pmtct indicators

GOAL: To contribute to the reduction of MTCT through support to PMTCT program in xx district of yz Region of Uganda between 2010 - 2015.

Activity Target population Target OutputObjectively verifiable indicator

Sources and Means of verification

Timeline

Responsible / lead

Critical Assumptions

Q1

Q2

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Q4

Objective 1: Increase service coverage of comprehensive, high quality, integrated, PMTCT services up to all HC III and functional HC II in the district.

1.1.1 Documentation of number of active PMTCT sites supported by project

PREFA Existing sites will provide services continuously inspite of resource constraints

1.1.2 Guide districts in compiling integrated district work plans for PMTCT services

Districts (See 5.1.1)

Number and % of districts that have a comprehensive integrated PMTCT plan

Final PMTCT annual plans presented through MOH for funding

MOH

1.1.3 Provide performance based grants to districts

Districts PREFA Districts will account on time avoiding un-necessary delays in implementation

1.2.1 Procurement of buffer stocks of HIV testing kits, CD4 test consumables, and Cotrimoxazole.

Health facilities providing RH services

% of stocks of key PMTCT supplies procured as buffer stock

Internal audit reports; quarterly progress reports

PREFA The actual gap may be 30% or less.

1.2.2 Procurement of buffer stocks of ARVS, and STI screening kits for PMTCT sites


% of stocks of key PMTCT supplies procured as buffer stock


PREFA



Timeline

Responsible / lead


Q1

Q2

Q3

Q4

1.2.3 Remodelling of space for counselling and laboratory services

Health facilities in W/Nile and Eastern region

Number and % of facilities remodelled according to the work plan

Internal audit reports; district finance reports

Districts

1.3.1 Establish courier system for lab tests

Districts Number of functional courier systems by region

Internal audit reports

PREFA

1.3.2 Transport CD4 and DBS samples and results between PMTCT sites and the testing laboratory.

Health facilities providing PMTCT services

Number and % of facilities that submit CD4 samples and receive results per month

District progress reports; Quarterly joint supervision reports

Districts

1.4.1 Hire additional staff (Midwives, Lab Asst, Peer Counsellors) for PMTCT sites

Districts Number of staff hired per year


Districts

1.4.2 Training Health Workers in comprehensive HIV/AIDS care using IMAI / IMPAC approach

Health workers at PMTCT sites

Number and % of health workers trained

Training reports; District progress reports; Quarterly joint supervision reports

PREFA

1.4.3 Training Health Workers in infant and young child feeding (IYCF).




PREFA



Timeline

Responsible / lead


Q1

Q2

Q3

Q4

1.4.4 Training Health Workers in rapid HIV testing and EID.




PREFA

1.4.5 Training of trainers in comprehensive PMTCT counselling, IYCF, EID, and RH/FP (using IMAI IMPACT approach)

District trainers/ health workers



PREFA

1.4.6 Orientation of CCAs in PMTCT service delivery including provision of modern FP services

CCAs attached to PMTCT sites

Number and % of CCAs trained


PREFA

1.4.7 Training of health workers in data management




PREFA

1.4.8 Training of family support group members as peer mentors


Number and % of FSG members trained


PREFA

1.4.9 Conduct post-training supervision


Number and % of health workers supervised within 3

Post-training supervision report

PREFA



Timeline

Responsible / lead


Q1

Q2

Q3

Q4

months of completion of training

1.4.10 DHT Conduct quarterly monitoring visits of PMTCT sites

PMTCT sites Number and % of facilities supervised by DHT at least once / quarter


Districts This is an integrated activity

1.4.11 HSD Conduct monthly monitoring visits of PMTCT sites

PMTCT sites Number and % of facilities supervised by HSD team at least once / month


Districts Funds reach HSDs in time

1.4.12 Conduct monthly technical support sessions (CMEs, mentoring, coaching) for Health Workers at PMTCT sites


Number or % of facilities conducting at least one CME session per quarter


Districts

Objective 2: Increase uptake of comprehensive PMTCT services from 65% to 80% of all expected pregnant women in the 40 districts.

2.1.1 Conduct radio talk shows

Adults of child bearing age in community

Number of radio sessions conducted

District progress reports

Districts

2.1.2 Conduct community education sessions on PMTCT by CCAs


Number of sessions conducted by each CCA


Districts

2.1.3 Facilitate PHA groups for PWP activities in the community.

PHA groups in community

Number of events conducted per quarter; Number and % of active PHA groups


Districts

2.1.4 Funding and technical Male peer groups Number of events District progress Districts Reviewed every 6



Timeline

Responsible / lead


Q1

Q2

Q3

Q4

guidance to male peer-group activities

in community conducted per quarter; Number and % of active male groups

reports

months this year. There is one group per district

2.2.1 Conduct referral of pregnant women to health facilities by CCAs

Pregnant women in community

Number and % of pregnant women referred by CCAs for RH services


Districts

2.2.2 Establish notice of community rights to service


Number and % of facilities with notices on community rights

District supervision reports

PREFA

3.1.1 Conduct monthly integrated PMTCT outreaches to HC IIs

Health facilities without PMTCT services

Number and % of lower facilities receive monthly visits from higher level facilities


Districts Hospitals and HC IV will build capacity for static PMTCT services at lower levels

3.1.2 Pre-test counselling of pregnant women

Pregnant women attending ANC

Number and % of pregnant women who receive pre-test counselling

Monthly HMIS and PMTCT reports

Districts 98% of 620,642 pregnant women attend ANC at least once at a public facility

3.1.3 Conduct rapid HIV tests for pregnant women and give them test results


Number and % of pregnant women who receive pre-test

Monthly HMIS and PMTCT

Districts 95% of new ANC clients will test for



Timeline

Responsible / lead


Q1

Q2

Q3

Q4

counselling reports HIV

3.1.4 Conduct Hb, Syphilis and urine tests


Number and % of pregnant women who receive Hb, urine and syphilis screening


Districts As a minimum, all women who test HIV positive also get other routine tests.

3.1.5 Identify HIV positive mothers for further care and support.

Pregnant women attending ANC who test for HIV

Number and % of pregnant women who test HIV positive


Districts 90% of expected HIV infected pregnant women attend ANC and take the HIV test.

3.2.1 Collection of blood samples for CD4 test from HIV positive women and document HIV clinical stage.

Pregnant HIV-infected women

Number and % of HIV positive pregnant women who have a blood sample taken for CD4 testing


Districts 100% HIV positive women attending ANC

3.2.2 Provide ARV prophylaxis to HIV positive women


Number and % of HIV positive pregnant women who receive ARVs for PMTCT, by regimen.


Districts 100% HIV positive women attending ANC

3.2.3 Conduct delivery of HIV infected women under skilled care


Number and % of HIV positive pregnant women who deliver under skilled care.


Districts 80% HIV positive women deliver under skilled care with good follow-up

3.2.4 Provide ARV prophylaxis to HIV exposed babies


Number and % of HIV exposed babies who receive ARV prophylaxis


Districts 100% of babies born to HIV positive women under skilled care

3.2.5 Provide Pregnant HIV- Number and % of HIV Monthly HMIS Districts 100% of HIV positive



Timeline

Responsible / lead


Q1

Q2

Q3

Q4

Cotrimoxazole prophylaxis for HIV positive pregnant women as part of a basic care package (BCP)

infected women positive pregnant women who receive Cotrim tablets

and PMTCT reports

women attending ANC

3.2.6 Provide Cotrimoxazole prophylaxis for HIV exposed babies


Number and % of HIV exposed babies who receive Cotrim


Districts 80% of babies born to HIV positive women are tracked for more services

3.2.7 Provide funds and technical guidance to family support group meetings


Number and % of pregnant women who test HIV positive


Districts Each HSD will have one group to support intensively

3.3.1 Establish and maintain system of referral to care and support within PMTCT site and to external ART sites

PMTCT and ART sites

Number and % of HSDs with documented referral network; Number and % of health facilities linked to network


Districts Each of 53 HSDs will have at least one ART site

3.3.2 Track HIV infected mothers and their babies at facility and community level


Number and % of HIV positive mothers tracked; Number and % of HIV exposed babies tracked


Districts CCAs and health workers will keep track of at least 80% of HIV infected women identified at PMTCT sites.

3.3.3 Conduct referral of HIV positive pregnant women/ their babies to ART and HIV care services


Number and % of HIV positive mothers referred; Number and % of HIV exposed


Districts



Timeline

Responsible / lead


Q1

Q2

Q3

Q4

babies referred

Objective 3: Provide early infant HIV testing to 80% of all HIV-exposed babies.

4.1.1 Health workers conduct (integrated) EID outreaches

Health facilities without PMTCT services

3.1.1 3.1.1

Districts

4.1.2 Mentoring health workers in EID for HIV exposed babies


Number of sessions conducted per facility per year; % of facilities receiving a session per quarter

District progress reports; Monthly PMTCT reports

Districts This is combined under 1.4.12

4.1.3 Identify HIV exposed infants in postnatal, immunization and outpatient clinics

HIV exposed babies

Number and % of HIV exposed babies who are identified


Districts All babies will have a code on their immunization cards

4.1.4 Collect DBS specimens from HIV exposed infants

HIV exposed babies

Number and % of HIV exposed babies who have a DBS taken for HIV testing within 12 months of birth


Districts At least 80% of exposed babies are delivered under skilled care and tracked for further services

4.1.5 Transport DBS (together with CD4) specimens and test results to and from the reference laboratory

Health facilities that provide PMTCT/MCH services

Number and % of facilities that submit DBS samples and receive PCR results per month


Districts

4.2.1 Conduct referral of HIV exposed infants from

HIV exposed babies

Number and % of HIV exposed babies


Districts 70% of babies are referred by the CCAs



Timeline

Responsible / lead


Q1

Q2

Q3

Q4

the community by CCAs referred from the community by CCAs

4.2.2 Conduct referral of HIV positive babies to ART and HIV care services

HIV exposed babies

Number and % of HIV infected babies referred for ART and HIV care


Districts 5.4% of babies tested may be infected with HIV

Objective 4: Promote integration of PMTCT with RH, nutrition, and HIV care and treatment service at 628 PMTCT sites in 40 districts.

5.1.1 Develop district plans integrating PHC and RH gaps

Districts Number and % of districts with comprehensive integrated PMTCT workplans

Plans presented through MOH for funding

Districts

5.1.2 District technical teams conduct supervision of integrated PMTCT/RH/PHC activities

PMTCT sites (see 1.4.10)

Number of visits per facility per year; % of facilities receiving a visit per year


Districts 1.4.10

5.1.3 Procurement of buffer stock of Infection control supplies and delivery care equipment

Health facilities providing PMTCT services

Number and % of buffer stocks of infection control supplies and delivery care equipment procured, by type


PREFA Need will be 25% or less

5.1.4 Procurement of therapeutic foods (RUFTs or RUTAFA) for treatment of acute malnutrition of


Proportion of budgeted funds used to procure therapeutic foods (RUFTs)


PREFA All hospitals and HC IV will be able to treat these clients



Timeline

Responsible / lead


Q1

Q2

Q3

Q4

HIV exposed clients.

5.2.1 Health workers conduct routine integrated PMTCT/RH/PHC outreaches

Health facilities without PMTCT services (see 3.1.1)

Number and % of lower facilities receive monthly visits from higher level facilities


Districts 3.1.1

5.2.2 Routine screening of HIV infected pregnant women for TB and referral for care and treatment

HIV infected pregnant women (see 3.1.5)

Number and % of pregnant women screened for TB


Districts

5.2.3 Routine screening and management of STIs among pregnant women


Number and % of pregnant women screened/ managed for STIs

Monthly HMIS; District progress reports

Districts

5.2.4 Conduct routine nutritional assessment of HIV infected mothers and their babies, including nutrition counselling and education during ANC, maternity and PNC care

HIV infected pregnant women and their babies

Number and % of pregnant women screened for nutrition status


MUJHU

5.2.5 Establish and maintain demonstration gardens and kitchens at HC IV and at community level

HSD Number of demonstration gardens established


MUJHU

5.2.6 CCA, CDO, and Agric Officer visits to provide FP commodities, Cotrim refills, to PMTCT

Pregnant HIV-infected women and their babies

Proportion of mothers visited by a community worker


MUJHU



Timeline

Responsible / lead


Q1

Q2

Q3

Q4

clients in the community

5.2.7 Treat HIV exposed Malnourished clients with RUTF

HIV exposed Malnourished children

Number and % of HIV exposed malnourished clients treated with RUTF


MUJHU

5.2.8 Establish tracking system within HSD for clients between PMTCT and ART sites

PMTCT and ART sites (see 3.3.1)

Number and % of HSDs with documented referral network; Number and % of health facilities linked to network


3.3.1

5.2.9 Conduct regular HSD coordination meetings involving all HIV service outlets in catchment area

PMTCT and ART sites

Number and % of monthly HSD coordination meetings held as planned


5.2.10 Community mobilisation including messages addressing other PHC and RH issues

Adults of child bearing age in community (see 2.1.3)

Number of sessions conducted by each (of 330) CCAs per month


2.1.3

Objective 5: Strengthen administration, management, and information systems at all levels of the project.

6.1.1 Hire of project staff Project staff Number of staff hired- by category

Minutes of Project Management meetings

PREFA

6.1.2 Capacity (training and equipment) of staff

Project staff Number and % of staff trained as

Minutes of Project Management

PREFA



Timeline

Responsible / lead


Q1

Q2

Q3

Q4

planned meetings

6.2.1 District leaders sign agreements with PREFA

Districts Number of MOUs signed with the districts

Minutes of Project Management meetings

PREFA

6.2.2 Update of district and sub county leaders on the PMTCT project

District leaders Number of districts that conducted update sessions

Program reports PREFA

6.2.3 Conduct administrative support supervision by district leaders

PMTCT sites Number and % of visits by district leaders per facility per year


Districts

6.2.4 Conduct joint PMTCT support supervision at district level by partners

PMTCT sites Number of joint supervision visits conducted by partners


PREFA PREFA, MUJHU, MOH and HIV stakeholders at district level are represented on the team

6.2.5 Conduct district PMTCT stakeholders' meeting

HIV stakeholders in district

Number of stakeholder meetings held per district


PREFA Each district has more than one HIV stakeholder who need to meet for better coordination

6.2.6 Conduct quarterly HSD coordination meetings (health workers and CCAs)

Health workers and CCAs

Number of HSDs conducting coordination meetings per quarter


Districts Two meetings; one with CCAs and the other with In charges of PMTCT sites

pmtct indicators

Documents