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Triple Benefit: Impact of an Integrated Early Childhood Development and PMTCT Intervention on ART Outcomes Among Mothers Living with HIV and Infants in Malawi—An Endline Evaluation

We conducted a programmatic, observational cohort study with mother-infant pairs (MIPs) enrolled in prevention-of-mother-to-child-transmission (PMTCT) programs in Malawi to assess the feasibility and potential HIV-related benefits of integrating Early Childhood Development (ECD) services into PMTCT...

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Autores principales: Dovel, Kathryn, Kalande, Pericles, Udedi, Evelyn, Bruns, Laurie, Desmond, Chris, Mbalanga, Chipariro, Gupta, Sundeep, Phiri, Sam, Chivwala, Mackenzie, Richter, Linda, Coates, Thomas J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10338574/
https://www.ncbi.nlm.nih.gov/pubmed/36746875
http://dx.doi.org/10.1007/s10461-022-03975-0
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author Dovel, Kathryn
Kalande, Pericles
Udedi, Evelyn
Bruns, Laurie
Desmond, Chris
Mbalanga, Chipariro
Gupta, Sundeep
Phiri, Sam
Chivwala, Mackenzie
Richter, Linda
Coates, Thomas J.
author_facet Dovel, Kathryn
Kalande, Pericles
Udedi, Evelyn
Bruns, Laurie
Desmond, Chris
Mbalanga, Chipariro
Gupta, Sundeep
Phiri, Sam
Chivwala, Mackenzie
Richter, Linda
Coates, Thomas J.
author_sort Dovel, Kathryn
collection PubMed
description We conducted a programmatic, observational cohort study with mother-infant pairs (MIPs) enrolled in prevention-of-mother-to-child-transmission (PMTCT) programs in Malawi to assess the feasibility and potential HIV-related benefits of integrating Early Childhood Development (ECD) services into PMTCT programs. Six health facilities were included in the intervention. We offered ECD counseling from the WHO/UNICEF Care for Child Development package in PMTCT waiting spaces while MIPs waited for PMTCT and broader treatment consultations. Primary outcomes were mothers’ retention in HIV care at 12 months and infant HIV testing at 6 weeks and 12 months after birth. Routine facility-level data from six comparison health facilities were collected as an adhoc standard of care comparison and used to calculate the cost of delivering the intervention. A total of 607 MIPs were enrolled in the integrated ECD-PMTCT intervention between June 2018 and December 2019. The average age of MIPs was 30 years and 7 weeks respectively. We found that 86% of mothers attended ≥ 5 of the 8 ECD sessions over the course of 12 months; 88% of intervention mothers were retained in PMTCT versus 59% of mothers in comparison health facilities, and 96% of intervention infants were tested for HIV by six weeks compared to 66% of infants in comparison health facilities. Costing data demonstrated the financial feasibility of integrating ECD and PMTCT programs in government health facilities in Malawi. Integrating ECD into PMTCT programs was feasible, acceptable, resulted in better programmatic outcomes for both mothers and infants. Further investigation is required to determine optimal delivery design for scale-up.
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spelling pubmed-103385742023-07-14 Triple Benefit: Impact of an Integrated Early Childhood Development and PMTCT Intervention on ART Outcomes Among Mothers Living with HIV and Infants in Malawi—An Endline Evaluation Dovel, Kathryn Kalande, Pericles Udedi, Evelyn Bruns, Laurie Desmond, Chris Mbalanga, Chipariro Gupta, Sundeep Phiri, Sam Chivwala, Mackenzie Richter, Linda Coates, Thomas J. AIDS Behav Original Paper We conducted a programmatic, observational cohort study with mother-infant pairs (MIPs) enrolled in prevention-of-mother-to-child-transmission (PMTCT) programs in Malawi to assess the feasibility and potential HIV-related benefits of integrating Early Childhood Development (ECD) services into PMTCT programs. Six health facilities were included in the intervention. We offered ECD counseling from the WHO/UNICEF Care for Child Development package in PMTCT waiting spaces while MIPs waited for PMTCT and broader treatment consultations. Primary outcomes were mothers’ retention in HIV care at 12 months and infant HIV testing at 6 weeks and 12 months after birth. Routine facility-level data from six comparison health facilities were collected as an adhoc standard of care comparison and used to calculate the cost of delivering the intervention. A total of 607 MIPs were enrolled in the integrated ECD-PMTCT intervention between June 2018 and December 2019. The average age of MIPs was 30 years and 7 weeks respectively. We found that 86% of mothers attended ≥ 5 of the 8 ECD sessions over the course of 12 months; 88% of intervention mothers were retained in PMTCT versus 59% of mothers in comparison health facilities, and 96% of intervention infants were tested for HIV by six weeks compared to 66% of infants in comparison health facilities. Costing data demonstrated the financial feasibility of integrating ECD and PMTCT programs in government health facilities in Malawi. Integrating ECD into PMTCT programs was feasible, acceptable, resulted in better programmatic outcomes for both mothers and infants. Further investigation is required to determine optimal delivery design for scale-up. Springer US 2023-02-06 2023 /pmc/articles/PMC10338574/ /pubmed/36746875 http://dx.doi.org/10.1007/s10461-022-03975-0 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Paper
Dovel, Kathryn
Kalande, Pericles
Udedi, Evelyn
Bruns, Laurie
Desmond, Chris
Mbalanga, Chipariro
Gupta, Sundeep
Phiri, Sam
Chivwala, Mackenzie
Richter, Linda
Coates, Thomas J.
Triple Benefit: Impact of an Integrated Early Childhood Development and PMTCT Intervention on ART Outcomes Among Mothers Living with HIV and Infants in Malawi—An Endline Evaluation
title Triple Benefit: Impact of an Integrated Early Childhood Development and PMTCT Intervention on ART Outcomes Among Mothers Living with HIV and Infants in Malawi—An Endline Evaluation
title_full Triple Benefit: Impact of an Integrated Early Childhood Development and PMTCT Intervention on ART Outcomes Among Mothers Living with HIV and Infants in Malawi—An Endline Evaluation
title_fullStr Triple Benefit: Impact of an Integrated Early Childhood Development and PMTCT Intervention on ART Outcomes Among Mothers Living with HIV and Infants in Malawi—An Endline Evaluation
title_full_unstemmed Triple Benefit: Impact of an Integrated Early Childhood Development and PMTCT Intervention on ART Outcomes Among Mothers Living with HIV and Infants in Malawi—An Endline Evaluation
title_short Triple Benefit: Impact of an Integrated Early Childhood Development and PMTCT Intervention on ART Outcomes Among Mothers Living with HIV and Infants in Malawi—An Endline Evaluation
title_sort triple benefit: impact of an integrated early childhood development and pmtct intervention on art outcomes among mothers living with hiv and infants in malawi—an endline evaluation
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10338574/
https://www.ncbi.nlm.nih.gov/pubmed/36746875
http://dx.doi.org/10.1007/s10461-022-03975-0
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