State of the Evidence for Using Mobile Phone Technology for Improving EMTCT Results

William C. Philbrickwphilbrick@mHealthAlliance.org

Photo courtesy of Kiwanja

RMNCH Continuum of Care with PPTCT (EMTCT)

Facility

Community

Focused antenatal care

Emergency Obstetric Care

Postpartum/post natal care for Mother and Baby, and IMNCI

Skilled attendance at birth

Family planning

Health education during pregnancy

birth planning

Skilled attendanceat birth

Pre-pregnancy Pregnancy Delivery Postpartum, post natal

Postpartum/Post natal care for mother and baby, Identifying/referring newborn illness

Family planning

PMTCT

Chart Source: UNICEF

RMNCH Continuum of Care with PPTCT (EMTCT)

Antenatal ServicesIntrapartum

Services (Labor and Delivery)

Postpartum/Postnatal Services

• Increase in Antenatal Care (ANC) Attendance• Provider-Initiated Testing and

Counseling (PITC) for HIV• HAART Eligibility Assessment

by CD4 or Clinical Staging• Provision of Antenatal ARV

Prophylaxis or HAART as Eligible• Infant Feeding Counseling

and Support• Subsequent Retesting for

Those Who Initially Test Negative• Family Planning and

Reproductive Health Services

• Encouragement of Facility-Based Delivery and of Delivery with a Skilled Attendant• Safe Delivery Techniques• Provider-Initiated Testing and

Counseling (PITC) for HIV• Intrapartum ARV Prophylaxia

or Continuation of HAART as Eligible• Infant Feeding Counseling

and Support• Family Planning and

Reproductive Health Services

• Postpartum ARV Prophylyaxis or Continuation of HAART as Eligible• Provider-Initiated Testing and

Counseling (PITC) for HIV• Infant Cotrimoxasole

Prophylaxis• Early Infant Diagnosis (EID) and

Follow-Up Testing to Determine Final HIV Status of Infant• Infant Feeding Support and

Adherence• Links to Care, Treatment, and

Support• Family Planning and

Reproductive Health Services

Source: AIDSTAR

Sources of Evidence

• Gaps and Needs Analysis on MNCH & mHealth• Published peer-reviewed literature• Systematic and Literature Reviews• “Grey” Literature• Current Project Descriptions• Interviews with Stakeholders

Antenatal and Other Appointment Reminders

Facility

Community

Focused antenatal care

Emergency Obstetric Care

Postpartum/post natal care for Mother and Baby, and IMNCI

Skilled attendance at birth

Family planning

Health education during pregnancy

birth planning

Skilled attendanceat birth

Pre-pregnancy Pregnancy Delivery Postpartum, post natal

Postpartum/Post natal care for mother and baby, Identifying/referring newborn illness

Family planning

PMTCT

Antenatal and Other Appointment Reminders

Chart Source: UNICEF

Delivery in Presence of Skilled Birth Attendant

Facility

Community

Focused antenatal care

Emergency Obstetric Care

Postpartum/post natal care for Mother and Baby, and IMNCI

Skilled attendance at birth

Family planning

Health education during pregnancy

birth planning

Skilled attendanceat birth

Pre-pregnancy Pregnancy Delivery Postpartum, post natal

Postpartum/Post natal care for mother and baby, Identifying/referring newborn illness

Family planning

PMTCT

Delivery in Presence of Skilled Birth Attendant

Chart Source: UNICEF

Treatment Adherence

Facility

Community

Focused antenatal care

Emergency Obstetric Care

Postpartum/post natal care for Mother and Baby, and IMNCI

Skilled attendance at birth

Family planning

Health education during pregnancy

birth planning

Skilled attendanceat birth

Pre-pregnancy Pregnancy Delivery Postpartum, post natal

Postpartum/Post natal care for mother and baby, Identifying/referring newborn illness

Family planning

PMTCT

Treatment Adherence

Chart Source: UNICEF

Promote Exclusive Breastfeeding, Immunizations, and Family Planning

Promote Exclusive Breastfeeding, Immunizations, and Family Planning

Facility

Community

Focused antenatal care

Emergency Obstetric Care

Postpartum/post natal care for Mother and Baby, and IMNCI

Skilled attendance at birth

Family planning

Health education during pregnancy

birth planning

Skilled attendanceat birth

Pre-pregnancy Pregnancy Delivery Postpartum, post natal

Postpartum/Post natal care for mother and baby, Identifying/referring newborn illness

Family planning

PMTCT

Chart Source: UNICEF

Protocols for Diagnosis: Obstetric Emergencies, Malnutrition, IMCI

Protocols for Diagnosis: Obstetric Emergencies, Malnutrition, IMCI

Facility

Community

Focused antenatal care

Emergency Obstetric Care

Postpartum/post natal care for Mother and Baby, and IMNCI

Skilled attendance at birth

Family planning

Health education during pregnancy

birth planning

Skilled attendanceat birth

Pre-pregnancy Pregnancy Delivery Postpartum, post natal

Postpartum/Post natal care for mother and baby, Identifying/referring newborn illness

Family planning

PMTCT

Chart Source: UNICEF

Data Collection, Training, and Improving Efficiencies

Facility

Community

Focused antenatal care

Emergency Obstetric Care

Postpartum/post natal care for Mother and Baby, and IMNCI

Skilled attendance at birth

Family planning

Health education during pregnancy

birth planning

Skilled attendanceat birth

Pre-pregnancy Pregnancy Delivery Postpartum, post natal

Postpartum/Post natal care for mother and baby, Identifying/referring newborn illness

Family planning

PMTCT

Data Collection, Training, and Improving Efficiencies

Chart Source: UNICEF

Integration and Systems Strengthening

• Supply Chain Management• Water, Sanitation and Hygiene (WASH)• Micro-finance• Maternal depression and psycho-social

well-being of CHWs• Economic livelihoods• Stigma and discrimination

THANK YOU!Contact:

William C. Philbrick, Consultant, mHealth Alliancewphilbrick@mHealthAlliance.org

Learn more at www.mHealthAlliance.org

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