The CIDRZ PMTCT Programme supporting the government of the Republic of Zambia aims to eliminate paediatric HIV through the provision of family-centered, comprehensive and integrated quality safe motherhood services; rendering of more efficacious PMTCT drug regimens to all HIV positive women; expansion of comprehensive HIV prevention, care and treatment and services to HIV-exposed babies; and strengthening monitoring and evaluation to enhance data quality.
Keeping Families Healthy
CIDRZ supports provision of comprehensive antenatal and newborn care for pregnant women and their families in over 70 sites in Zambia. HIV testing is the entry point into HIV prevention, care and treatment.
CIDRZ has played an important role in supporting the Ministry of Health and the Ministry of Community Development Mother and Child Health to implement innovative and comprehensive PMTCT strategies. Due to our extensive public health work in this area, we have identified key challenges to efficient programme implementation and promoted evidence-based strategies to address them. These have included enhancement of service integration between maternal-child health and HIV services; promotion of community messaging to increase male partner HIV testing; demonstration projects showing the feasibility and acceptability of three-drug combination regimens for PMTCT; third-trimester and delivery ward HIV testing for women of unknown status; and expanded early diagnostic testing for HIV-exposed infants.
CIDRZ supports the role of Neighbourhood Health Committees, Safe Motherhood Groups, Traditional leaders and Church leaders to sensitize communities on couples counselling and HIV testing, early infant nutrition, timely seeking of HIV care, and adherence to prescribed drugs for improved health outcomes.
We have worked in partnership with the Zambian government to extend the reach of effective PMTCT services to the most rural and remote areas, while implementing new strategies to improve service efficiency. For example, we serve as a key technical and implementing partner in Zambia’s adoption of Option B+, where all HIV-infected pregnant women will receive lifelong antiretroviral therapy.
“Aliyense” – Reaching Every Family to End Paediatric HIV at Chainda South Health Centre
This M.A.C AIDS Fund-supported demonstration programme aims to 1) Improve community knowledge and uptake of lifelong ART for pregnant women; 2) Eliminate the bottlenecks that prevents good clinical care; and 3) Achieve high levels of patient retention and adherence in the
Chainda South Health Centre catchment area.
Aliyense means “everyone” and the Aliyense approach to improving care is comprehensive. Improving community knowledge and anti-retroviral (ART) uptake for pregnant women is based on the successful PEPFAR-funded Community COMPACT programme model which trains community volunteers to provide house-to-house, and public, outreach and education. Clinic bottlenecks that prevent the delivery of high-quality clinical care is built on standard quality improvement methodologies that CIDRZ uses to improve primary health care and HIV treatment services in more than 100 CIDRZ-supported clinics across Zambia. We ensure that clinical protocols are clear and that basic information is collected to allow for ongoing monitoring and review; we provide quality improvement training and engage the clinical staff to identify problems and suggest sustainable solutions; and clinical training is provided through hands-on peer-to-peer training and mentoring. High levels of patient ART adherence and clinic visit retention is achieved through individual peer counseling as well as through rigorous but low-tech patient tracking. Trained peer counselors work with HIV-infected pregnant and postpartum women at the clinic to develop individually tailored counseling and adherence support plans. If any mothers or HIV exposed infants miss clinic visits, counselors will follow-up with reminders by cell-phone or visits in the community.