Baseline Assessment Tools for Preventing Mother to Child Transmission (PMTCT) of HIV
To ensure the safe and effective application of Preventing Mother to Child Transmission (PMTCT) in Antenatal Care (ANC) and Mother and Child Health (MCH) services through evaluation of existing services and systematic monitoring and evaluation to:
- Help determine whether existing health services are adequately prepared for the introduction of PMTCT interventions
- Identify gaps for improving ANC/MCH services and for integrating PMTCT services to ensure that PMTCT interventions are safe and effective
- Provide guidance for maintaining high quality services through effective monitoring and evaluation of PMTCT programs.
Description:
This package consists of six tools. Each tool has been developed to be able to stand alone and to be used in any type of facility, whether a large referral hospital or small health center. The six tools are:
- PMTCT Prenatal Care Assessment Tool: Assesses the existing ANC, and if applicable, PMTCT services. This tool looks specifically at organization of services and hours of operation; infrastructure, equipment, and commodities; services provided; referrals; protocols and guidelines; well-baby care; community mobilization and BCC; HMIS; costs; human resources and management.
- PMTCT Maternity Tool (labor, delivery, and postnatal) Assesses the maternity and postnatal services, and if applicable, PMTCT services. This tool looks specifically at general services, infrastructure, and supplies, the labor and delivery ward, the postnatal ward, costs, and HMIS. The PMTCT services section assesses protocols and guidelines, confidentiality, follow-up of mother-infant pairs, counseling, referrals, and materials.
- PMTCT Laboratory Assessment Tool: Assesses equipment and supplies, tests conducted, testing protocols and policies, confidentiality, human resources and HMIS.
- Inventory Checklist: Assesses supplies and data collection records.
- PMTCT Health Provider Assessment Tool Explores health care provider qualifications, capacity, attitudes, knowledge, and motivation
- PMTCT Client Exit Interview Assesses clients’ experiences with the service and attitudes.
Intended users:
This tool can be used by public and private health facilities, at all levels, who wish to implement PMTCT services and/or wish to assess their existing MCH services.
NGO and site-level PMTCT program/project managers, administrators of health facilities, and all staff at a health facility where PMTCT services may be or have been introduced including: PMTCT site managers and staff directly involved in the program, and MCH staff affected by the introduction of PMTCT and/or HIV testing services. It can also benefit community health staff linked to the health facility, including TBAs, CHWs, etc.
Developed by:
Family Health International, Institute for HIV/AIDS, 2101 Wilson Blvd., Suite 700, Arlington, VA 22201
Application:
Burundi, January and February 2004: the tool was used to assess the readiness of around 10 hospitals and health centers to start implementing PMTCT.
Kenya, November and December 2003: the tool was used to assess 24 sites where PMTCT should be shortly implemented.
Haiti, August and September 2003: the tool was used by FHI/country office to evaluate 20 potential sites before launching PMTCT programs in some of them.
EGPAK/Kenya: the tool has been continuously used to assess sites as PMTCT interventions are being rolled out.
In each of these cases, the tool has been adapted to capture elements specific to each context.
Advantages:
The tool allows a program to assess both the readiness of a site to implement the PMTCT intervention, as well as assess the intervention itself if already implemented. It allows for flexibility of the assessment team according to the type of site. It can be used at a site with a “one-stop-shop” model of PMTCT service delivery; or at a site where PMTCT services are only offered at the ANC or at a maternity; or in a modular way according to necessities, for example, use only ANC plus the laboratory assessment tool if relevant to the facility.
It is generic enough that most of the questions and structure are appropriate for any region, but can be adapted to the context of the country.
Limitations:
The length of the surveys requires a substantial investment of time; the developers do not mention how long each survey would take to administer. There are no clear guidelines for analysis of results, or what to do with the results. Guidance on using the tool is limited; it may require training and/or preparatory time.
Recommendations for users:
It is recommended to conduct initial baseline assessments; they can also be used for follow-up assessments. If PMTCT services have not been implemented prior to the baseline assessment, it is recommended to return to the facility after implementation of the intervention to conduct an assessment of the PMTCT services post-implementation (6 months or 1 year), and a follow-up assessment of the MCH services.
For successful integration of PMTCT services, the assessments should be conducted with participation from site-level staff. Key questions can be pulled from these tools for regular monitoring of a program’s progress.
Reports and Publications: None at this time.
Availability: English
Contact:
Gloria Sangiwa, Associate Director
VCT/MTCT Unit, Care & Treatment Division
Family Health International Institute for HIV/AIDS
2101 Wilson Blvd.
Suite 700
Arlington, VA 22201