What Works in Elimination of Mother-to-Child Transmission of HIV: Lessons from the Partnership for HIV-Free Survival

Join MEASURE Evaluation January 16 from 9–10am EST for a webinar on what works to eliminate mother-to-child transmission (MTCT) of HIV. The clear and compelling legacy of the Partnership for HIV-Free Survival (PHFS), a six-country USAID and PEPFAR-funded effort aimed at improving nutrition and MTCT outcomes in sub-Saharan Africa, is that a combination of straightforward activities can be introduced, implemented, and embraced by frontline staff as a way to improve service delivery and outcomes for prevention of mother-to-child transmission (PMTCT).

Our evaluation identified three main categories of PHFS activities that helped improve the performance of PMTCT programs:

• Service delivery
• Quality improvement
• Stakeholder engagement (oversight and implementation)

The PHFS approach succeeded in the facilities where it was implemented because it actively engaged the frontline staff in:

• The process of quality improvement (e.g., creating quality improvement [QI] teams, using QI journals, and implementing change ideas)
• Improvements to technical approaches and skills (e.g., integration of services, mother-baby pairs, and mother-baby clinics).

The other critical legacy of PHFS is that sustaining improvements in PMTCT outcomes at the facility level requires an ongoing commitment and capacity to provide the necessary technical and financial support. Our evaluation found that limited technical support to PHFS facilities past the direct PHFS implementation period – in particular, limited or nonexistent ongoing mentoring and coaching – limited facilities’ sustainment of effective QI activities and continual improvement of PMTCT services. However, the need for additional financial support at the facility level for PHFS activities is minimal because core PHFS activities essentially build on existing infrastructure and human resources.

Given the contributions of the combination of the PHFS activities to the elimination of MTCT of HIV, and, in turn, HIV epidemic control, these activities can and should be scaled up in PHFS countries as well as in other countries in region.

Register to attend the webinar.

The Speakers

Emily Bobrow, PhD, MPH, is a senior technical specialist for evaluation and learning at MEASURE Evaluation. Emily has nearly 20 years of technical and programmatic experience in international public health, has designed and implemented numerous public health programs and implementation research studies, and has provided evidence to support practical interventions. She is the leader of the Nutrition Assessment, Counseling and Support (NACS) and PMTCT portfolios and the Learning Agenda at MEASURE Evaluation. She also was the lead of the team which conducted the evaluation of the PHFS.

Heather Davis, MPH, is a research program manager for MEASURE Evaluation, including the PHFS country assessments activity and other activities in the NACS portfolio. She has more than 15 years of experience in global health coordination and research implementation, including leading two PEPFAR country programs. She supports qualitative research development, implementation, and analysis, as well as budget management, contracts negotiation, and quantitative research implementation.

David Hales is a long-time consultant in public health with specific expertise in HIV, nutrition, quality improvement, and M&E. He has extensive experience working with government, nongovernmental, bilateral and multilateral organizations in Africa, Asia and Europe. He is a consultant to MEASURE Evaluation for the evaluation of the PHFS.

Allie Munson, MPH, is a research specialist at MEASURE Evaluation and a research project manager at the Lineberger Comprehensive Cancer Center at the University of North Carolina in Chapel Hill. As a graduate research assistant at MEASURE Evaluation, she supported capacity building and evaluation activities. She worked on qualitative components of the evaluation of the PHFS, including the country-level assessments activity.