Using the PMTCT Cascade to Accelerate Achievement of the Global Plan Goals

Abstract

Background:Development of country plans for prevention of mother-to-child HIV transmission (PMTCT), including expansion of comprehensive, integrated services, was key to Global Plan achievements.Approaches:Use of the PMTCT cascade, an evolving series of sequential steps needed to maximize the health of women and HIV-free survival of infants, was critical for development and implementation of PMTCT plans. Regular review of cascade data at national/subnational levels was a tool for evidence-based decision making, identifying areas of greatest need at each level, and targeting program interventions to address specific gaps. Resulting improvements in PMTCT service delivery contributed to success. Populating the cascade highlighted limitations in data availability and quality that focused attention on improving national health information systems.Limitations:Use of aggregate, cross-sectional data in the PMTCT cascade presents challenges in settings with high mobility and weak systems to track women and children across services. Poor postnatal follow-up and losses at each step of the cascade have limited use of the cascade approach to measure maternal and child health outcomes beyond the early postnatal period.Lessons Learned:A cascade approach was an effective means for countries to measure progress, identify suboptimal performance areas, and be held accountable for progress toward achievement of Global Plan goals. Using the cascade requires investment of time and effort to identify the type, source, and quality of data needed as programs evolve. Ongoing review of cascade data, with interventions to address discontinuities in the continuum of care, can translate across health areas to improve health care quality and outcomes.

Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome: Epidemiological Changes in the World and Turkey

“…Korunmada; eğitim -tek eşlilik, kondom kullanımı, riskli davranış modellerinin bilinmesi, cinsel yolla bulaşan hastalıklardan korunma-, tanı algoritmaları, temas öncesi ve sonrası proflaksi, hastaların viral yüklerinin devamlı negatif olarak kalması, anne-çocuk iletisinin engellenmesi, sağlık çalışanlarının korunması başlıkları gündemdedir (25). DSÖ; ülkeler tarafından HIV enfeksiyonu için yapılacak sürveyansta biyolojik sürveyansa ek olarak davranışsal sürveyansın da yapılarak riskli grupların belirlenmesi ve risk taşıyan temel davranış modellerinin saptanmasını önermektedir.…”

Overcoming Health System Challenges for Women and Children Living With HIV Through the Global Plan

“…In addition, by simplifying requirements for antiretroviral therapy initiation and harmonizing antiretroviral regimens for all adults living with HIV, Option B+ facilitated task sharing of antiretroviral therapy initiation and management. 44 …”

Adherence to Highly Active Antiretroviral Therapy and Its Association with HIV Disclosure status among People Living with HIV/AIDS in Ethiopia: A systematic review and Meta-Analysis.

“…The human immune deficiency virus(HIV) affects many segments of the world population in different aspects (1). Africa, Asia, and Latin America were the major continents affected by HIV (2). In this regard in 2016, there were about 36.7 million people lived with HIV (3).…”

“…Globally and in sub-Saharan Africa there were 160,000 and 110,000 children had got HIV infection in different ways respectively (2)(3)(4). According to the WHO report in 2016, an estimated 2.1 million adolescents were living with HIV of this 84% were living in sub-Saharan Africa (5).…”