In the quest to attain elimination of mother-to-child transmission of HIV,the project has continued to strengthen a family-centered approach in the eMTCT campaign. Universal HTS for every pregnant and lactating woman and enrolment into chronic HIV/AIDS care and treatment for all HIV positive mothers continues to take root in Rwenzori region. 51 health units received comprehensive mentorship in PMTCT/EID over the period. The project attained 122% of the quarterly target for mothers attending ANC who received HTS with 99.9% of the HIV positive mothers started on ART. Overall HIV prevalence in MCH was 5.0% in the April-June 2017 quarter with Kabarole, Kyenjojo, Kyegegwa and Kamwenge reporting a higher burden of HIV in ANC than the regional average. Identification of HIVexposed infants through the normal continuum of MCH service delivery as well as integrating EID services in YCC/Immunization clinics has yielded good results over time in addition to routine monthly MCH outreaches supported by the sister project (SMGL) and UNICEF/MOH. EID coverage now stands at 76.5% with 61.6% exposed infants having the 1st DNA PCR within 2 months of age. The EID positivity rate has been reduced to 2.1% over the period. On birth cohort analysis, HIV Free survival increased by one percentage point from 71% in the January-March 2015 birth cohort to 72% in the April- June 2015 birth cohort. Lost to follow up has reduced to 9.6% in the April-June 2015 birth cohort down from 14% in the January-March 2015 birth cohorts. This good performance is attributed to mother baby care points across the targeted high volume 80 sites in the region that have also improved retention of mother-baby pairs in HIV care and treatment with pregnant mothers retention improving from 82%(Jan March ) to 86% and 86 to 89 % for breastfeeding women. This has been further strengthened by support provided to 81 peer mothers and expert clients in tracking mother baby pairs in the region. EID cascades were collected using EID expert clients who are assigned to facilities within their catchment for follow up and mentorship. Over the April-June 2017 quarter, over 80% of results were returned to the facility within 2 weeks except Kabarole and Kyenjojo where a significant number of results had not returned due to delays in dispatch of sample results. Majority of the facilities performed well on the weekly option B+ sms report and birth cohort monitoring based on data summaries reviewed in ANC registers and what was reported in the HMIS012 report. During the quarter, regional hubs received printers to bfacilitate printing of results at hub level and mitigate delays in transporting results from CPHL to the hub. This has reduced the proportion of facilities that have not received results from 20% to 12%. Couple counseling and PITC in ANC/PNC to address the effects of stigma, disclosure and ART adherence is still being emphasized to optimize gains in eMTCT. Kasese and Kabarole still registered below average male partner testing for the region but this quarter the two districts improved from 11% in January-March 2017 to 19% this quarter in Kabarole while Kasese improved from 17% to 22% across the two quarters. Overall the region attained an increase in couples tested from the previous 29% to 32%.Demand to increase uptake of eMTCT services and other biomedical prevention interventions is generated through close collaboration the existing VHT network, the community facility framework which supports community dialogues, the media-spot messages/radio talk shows, supported jointly with Communications for Health Communities (CHC). A total of 69,906 family planning methods were dispensed and of these 37.4% (26,155/69,906) were injectable contraceptives and 47% male condoms among couples/mothers attending postnatal services. IUDs are still being preferred as a long term method among all clients.
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