Protocol for Program Evaluation of the Antiretroviral – Antenatal Care Integration Project in Southern Zambia

Project Description

Despite advancements in antenatal HIV testing of pregnant women and early anti-retroviral (ART) therapy to reduce mother-to-child transmission (MTCT) of HIV, 35% of new HIV cases worldwide are attributed to MTCT of the virus. Early ART regimens are effective in reducing perinatal HIV transmission from initial rates of 25-40% to less than 4%. However, what is urgently needed is the appropriate infrastructure and service delivery models to increase uptake of prevention of mother-to-child transmission (PMTCT) interventions.

This project is an evaluation of one of the projects implemented by Zambia’s Southern Province Ministry of Health in several health centers to address the gap between services offered and services received by pregnant women in antenatal clinics. This program will pilot 3 innovative components, including: 1) integration of HIV/AIDS care and treatment with maternal, child health care; 2) utilization of point of care testing machines for CD4 count and renal function; 3) pairing with a community lay counselor to support the mother-baby through the PMTCT cascade to boost adherence to PMTCT schedules for medications and testing.  Each of these components addresses obstacles that contribute to the delay of ART initiation for PMTCT.

By integrating ART initiation directly into antenatal care services, mothers may be screened for HIV and started on life-saving therapy within the same visit and by the same provider. This positively impacts health outcomes for both mother and baby, bolsters PMTCT, as well as strengthens proven antenatal care interventions that directly effect maternal and neonatal morbidity and mortality.

This is a sub-project of the Boston University Prevention of Mother to Child Transmission Integration Project.

Project Details

Principal Investigator Donald M. Thea
Boston University Co-Investigators Julie HerlihyGodfrey Biemba, Matthew FoxCaitlin Goggin, Leoda Hamomba, Anna Knapp,  Arthur Mazimba
Collaborators
Country(ies) Zambia
Dates of Activity 2006–2014
Donor/Funder