title: A 'one-stop shop' approach in antenatal care: does this improve antiretroviral treatment uptake in Zimbabwe?
abstract: METHODS
  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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.affiliation: Mpilo Central Hospital, Bulawayo, Zimbabwe ; National University of Science and Technology, Bulawayo, Zimbabwe.
authors.forename: H
authors.initials: H
authors.lastname: Gunguwo
authors.affiliation: Médecins Sans Frontières, Brussels Operational Centre, Luxembourg, Luxembourg.
authors.forename: R
authors.initials: R
authors.lastname: Zachariah
authors.affiliation: International Union Against Tuberculosis and Lung Disease, Paris, France ; School of Population Health, The University of Auckland, Auckland, New Zealand.
authors.forename: K
authors.initials: K
authors.lastname: Bissell
authors.affiliation: Mpilo Central Hospital, Bulawayo, Zimbabwe ; National University of Science and Technology, Bulawayo, Zimbabwe.
authors.forename: W
authors.initials: W
authors.lastname: Ndebele
authors.affiliation: Mpilo Central Hospital, Bulawayo, Zimbabwe ; National University of Science and Technology, Bulawayo, Zimbabwe.
authors.forename: J
authors.initials: J
authors.lastname: Moyo
authors.affiliation: Ministry of Health and Child Welfare, AIDS and TB Unit, Harare, Zimbabwe.
authors.forename: T
authors.initials: T
authors.lastname: Mutasa-Apollo
keywords: PMTCT; Zimbabwe; integration; operational research; task-shifting