Improving the Percent of HIV-Exposed Infants Receiving 18-Month Confirmatory Tests

Baseline performance for January to May 2022 showed a range of 35% to 95% across the councils, with an average of 51%. However, this was far below the national target of 95%. The main causes contributing to low testing numbers included inadequate follow-up strategies, insufficient awareness among mothers, and lack of availability of monitoring and evaluation tools at some health facilities. To address these issues, capacity building and mentorship were provided to healthcare workers (HCWs) on the importance of confirmatory tests. Monthly monitoring and follow-up on health education provision were also implemented, as well as mentorship in identifying eligible children for confirmatory tests. Review of supportive supervision checklists was conducted to include actions for improving confirmatory tests. Regular follow-up by Council Health Management Teams (CHMTs) was also implemented to review lists of children eligible for confirmatory tests using the CTC2 database and mother-child cohort registers. Integration of 18-month Mumps-Rubella vaccination with prevention of mother-to-child transmission (PMTCT) services was also introduced to link HEIs to confirmatory tests. The outcome of these implemented strategies showed significant improvement in the percentage of HEIs receiving 18-month confirmatory tests. The average rate for the period of June 2022 to January 2023 ranged from 55% to 75%, which is still below the national target but shows a notable improvement compared to the baseline performance. The use of quality improvement (QI) tools and live data review from the District Health Information System (DHIS) enabled CHMTs to improve performance in a scientific manner. Frequent Data Review Situation Room meetings were essential to improve the quality of health services. A combination of QI tools and live data review enabled CHMTs to improve performance in a scientific way. Focusing on improving an indicator promoted focused follow-ups in terms of high-volume and low-performing health facilities. Data use practice promoted more meaningful reporting practices among HCWs. The initiative was part of the Data for Implementation (Data.FI) program, a five-year cooperative agreement funded by the U.S. President's Emergency Plan for AIDS Relief through the U.S. Agency for International Development. The program aimed to improve the quality of health services in Tanzania.