HIV

MCHIP focused on a strategic approach that helped countries scale up high-impact interventions to prevent new infections and ensure that HIV+ persons are linked to the care and treatment they need.

In the area of eMTCT (elimination of mother-to-child transmission of HIV), MCHIP continued to have great success in engaging communities to increase access to services. The number of women who were lost from care at each level of the service remained the key challenge for successful eMTCT programs. Partnering with the community, therefore, played a huge role to not only increase access, but also to improve utilization of services at the community and facility levels. Using an integrated approach, with PMTCT services embedded in antenatal and postnatal care, ensured that women and their families receive the appropriate care they needed for all aspects of their health. MCHIP was committed to ensuring that women and their families had access and were encouraged to utilize the continuum of care.

HTC remained a critical gateway to treatment, care and prevention interventions. Specifically, HTC was an essential component for achieving 2015 treatment goals, VMMC targets, and PMTCT goals. MCHIP undertook key assessments to evaluate different approaches to HCT. These assessments were used to guide technical and implementation practices for improving and developing successful HTC models that were deployed throughout MCHIP programs.

With the provision of VMMC services at scale, MCHIP made great strides employing research findings related to VMMC while ensuring implementation from the ground up. VMMC programs were performing well, guidance documents were developed, VMMC services were truly country-owned, and services were integrated with the existing systems. MCHIP continued to focus on refining implementation at scale while providing high-level guidance to countries and ensuring that new research was employed when applicable (such as circumcision devices), quality was maintained, and results were documented and disseminated.

Key Contributions to Reducing HIV

  • By adapting the Reaching Every District (RED) approach for PMTCT in Kenya, MCHIP and the Bondo district health office achieved increased coverage of the district by CHWs from 38% in June 2010 to 100% in June 2012. The proportion of those who completed four focused antenatal care (ANC) visits (proxy indicator of early ANC attendance) improved from 25% to 41% and delivery with a skilled attendant increased from 23% to 47% between 2010 and 2012.
  • Implemented MCHIP VMMC programs in three countries: Malawi, Lesotho and Tanzania.
– As of June 2013, 192,629 VMMCs were performed, which averted approximately 28,000 new HIV infections according to modeling data. As a result of this contribution by MCHIP for the last four years, Iringa, Tanzania doubled the VMMC prevalence from 29% to 60%.
– MCHIP supported the development of key global VMMC documents and meetings with the aim of providing implementers with a comprehensive and consistent process for establishing new and existing VMMC services for HIV prevention.
  • MCHIP improved HTC systems by conducting HTC research and scale up of provider initiated testing and counseling (PITC).
– In South Sudan, a total of 56 health facility staff were trained in PITC, which was then implemented in 15 health facilities in two states. More than 4,450 people were tested through the PITC program.

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1 Effect of HIV infection on pregnancy-related mortality in sub-Saharan Africa: secondary analyses of pooled communitybased data from the network for Analysing Longitudinal Population-based HIV/AIDS data on Africa (ALPHA). Basia Zaba, Clara Calvert, Milly Marston et. al, Lancet 2013; 381: 1763-71.