title: RED for PMTCT: an adaptation of immunization's Reaching Every District approach increases coverage, access, and utilization of PMTCT care in Bondo District, Kenya.
abstract: Gaps exist in coverage, early access, and utilization of prevention of mother-to-child transmission of HIV (PMTCT) services in Kenya. The Maternal and Child Health Integrated Program, led by Jhpiego, piloted an adaptation of immunization's Reaching Every District (RED) approach in Bondo District as a way of improving PMTCT care. Routine district-level monthly summary service delivery pre- and post-implementation data were analyzed. Marked improvements resulted in the proportion of HIV-infected and non-infected pregnant women completing four focused prenatal care visits, from 25% to 41%, and the proportion of HIV-exposed infants (HEIs) tested at six weeks, from 27% to 78% (P<0.001). The proportion of HEIs tested for HIV infection at 12months was 52%, while 77% of HEIs were issued antiretroviral prophylaxis by the end of the pilot. Implementation of RED for PMTCT demonstrated that PMTCT services can be delivered effectively in the context of the existing community strategy and resulted in increased coverage, access, and utilization of care for HIV-positive pregnant women and their children.
authors.affiliation: Jhpiego/MCHIP, Nairobi, Kenya. Electronic address: Lynn.Kanyuuru@jhpiego.org.
authors.forename: Lynn
authors.initials: L
authors.lastname: Kanyuuru
authors.affiliation: Jhpiego, Baltimore, MD, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Kabue
authors.affiliation: Jhpiego /MCHIP, Washington, DC, USA.
authors.forename: Tigistu A
authors.initials: TA
authors.lastname: Ashengo
authors.affiliation: Jhpiego, Baltimore, MD, USA.
authors.forename: Chandrakant
authors.initials: C
authors.lastname: Ruparelia
authors.affiliation: JSI/MCHIP, Nairobi, Kenya.
authors.forename: Evans
authors.initials: E
authors.lastname: Mokaya
authors.affiliation: Jhpiego/MCHIP, Nairobi, Kenya.
authors.forename: Isaac
authors.initials: I
authors.lastname: Malonza
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006297:Health Services Accessibility; D006801:Humans; D007114:Immunization; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D007630:Kenya; D011247:Pregnancy; D011295:Prenatal Care
chemical_list: D019380:Anti-HIV Agents
keywords: Access; Coverage; Maternal and child health; Prevention of mother-to-child transmission (PMTCT); Reaching Every District approach; Utilization