Improving PMTCT 12-month Retention Rates in Tanzania

The rate remained stable at 96% in the subsequent evaluation period. Health units in Tanzania report the rate of retention at 12 months for pregnant and breastfeeding women registered at the unit and alive, receiving prevention of mother-to-child transmission (PMTCT) care. The baseline performance of the 12-month retention rate for the period May-August 2022 was 95%, 91%, 93%, 93%, 96%, 100%, 100%, 100%, 100%, and 100%. The rate varied across different health units, with some reporting 95% and others 100%. The national target for the 12-month retention rate is 95%. The main causes contributing to low PMTCT retention rates after 12 months of follow-up include inadequate PMTCT data quality monitoring, insufficient documentation on PMTCT M&E tools, and inadequate data review of reports before submission to the council. Implemented actions to address these challenges include capacity building of healthcare providers on documentation, coaching on proper documentation during supportive supervision, and ensuring the availability of PMTCT tools. Data review during weekly situation room meetings of Council Health Management Teams (CHMTs) showed that the performance of some health units fell below the national target of 95% on the proxy indicator 'Alive on PMTCT care.' The main causes contributing to low PMTCT retention rates after 12 months of follow-up include inadequate PMTCT data quality monitoring, insufficient documentation on PMTCT M&E tools, and inadequate data review of reports before submission to the council. The implemented actions to address these challenges include capacity building of healthcare providers on documentation, coaching on proper documentation during supportive supervision, and ensuring the availability of PMTCT tools. Developed data validation rules on iMES were also implemented to improve data quality. The overall PMTCT retention rate in the nine councils improved from 96% to 97% as a result of weekly review of data collection and HIV transmission issues for PMTCT. Data review meetings by CHMTs through situation rooms and supportive supervision at the health facilities help identify strategies for improvement. The implemented strategies seem to work, but two councils out of nine demonstrate weakened performance. The CHMTs of those two councils are working to strengthen collection of HIV viral load (HVL) samples, delivery to the laboratory for processing, and strengthening data entry after the health facility receives the HVL results. The PMTCT 12-month retention rate in the nine councils improved from 96% to 97% between May-August 2022 and September 2022-January 2023. The rate varied across different health units, with some reporting 88%, 91%, 93%, 91%, 96%, 100%, 100%, 100%, 100%, and 97%. The implemented strategies seem to work, but two councils out of nine demonstrate weakened performance. The overall PMTCT retention rate in the nine councils improved from 96% to 97% as a result of weekly review of data collection and HIV transmission issues for PMTCT. Data review meetings by CHMTs through situation rooms and supportive supervision at the health facilities help identify strategies for improvement. The implemented strategies seem to work, but two councils out of nine demonstrate weakened performance.