Measuring the Impact of Integrating Maternal and Newborn HIV Testing With Childhood Immunization Services
- Conditions
- HIV
- Interventions
- Other: HIV testing commodity reinforcementOther: Policy reinforcement meetingOther: Opt-out HIV testing for mothers and newbornsOther: Operational support for service integrationOther: Community sensitization
- Registration Number
- NCT02479659
- Lead Sponsor
- IDinsight
- Brief Summary
This randomized evaluation measured the impact of two levels of support for the integration of infant and postpartum maternal HIV testing with routine immunization services in Southern Zambia on the number of postpartum maternal HIV tests, infant HIV tests, and 1st dose diphtheria, pertussis, and tetanus (DPT1) vaccines.
- Detailed Description
This evaluation assessed two levels of support for the integration of early infant and maternal HIV testing with existing routine immunization services in rural health facilities in Southern Zambia with the aim of determining whether infant and postpartum maternal HIV testing rates would increase without harming immunization uptake. The evaluation randomized 60 health facilities to one of three study arms: 1) Control (status quo); 2) Simple Intervention; and 3) Comprehensive Intervention. The Simple Intervention included restocking of HIV test kits and reminding health facilities of existing HIV testing guidelines by government health officials. The Comprehensive Intervention included the Simple Intervention components, as well as community sensitization, hands-on operational support to integrate services and improve patient flow, and opt-out HIV testing for mothers and infants according to existing guidelines. The change in the average number of monthly HIV tests and immunizations (DPT1) between the intervention period and baseline were compared between treatment and control facilities.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 60
- Mothers who had an infant within the past 18 months during the intervention period (Oct 2013 - Mar 2014)
- Infants who were at least six weeks of age and under six months of age during the intervention period (Oct 2013 - Mar 2014)
- Qualitative activities included facility staff and mothers and caregivers whose infants were due for their 6 week immunization during the intervention period.
- Mothers who did not have an infant within the past 18 months during the intervention period
- Infants who were less than six weeks of age during the intervention period or greater than six months of age throughout out the intervention period.
- Adults who were not mothers or caregivers with an infant due for his/her 6 week immunization during the intervention period were excluded from the qualitative activities.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Comprehensive Intervention Operational support for service integration This arm included: 1) HIV testing commodity reinforcement, 2) a policy reinforcement meeting, 3) community sensitization, 4) Opt-out HIV testing for mothers and newborns, and 5) Operational support for service integration Comprehensive Intervention Community sensitization This arm included: 1) HIV testing commodity reinforcement, 2) a policy reinforcement meeting, 3) community sensitization, 4) Opt-out HIV testing for mothers and newborns, and 5) Operational support for service integration Comprehensive Intervention Opt-out HIV testing for mothers and newborns This arm included: 1) HIV testing commodity reinforcement, 2) a policy reinforcement meeting, 3) community sensitization, 4) Opt-out HIV testing for mothers and newborns, and 5) Operational support for service integration Simple Intervention HIV testing commodity reinforcement This included: 1) HIV testing commodity reinforcement and 2) a policy reinforcement meeting Simple Intervention Policy reinforcement meeting This included: 1) HIV testing commodity reinforcement and 2) a policy reinforcement meeting Comprehensive Intervention HIV testing commodity reinforcement This arm included: 1) HIV testing commodity reinforcement, 2) a policy reinforcement meeting, 3) community sensitization, 4) Opt-out HIV testing for mothers and newborns, and 5) Operational support for service integration Comprehensive Intervention Policy reinforcement meeting This arm included: 1) HIV testing commodity reinforcement, 2) a policy reinforcement meeting, 3) community sensitization, 4) Opt-out HIV testing for mothers and newborns, and 5) Operational support for service integration
- Primary Outcome Measures
Name Time Method Change in average monthly number of infant DBS HIV tests Baseline and 6 mos (endline) Using a difference-in-differences analytic approach, the investigators analyzed counts of the number of infant dried blood spot (DBS) HIV tests administered per month at each of the 60 study facilities between Oct 2013 and Mar 2014 (intervention period), and compared it to retrospective baseline data from Jan 2012 - Sept 2013
Change in average monthly number of maternal postpartum HIV tests Baseline and 6 mos (endline) Using a difference-in-differences analytic approach, the investigators analyzed counts of the number of maternal postpartum HIV tests administered per month at each of the 60 study facilities between Oct 2013 and Mar 2014 (intervention period), and compared it to retrospective baseline data from Jan 2013 - Sept 2013
Change in average monthly number of DPT1 doses administered Baseline and 6 mos (endline) Using a difference-in-differences analytic approach, the investigators analyzed counts of the number of first dose diphtheria, pertussis, and tetanus vaccine (DPT1) administered per month at each of the 60 study facilities between Oct 2013 and Mar 2014 (intervention period), and compared it to retrospective baseline data from Jan 2012 - Sept 2013
- Secondary Outcome Measures
Name Time Method