title: Implementation and Operational Research: Scaling Up the Provision of the PMTCT Services, Using the Linked Response Approach in Cambodia From 2008 to 2012.
abstract: BACKGROUND
  In Cambodia, the Linked Response (LR) approach for strengthening linkages between HIV and reproductive health services, especially for the prevention of mother-to-child transmission of HIV (PMTCT), was scaled up in 2009. This article describes the LR scale-up and the concomitant evolution of key PMTCT indicators at the national level.
  
  
  METHODS
  A descriptive analysis of routine LR, PMTCT programme data, and national laboratory data from 2008 to 2012 was conducted.
  
  
  RESULTS
  LR data show that between 2008 and 2012, the number of LR/PMTCT sites increased from 67 to 956 (of 1004) public health facilities to cover 74 (of 77) operational districts. In LR operational districts, the number of pregnant women (PW) tested for HIV increased from 41,800 in 2009 to 269,935 [of whom 375 (0.14%) were newly tested positive for HIV] in 2012; the number of PW living with HIV and exposed infants receiving antiretrovirals increased from 49 and 44 in 2009 to 720 and 551 in 2012, respectively. Concomitantly, national PMTCT programme data showed that the percent of PW tested for HIV increased from 34.4% (117,832 of 342,929 estimated PW) in 2008 to 86.1% (324,996 of 377,340) in 2012. In 2012, 65.3% (862 of 1321) of estimated HIV-positive PW and 72.7% (960 of 1321) of exposed infants received antiretrovirals. By 6-8 weeks postpartum, 7.4% (8 of 108) and 1.5% (6 of 409) of DNA-polymerase chain reaction tested positive in 2008 and in 2012, respectively.
  
  
  CONCLUSIONS
  The LR approach provided a model, which catalyzed increased access of PW to HIV testing and treatment, thereby contributing to the scale-up of PMTCT service provision and improved coverage in Cambodia.
authors.affiliation: *National Center for HIV/AIDS, Dermatology and STD, Phnom Penh, Cambodia; †National Center for Mother and Child Health, Phnom Penh, Cambodia; ‡Clinton Health Access Initiative; §World Health Organization, Cambodia; and ‖Public Health Department, Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Sophay
authors.initials: S
authors.lastname: Sim
authors.forename: Sovanna
authors.initials: S
authors.lastname: Tuon
authors.forename: Emily
authors.initials: E
authors.lastname: Welle
authors.forename: Sovannarith
authors.initials: S
authors.lastname: Samreth
authors.forename: Sokleng
authors.initials: S
authors.lastname: Sun
authors.forename: Bora
authors.initials: B
authors.lastname: Ngauv
authors.forename: Vichea
authors.initials: V
authors.lastname: Ouk
authors.forename: Masami
authors.initials: M
authors.lastname: Fujita
authors.forename: Sopheap
authors.initials: S
authors.lastname: Seng
authors.forename: Chhi Vun
authors.initials: CV
authors.lastname: Mean
authors.forename: Thérèse
authors.initials: T
authors.lastname: Delvaux
mesh_terms: D002160:Cambodia; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000821:virology*; D011635:Public Health Administration / Q000379:methods*