Abstract
BackgroundThe prevention of mother-to-child transmission (PMTCT) of HIV requires innovative solutions. Although routine monitoring is effective in some areas, standardized and easy-to-scale solutions to identify and monitor pregnant women, test them for HIV, and treat them and their children is still lacking. Mobile health (mHealth) offers opportunities for surveillance and reporting in rural areas of low- and middle-income countries.ObjectiveThe aim of this study was to document the preliminary impacts of the Tanzania Health Information Technology (T-HIT) system mHealth intervention aimed at health workers for PMTCT care delivery and capacity building in a rural area of Tanzania.MethodsWe developed T-HIT as a tablet-based system for an electronic data collection system designed to capture and report PMTCT data during antenatal, delivery, and postnatal visits in Misungwi, Tanzania. T-HIT was tested by health workers in a pilot randomized trial comparing seven sites using T-HIT assigned at random to seven control sites; all sites maintained standard paper record-keeping during the pilot intervention period. We compared numbers of antenatal visits, number of HIV tests administered, and women testing positive across all sites.ResultsHealth workers recorded data from antenatal visits for 1530 women; of these, 695 (45.42%) were tested for HIV and 3.59% (55/1530) tested positive. Health workers were unable to conduct an HIV test for 103 women (6.73%, 103/1530) because of lack of reagent, which is not captured on paper logs. There was no difference in the activity level for testing when comparing sites T-HIT to non-T-HIT sites. We observed a significant postintervention increase in the numbers of women testing positive for HIV compared with the preintervention period (P=.04), but this was likely not attributable to the T-HIT system.ConclusionsT-HIT had a high degree of acceptability and feasibility and is perceived as useful by health workers, who documented more antenatal visits during the pilot intervention compared with a traditional system of paper logs, suggesting potential for improvements in antenatal care for women at risk for HIV.
Highlights
When countries gathered in New York at the beginning of this century to articulate a new development agenda, one of the most momentous steps they took was to elevate health on the global development agenda
The pledges made by countries in the 2011 UN Political Declaration include specific improvements in health outcomes (e.g. 50% reductions in both sexual and drug-related HIV and the transmission, elimination of new HIV infections among children); coverage and resource targets; elimination targets; and steps to ensure the sustainability of the response
As a result of sustained progress in meeting the needs of tuberculosis patients living with HIV, the world is within reach of achieving the 2015 target of reducing by 50% tuberculosis-related deaths among people living with HIV
Summary
When countries gathered in New York at the beginning of this century to articulate a new development agenda, one of the most momentous steps they took was to elevate health on the global development agenda. Determined to build on prior gains in reducing new HIV infections and AIDS-related deaths, and looking forwards to the eventual end of the AIDS epidemic, they endorsed the 2011 UN Political Declaration on HIV/AIDS, which set forth a series of ambitious targets and elimination commitments for 2015. FIGURE A Numbers of people living with HIV, new HIV infections, and AIDS deaths, 2001-2012, globally. Momentum accelerated in 2012 towards the scale-up of one such biomedical intervention – voluntary medical male circumcision
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