PMTCT PROGRAMME MONITORING

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PMTCT PROGRAMME MONITORING

• DR. S.K CHATURVEDI
• DR. KANUPRIYA CHATURVEDI

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OBJECTIVES

• Describe the program cycle
• Describe the key components of a PPTCT program
• Discuss the purposes of global and national PPTCT
  indicators
• Understand the role of the healthcare provider in
  monitoring a PPTCT program

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The PPTCT Program Network

• HIV testing and counselling centres
• Family planning programs
• Antenatal clinics
• STI programs
• Labour and delivery care
• Postpartum and infant care clinics
• HIV/AIDS care and treatment
• Community services for persons living with
  HIV/AIDS

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Review of PPTCT Intervention

• Voluntary testing and counselling
• Safe obstetric practices
• ARV prophylaxis for HIV-infected women and
  their infants
• Safer infant-feeding counselling
• Links to care and support
• Careful infection prevention practices

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Choosing PPTCT Interventions

• Ethically sound
• Technically up-to-date
• Relevant to the setting
• Accepted or endorsed by the communit

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Points to Remember

• Involve the community
• Strive for a full range of services
• Develop interventions that causes minimal
  burden to clients and families
• Remain flexible

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Importance of PPTCT Program Indicators

• Determine if the PPTCT programs are implemented
  as planned
• Assess the effects of programs on preventing
  MTCT
• Decide how programs can be more effective

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Indicators for PPTCT Programs

• National indicators
• Reflect goals, objectives and activities of
  nationwide plan
• Health facility indicators
• Help set targets and track progress towards PPTCT
  goals
• Global indicators
• Reflect current worldwide situation in one health
  area

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Example of Global PPTCT Indicators

• Number of pregnant women who tested positive
  for HIV
• Number of HIV-positive pregnant women who
  received ARV prophylaxis
• Number of newborn babies who received ARV
  prophylaxis

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Examples of National PPTCT Indicators

• How will we know if we are reducing MTCT?
• Proportion of pregnant women who agreed for HIV
  testing
• Proportion of HIV positive pregnant women
  attending ANC who undergo institutional delivery
• Proportion of HIV positive pregnant women who
  receive ARV prophylaxis

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Health Facility Indicators Should Answer These
Questions

• Are our programs running the way we planned?
• Are we reaching the right people?
• Are clients satisfied with our services?
• Are our clients becoming healthier?
• How can we improve our program?
• What program information is needed at the
  national level?

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Health Facility Indicators Should Answer These
Questions

• Are our programs
• Running the way we planned
• Reaching the right people
• Requiring improvement
• Are our patients
• Satisfied with our services
• Becoming healthier

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Monitoring and Evaluation in PPTCT

• Monitoring
• Tracks indicators
• Data gathering
• Analysis and regular reporting
• Determines if programs are carried out as planned
• Usually is conducted at health facility

• Evaluation
• Measures changes in a situation resulting from
  an intervention (e.g., a PPTCT service)
• Usually is conducted at the national level
• Is costly and complex

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Flow of Record Keeping Data

• Individual
• Record Form

• Daily
• Summary
• Reports

Monthly Reports
Quarterly Reports
Annual Global PMTCT Reports
district/ national
department/ facility
department/ facility
Facility district
national
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Characteristics of Good Monitoring Systems

• Clear definitions of indicators
• Standard tools, data sources and collection
  methods
• Clear roles and responsibilities
• Clear guidelines and protocols

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Tips for Good Data Collection

• Understand the data
• Record the data every time
• Record all the data
• Record the data in the same way every time

The healthcare worker should know who is
responsible for the monitoring system, be able to
record data accurately and reliably, and
understand how and when to report service and
client health-related information.
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Key Points

• The program cycle describes the process required
  to conduct a program. Program cycle steps include
  situation analysis, planning and design,
  implementation, monitoring, and evaluation.
• Use global, national and facility-level
  indicators to measure progress toward program and
  health goals.
• Health facility data should reflect national
  indicators for PPTCT so the program data can
  contribute to the national-level monitoring and
  evaluation.

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Key Points (continued)

• Monitoring is the routine tracking of program
  information
• Reliable and accurate health facility record
  keeping provides essential information for
  providing quality health care and monitoring
  PPTCT programs.