is the lack of knowledge among health care providers in the ANCs. Lack of integration of antenatal care services including IPTp and PMTCT in the health facilities is also a contributing factor for irrational use of SP and co-trimoxazole in HIV-infected pregnant women 26,27…”

Section: Discussionmentioning

confidence: 99%

Implementation of co-trimoxazole preventive therapy policy for malaria in HIV-infected pregnant women in the public health facilities in Tanzania

Kamuhabwa

Gordian

Mutagonda

2016

DHPS

View full text Add to dashboard Cite

BackgroundIn 2011, Tanzania adopted a policy for provision of daily co-trimoxazole prophylaxis to HIV-infected pregnant women for prevention of malaria and other opportunistic infections. As per the policy, HIV-infected pregnant women should not be given sulfadoxine-pyrimethamine (SP) for intermittent preventive therapy. The challenges associated with this policy change and the extent to which the new policy for prevention of malaria in pregnant women coinfected with HIV was implemented need to be assessed.AimTo assess the implementation of malaria-preventive therapy policy among HIV-infected pregnant women in the public health facilities in Dar es Salaam, Tanzania.MethodologyThe study was conducted in Kinondoni Municipality, Dar es Salaam, Tanzania, from January 2015 to July 2015. Three hundred and fifty-three HIV-infected pregnant women who were attending antenatal clinics (ANCs) and using co-trimoxazole for prevention of malaria were interviewed. Twenty-six health care workers working at the ANCs were also interviewed regarding provision of co-trimoxazole prophylaxis to pregnant women. A knowledge scale was used to grade the level of knowledge of health care providers. Focus group discussions were also conducted with 18 health care workers to assess the level of implementation of the policy and the challenges encountered.ResultsTwenty-three (6.5%) pregnant women with known HIV serostatus were using co-trimoxazole for prevention of opportunistic infections even before they became pregnant. Out of the 353 HIV-infected pregnant women, eight (2.5%) were coadministered with both SP and co-trimoxazole. Sixty (16.7%) pregnant women had poor adherence to co-trimoxazole prophylaxis. Out of the 26 interviewed health care providers, 20 had high level of knowledge regarding malaria-preventive therapy in HIV-infected pregnant women. Lack of adequate supply of co-trimoxazole in health facilities and inadequate training of health care providers were among the factors causing poor implementation of co-trimoxazole prophylaxis for prevention of malaria in HIV-infected pregnant women.ConclusionThere is a need to continue sensitization of pregnant women and communities about the importance of early attendance to the ANCs for testing of HIV and provision of co-trimoxazole prophylaxis. Availability of co-trimoxazole in the health facilities, regular training, and sensitization of health care providers are necessary for effective implementation of this policy.

show abstract

Section: Discussionmentioning

confidence: 99%

Implementation of co-trimoxazole preventive therapy policy for malaria in HIV-infected pregnant women in the public health facilities in Tanzania

Kamuhabwa

Gordian

Mutagonda

2016

DHPS

View full text Add to dashboard Cite

show abstract

“…Duber et al found that vertical programs, even on the scale of PEPFAR, may not impact health outcomes that were not specifically targeted on a national level [12]. Attempts have been made to integrate donor-funded HIV prevention, care, and treatment programs into national health systems to ensure efficiency and sustainability, including: TB [13••, 14], maternal-child health (MCH) [15–20], cervical cancer screening [21], sexually transmitted infection (STI) [16, 22], and family planning [23, 24] programs. In addition, ART has increased the life expectancy of people living with HIV, and HIV is now considered a chronic disease.…”

Section: Introductionmentioning

confidence: 99%

Integrating Human Immunodeficiency Virus and Reproductive, Maternal and Child, and Tuberculosis Health Services Within National Health Systems

et al. 2016

View full text Add to dashboard Cite

Joint United Nations Programme on HIV/AIDS (UNAIDS) established 90–90–90 HIV treatment targets for 2020 including the following: 90 % of HIV-infected people know their HIV status, 90 % of HIV-infected people who know their status are on treatment, and 90 % of people on HIV treatment have a suppressed viral load. Integration of HIV and other programs into the national health system provides an important pathway to reach those targets. We examine the case for integrating HIV and other health services to ensure sustainability and improve health outcomes within national health systems. In this non-systematic review, we examined recent studies on integrating HIV, tuberculosis (TB), maternal-child health (MCH), and sexually transmitted infection (STI) programs. Existing evidence is limited about the effectiveness of integration of HIV and other services. Most studies found that service integration increased uptake of services, but evidence is mixed about the effect on health outcomes or quality of health services. More rigorous studies of different strategies to promote integration over a wider range of services and settings are needed. Research on how best to maximize benefits, including sustainability, of integrated services is necessary to help inform international and national policy. We recommend additional interventions to test how best to integrate HIV and MCH services, HIV and TB services, HIV testing and treatment, and STI testing and treatment.

show abstract

“…In 2016, the WHO released guidelines that increased the recommended contacts to eight visits [10], although this has not yet been widely adopted as a measure of coverage. Studies on quality-adjusted coverage have used both one visit and four visits to quantify ANC coverage, which is based typically on maternal self-report in household surveys [11][12][13][14][15][16][17][18][19]. Facility measures have similarly followed WHO guidance on the expectations for ANC and have generally focused on inputs to care, with studies that define structural quality measures for health facilities such as functional diagnostics and medications [11,15,16].…”

Section: Viewpoints Research Theme 1: Countdown Coveragementioning

confidence: 99%

Variance estimation for effective coverage measures: A simulation study

Sauer¹,

Pullum²,

Wang³

et al. 2020

Journal of Global Health

View full text Add to dashboard Cite

show abstract

Bottlenecks in the implementation of essential screening tests in antenatal care: Syphilis, HIV, and anemia testing in rural Tanzania and Uganda

Abstract: Our findings reinforce essential screening as a missed opportunity, caused by a lack of integration of funding and support for comprehensive antenatal care programs.

Cited by 41 publications

References 15 publications

Implementation of co-trimoxazole preventive therapy policy for malaria in HIV-infected pregnant women in the public health facilities in Tanzania

Implementation of co-trimoxazole preventive therapy policy for malaria in HIV-infected pregnant women in the public health facilities in Tanzania

Integrating Human Immunodeficiency Virus and Reproductive, Maternal and Child, and Tuberculosis Health Services Within National Health Systems

Variance estimation for effective coverage measures: A simulation study

Contact Info

Product

Resources

About