Evaluation of a quality improvement intervention to prevent mother-to-child transmission of HIV (PMTCT) at Zambia defence force facilities

摘要: The Zambian Defence Force (ZDF) is working to improve the quality of services prevent mother-to-child transmission HIV (PMTCT) at its health facilities. This study evaluates impact an intervention that included provider training, supportive supervision, detailed performance standards, repeated assessments service quality, and task shifting group education lay workers. Four ZDF facilities implementing were matched with four comparison sites. Assessors visited sites before after completed checklists while observing 387 antenatal care (ANC) consultations 41 sessions. A checklist was used observe facilities’ infrastructure support systems. Bivariate multivariate analyses conducted findings on during consultations. Among 137 women observed their initial ANC visit, 52% came first 20 weeks pregnancy, but 19% waited until 28th week or later. Overall scores for providers’ PMTCT skills rose from 58% baseline 73% endline (p=0.003) sites, remained stable Especially large gains seen in family planning counseling (34% 75%, p=0.026), testing return visits (13% 48%, p=0.034), HIV/AIDS management did not include test (1% 34%, p=0.004). 67% 74% declined 65% 59% sites; neither change significant analysis. 87% 91% 78% 57% overall facility readiness score 88% 75% 82% These are relevant civilian as well military systems Zambia because two closely coordinated. Lessons learned include: ability standards draw attention strengthen areas weakness; benefits training workers take over non-clinical tasks; need encourage pregnant seek early.