PMTCT/MNCH and PCT focus areas
D4T phase out
Test treat strategy implementation in children age less than 15 years old
Option B plus implementation according to the national guide line
The use of the new option B plus register and reporting system
Monthly performance review at each level
Ensure the completeness of HEI register, follow by appointment log book, attach on
pediatrics ART and HEIs (family centered approach), strengthen EID and linkage those
positive because 234/693 enrolled pediatrics cases should be infant less than 1 year
Ensure the revised guideline is available and different necessary PSM availability/need
Update on MER indicators
Follow up of SIMS findings
Trained manpower
Partner testing and disclosure need to be strengthen
Ensure clinical adherence for pregnant women and children
Post annual plan and divide in month and follow performance
FP integration need to be strengthen
Ensure quality ANC, L&D, & PNC service provision (including lab testing)
EID (DBS transportation issues, TAT, supply issues) coordinate with PFSA hubs
Make sure that no HF providing prophylaxis to HIV positive pregnant women
Data quality issues need to be stressed
PMTCT/PCT Regional Targets Tar
Number of HIV-positive pregnant women who received antiretrovirals to reduce risk of mother-to-child-
transmission (MTCT) during pregnancy and delivery 3
Number of HIV- positive pregnant women identified in the reporting period (including known HIV-positive at
entry) 4
Single-dose nevirapine (with or without tail)
Sub-Disag of Life-long ART: Newly initiated on treatment during the current pregnancy
Maternal triple ARV prophylaxis (provided with the intention to stop at the end of the breastfeeding period)
Sub-Disag of Life-long ART: Already on treatment at the beginning of the current pregnancy 2
Number of infants who had a virologic HIV test within 12 months of birth during the reporting period
3
Number of HIV- positive pregnant women identified during the reporting period (include known HIV-positive
women at entry into PMTCT) 4
Number of PEPFAR-supported sites achieving 90% ARV or ART coverage for HIV+ pregnant women
Total number of PEPFAR supported sites providing PMTCT services (HTC and ARV or ART services)
Number of PEPFAR-supported clinical service sites with a quality improvement activity completed that addresses
clinical HIV programs and has documented process results in the last 6 months=19
Number of PEPFAR-supported DSD and TA sites by program area/support type: PMTCT Direct Service Delivery
(DSD)=211
Number of HIV positive children who received at least one of the following during the reporting period: clinical
assessment (WHO staging) or CD4 count or viral load=9776 (F=4688, M=5088) 9
Newly enrolled pediatrics ART= 693 (F=353, M=340)
Newly enrolled pediatrics ART age less than 1 year= 234 (F=115, M=119) 34% of all newly initiated pediatrics ART
cases
Number of PEPFAR-supported ART sites with a retention rate of 75% or greater for patients 12 months after ART
initiation
Number of Zone documented Quarterly supportive supervision visits to 75% of HIV care and treatment sites
supported by the Zone
Number of children < 15 yrs who received T&C services for HIV and received their test results during the last 12
month 141
How to increase PCT uptake (Total plan 9776, newly enrolled=693)
Implement the new test and treat recommendation
Implement PITC to high risk children (OVC, malnourished, TB patients, admitted
children, ) because Strengthen pediatric PITC to high risk children (OVCs, malnourished
children, children with TB) at all health facility entry points is RHB priority
Improve HEI follow up and EID
Strengthen PMTCT service including ANC, institutional delivery, and post natal follow up
Improve quality of service and client retention
Strengthen mother support group
Continuous performance review
Ensure the use of self-assessment form
Support CSM and CAM
Common PMTCT/PCT SIMS findings/challenges
Availability of updated guideline
Facilities are not using the new PMTCT register
Few facilities do not provide ART at ANC clinics
Cotrimozaxole provision and record (register, follow up card)
Cotrimozaxole interruption
Unable to do routine HIV Testing for Children
No youth friendly service targeting PLHIV adolescents (An important aim of these programs is
to provide an environment that is conducive to engaging and retaining adolescents in care,
ensuring the successful transition of their care into adult services, and addressing psychosocial
and behavioral needs. Put written policy regarding disclosure and consent for HIV testing)
CTX for HIV-infected Pregnant and Breastfeeding Women is not provided/documented
Poor IPT provision
Does not refer clients to community services or document (identify and refer needy clients to
community services and document their referral and ensure getting the service)
Unable to trace mother and their infant (Prepare and use appointment logbook for exposed
infants and positive mother)
Family Planning
No family planning quality assurance. Quality assurance activities can include supportive
supervision, monitoring visits, and/or client satisfaction assessments?
No written SOP or clinic algorithm available for providing family planning counseling and/or
services at this service delivery point?
For clients who are referred to family planning services off-site, is there a system in place with
standard tools to track completed referrals? (use referral logbook)
Ensure that clients have access to at least three contraceptive methods either onsite or through
referral?
Ensuring availability of trained (FP) at ART clinic
Pediatrics ART monitoring
Unable to do CD4 testing as per the national guideline
There was D4T stock-out which has resulted in temporary interruption. The site failed to plan in
accordance with the D4T phase-out strategy due to communication gaps (FHRH)
HIV positive women and newborn prophylaxis at L&D clinic has no information in the HMIS
registers in the facility with respective HBM
Poor early infant diagnosis
DBS kit stock-out
Poor Pediatrics growth monitoring (we have to insert WHO growth monitoring chart to all
pediatrics client folder and appropriately plot and interpret at every visit)
