Optimizing PMTCT service delivery in rural North-Central Nigeria: protocol and design for a cluster randomized study.
Contemp Clin Trials
; 36(1): 187-97, 2013 Sep.
Article
em En
| MEDLINE
| ID: mdl-23816493
ABSTRACT
Nigeria has more HIV-infected women who do not receive needed services for the prevention of mother-to-child transmission of HIV (PMTCT) than any other nation in the world. To meet the UNAIDS/WHO goal of eliminating mother-to-child HIV transmission by 2015, multiple interventions will be required to scale up PMTCT services, especially to lower-level, rural health facilities. To address this, we are conducting a cluster-randomized controlled study to evaluate the impact and cost-effectiveness of a novel, family-focused integrated package of PMTCT services. A systematic re-assignment of patient care responsibilities coupled with the adoption of point-of-care CD4 + cell count testing could facilitate the ability of lower-cadre health providers to manage PMTCT care, including the provision and scale-up of antiretroviral therapy (ART) to pregnant women in rural settings. Additionally, as influential community members, male partners could support their partners' uptake of and adherence to PMTCT care. We describe an innovative approach to scaling up PMTCT service provision that incorporates considerations of where and from whom women can access services (task-shifting), ease of obtaining a CD4 + cell count result (point-of-care testing), the degree of HIV service integration for HIV-infected women and their infants, and the level of family and community involvement (specifically male partner involvement). This systematic approach, if proven feasible and effective, could be scaled up in Nigeria and similar resource-limited settings as a means to accelerate progress toward eliminating mother-to-child transmission of HIV and help women with HIV infection take ART and live long, healthy lives (Trial registration NCT01805752).
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
2_ODS3
/
5_ODS3_mortalidade_materna
Base de dados:
MEDLINE
Assunto principal:
Projetos de Pesquisa
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Infecções por HIV
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Transmissão Vertical de Doenças Infecciosas
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Antirretrovirais
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Centros de Saúde Materno-Infantil
Tipo de estudo:
Clinical_trials
Limite:
Female
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Humans
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Infant
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Newborn
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Pregnancy
País/Região como assunto:
Africa
Idioma:
En
Revista:
Contemp Clin Trials
Ano de publicação:
2013
Tipo de documento:
Article