H Gunguwo1, R Zachariah2, K Bissell3, W Ndebele1, J Moyo1, T Mutasa-Apollo4. 1. Mpilo Central Hospital, Bulawayo, Zimbabwe ; National University of Science and Technology, Bulawayo, Zimbabwe. 2. Médecins Sans Frontières, Brussels Operational Centre, Luxembourg, Luxembourg. 3. International Union Against Tuberculosis and Lung Disease, Paris, France ; School of Population Health, The University of Auckland, Auckland, New Zealand. 4. Ministry of Health and Child Welfare, AIDS and TB Unit, Harare, Zimbabwe.
Abstract
SETTING: Prevention of mother-to-child transmission (PMTCT) programme, Mpilo Hospital antenatal clinic, Zimbabwe. OBJECTIVE: Before and after the introduction of a one-stop shop approach and task-shifting of antiretroviral treatment (ART) to midwives in the PMTCT programme, 1) to compare ART uptake and 2) to determine socio-demographic and other characteristics associated with non-initiation of ART post integration. DESIGN: Before and after cohort study. RESULTS: A total of 285 women were eligible for ART before the introduction of the one-stop approach and 280 after. Of the 285, 163 (57%) initiated ART before integration; this increased to 244/280 (87%) after integration (RR 1.5, 95% CI 1.4-1.7, P < 0.001). A total of 36 (13%) women did not initiate ART after integration; this was significantly associated with cotrimoxazole uptake (P = 0.03). CONCLUSION: Integrating ART into antenatal care along with task-shifting to midwives considerably increased the uptake of ART. This provides further evidence for scaling up integration rapidly to other facilities in Zimbabwe, and is in line with the vision of a world where no child will be born with the human immunodeficiency virus by 2015.
SETTING: Prevention of mother-to-child transmission (PMTCT) programme, Mpilo Hospital antenatal clinic, Zimbabwe. OBJECTIVE: Before and after the introduction of a one-stop shop approach and task-shifting of antiretroviral treatment (ART) to midwives in the PMTCT programme, 1) to compare ART uptake and 2) to determine socio-demographic and other characteristics associated with non-initiation of ART post integration. DESIGN: Before and after cohort study. RESULTS: A total of 285 women were eligible for ART before the introduction of the one-stop approach and 280 after. Of the 285, 163 (57%) initiated ART before integration; this increased to 244/280 (87%) after integration (RR 1.5, 95% CI 1.4-1.7, P < 0.001). A total of 36 (13%) women did not initiate ART after integration; this was significantly associated with cotrimoxazole uptake (P = 0.03). CONCLUSION: Integrating ART into antenatal care along with task-shifting to midwives considerably increased the uptake of ART. This provides further evidence for scaling up integration rapidly to other facilities in Zimbabwe, and is in line with the vision of a world where no child will be born with the human immunodeficiency virus by 2015.
Authors: R Zachariah; N Ford; M Philips; S Lynch; M Massaquoi; V Janssens; A D Harries Journal: Trans R Soc Trop Med Hyg Date: 2008-11-06 Impact factor: 2.184
Authors: Amitabh B Suthar; David Hoos; Alba Beqiri; Karl Lorenz-Dehne; Craig McClure; Chris Duncombe Journal: Bull World Health Organ Date: 2012-11-28 Impact factor: 9.408
Authors: Anthony D Harries; Rony Zachariah; Rhehab Chimzizi; Felix Salaniponi; Francis Gausi; Henry Kanyerere; Erik J Schouten; Andreas Jahn; Simon D Makombe; Frank M Chimbwandira; James Mpunga Journal: BMC Public Health Date: 2011-07-27 Impact factor: 3.295
Authors: Lorainne Tudor Car; Michelle H M M T Van Velthoven; Serena Brusamento; Hoda Elmoniry; Josip Car; Azeem Majeed; Peter Tugwell; Vivian Welch; Ana Marusic; Rifat Atun Journal: PLoS One Date: 2012-04-27 Impact factor: 3.240
Authors: A M V Kumar; H D Shewade; J P Tripathy; N Guillerm; K Tayler-Smith; S Dar Berger; K Bissell; A J Reid; R Zachariah; A D Harries Journal: Public Health Action Date: 2016-01-04