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Effective Monitoring for HIV Prevention:
Re-testing HIV-Negative Pregnant Clients
Presenter: Phylis Mutiso, mothers2mother...
Presentation Outline
• Introduction
– About m2m
– KMMP services
• Mentor Mother M/E tools
• Methods
• Lessons learnt
Background
mothers2mothers (m2m)
• Provide Peer Education
(PE) and Psychosocial
support (PSS) to HIV
positive pregnant wom...
Background
• m2m directly implements this model at 30
high volume health facilities under
umbrella of MOH Kenya Mentor Mot...
Background
• MMs are competitively
recruited and undergo a
two-week national
KMMP curriculum-based
Pre-Service Training(PS...
KMMP Services
• one-on-one/couple
PE and PSS
• support groups
• defaulter tracing
• internal referrals
and linkages
• serv...
KMMP Monitoring & Evaluation Tools
Longitudinal records
HIV+ logbook tracks HIV
+ mother-baby pairs
from pregnancy to 18
m...
Context
• PMTCT national guidelines recommend
re-test of HIV pregnant clients after
three months
• Roll out of re-testing ...
Description
• MMs provide services through
interaction with HIV positive pregnant
clients & new mothers
• They provide 2 p...
Description
• Client details are recorded in an HIV
negative longitudinal register which is
updated when clients return fo...
Description
• MMs conduct telephonic defaulter
tracing
• Depending on client consent, it starts
with an SMS
• If a client ...
Lessons Learned
Lessons Learnt
• Re-testing remains a challenge
• Most clients come late in pregnancy
• Re-testing uptake lower in Western...
Lessons Learnt
• Data from 30 health facilities from Jan
to Dec indicates that only 23% of HIV
negative clients returned f...
Conclusion
• Effective program monitoring is an
essential part of PMTCT programming
– To ensure available services are bei...
Conclusion
• Monitoring for re-
testing should include
post natal period
• Re-testing must be
integrated in to health
syst...
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Effective Monitoring for HIV Prevention: Re-testing HIV-Negative Pregnant Clients

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HIV+ logbook tracks HIV + mother-baby pairs from pregnancy to 18 months post-partum

HIV- logbook tracks HIV- women through pregnancy for retesting at three months

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Effective Monitoring for HIV Prevention: Re-testing HIV-Negative Pregnant Clients

  1. 1. Effective Monitoring for HIV Prevention: Re-testing HIV-Negative Pregnant Clients Presenter: Phylis Mutiso, mothers2mothers NOPE Conference, Nairobi June 2014
  2. 2. Presentation Outline • Introduction – About m2m – KMMP services • Mentor Mother M/E tools • Methods • Lessons learnt
  3. 3. Background mothers2mothers (m2m) • Provide Peer Education (PE) and Psychosocial support (PSS) to HIV positive pregnant women and new mothers to promote PMTCT
  4. 4. Background • m2m directly implements this model at 30 high volume health facilities under umbrella of MOH Kenya Mentor Mother Program (KMMP) • The KMMP seeks to improve PMTCT uptake and retention by integrating mothers living with HIV into health facilities to provide PE & PSS to their peers as Mentor Mothers (MMs)
  5. 5. Background • MMs are competitively recruited and undergo a two-week national KMMP curriculum-based Pre-Service Training(PST) • PST prepares them to provide quality services to clients through task shifting approach
  6. 6. KMMP Services • one-on-one/couple PE and PSS • support groups • defaulter tracing • internal referrals and linkages • services are captured in appropriate KMMP M&E tools
  7. 7. KMMP Monitoring & Evaluation Tools Longitudinal records HIV+ logbook tracks HIV + mother-baby pairs from pregnancy to 18 months post-partum HIV- logbook tracks HIV- women through pregnancy for retesting at three months
  8. 8. Context • PMTCT national guidelines recommend re-test of HIV pregnant clients after three months • Roll out of re-testing has been slow across the country • Monitoring of client uptake and outcomes of re-testing remains a challenge
  9. 9. Description • MMs provide services through interaction with HIV positive pregnant clients & new mothers • They provide 2 part-focused interaction (first visit and return visit for re-testing) with HIV negative to motivate them to return for re-testing and influence their male partners to come in for testing at the health facility
  10. 10. Description • Client details are recorded in an HIV negative longitudinal register which is updated when clients return for services • Client return date is booked in a calendar diary • Diaries are reviewed daily to identify clients due for re-testing who have missed appointments • The defaulter tracing process is started the next day
  11. 11. Description • MMs conduct telephonic defaulter tracing • Depending on client consent, it starts with an SMS • If a client does not respond to the sms a telephone call is made • MMs develop list of clients for home visiting by CHWs through the CHEW
  12. 12. Lessons Learned
  13. 13. Lessons Learnt • Re-testing remains a challenge • Most clients come late in pregnancy • Re-testing uptake lower in Western Kenya than in Nairobi • Sero-conversion is higher in Western- (Nyanza where prevalence is at 15.1% KAIS 2012)
  14. 14. Lessons Learnt • Data from 30 health facilities from Jan to Dec indicates that only 23% of HIV negative clients returned for re- testing (7,816 out of 34,103) • 1 % (89 out 7816) sero converted during pregnancy and tested HIV positive, standing a high chance of infecting their infants
  15. 15. Conclusion • Effective program monitoring is an essential part of PMTCT programming – To ensure available services are being utilized – To link high risk clients to care as quickly as possible
  16. 16. Conclusion • Monitoring for re- testing should include post natal period • Re-testing must be integrated in to health system monitoring

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