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Guillaine N, Mwizerwa W, Odhiambo J, et al. A Novel Combined Mother-Infant Clinic to Optimize Post-Partum Maternal Retention, Service Utilization, and Linkage to Services in HIV Care in Rural Rwanda. Int J MCH AIDS. 2017;6(1):36-45doi: 10.21106/ijma.186.
Guillaine, N., Mwizerwa, W., Odhiambo, J., Hedt-Gauthier, B. L., Hirschhorn, L. R., Mugwaneza, P., Umugisha, J. P., Cyamatare, F. R., Mutaganzwa, C., & Gupta, N. (2017). A Novel Combined Mother-Infant Clinic to Optimize Post-Partum Maternal Retention, Service Utilization, and Linkage to Services in HIV Care in Rural Rwanda. International journal of MCH and AIDS, 6(1), 36-45. https://doi.org/10.21106/ijma.186
Guillaine, Neza, et al. "A Novel Combined Mother-Infant Clinic to Optimize Post-Partum Maternal Retention, Service Utilization, and Linkage to Services in HIV Care in Rural Rwanda." International journal of MCH and AIDS vol. 6,1 (2017): 36-45. doi: https://doi.org/10.21106/ijma.186
Guillaine N, Mwizerwa W, Odhiambo J, Hedt-Gauthier BL, Hirschhorn LR, Mugwaneza P, Umugisha JP, Cyamatare FR, Mutaganzwa C, Gupta N. A Novel Combined Mother-Infant Clinic to Optimize Post-Partum Maternal Retention, Service Utilization, and Linkage to Services in HIV Care in Rural Rwanda. Int J MCH AIDS. 2017;6(1):36-45. doi: 10.21106/ijma.186. PMID: 28798892; PMCID: PMC5547224.
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Int J MCH AIDS. 2017;6(1):36-45. doi: 10.21106/ijma.186.

A Novel Combined Mother-Infant Clinic to Optimize Post-Partum Maternal Retention, Service Utilization, and Linkage to Services in HIV Care in Rural Rwanda.

International journal of MCH and AIDS

Neza Guillaine, Wilberforce Mwizerwa, Jackline Odhiambo, Bethany L Hedt-Gauthier, Lisa R Hirschhorn, Placidie Mugwaneza, Jean Paul Umugisha, Felix Rwabukwisi Cyamatare, Christine Mutaganzwa, Neil Gupta

Affiliations

  1. Partners In Health/Inshuti Mu Buzima, Kigali, Rwanda.
  2. Ministry of Health, Kigali, Rwanda.
  3. Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02125, USA.
  4. Partners In Health, Boston, MA 02199, USA.
  5. Ariadne Labs, Boston, MA 02215, USA.
  6. Rwanda Biomedical Centre, Kigali, Rwanda.
  7. Division of Global Health Equity, Brigham & Women's Hospital, Boston, MA 02115, USA.

PMID: 28798892 PMCID: PMC5547224 DOI: 10.21106/ijma.186

Abstract

BACKGROUND AND OBJECTIVES: Despite recent improvements in accessibility of services to prevent mother-to-child transmission of HIV, maternal retention in HIV care remains a challenge in the post-partum period. This study assessed service utilization, program retention, and linkage to routine services, as well as clinical outcomes for mothers and infants, following implementation of an integrated mother-infant clinic in rural Rwanda.

METHODS: We conducted a retrospective cohort study of all HIV-positive mothers and their infants enrolled in the integrated clinics in two rural districts between July 1, 2012, and June 30, 2013. At 18 months post-partum, data on mother-infant service utilization and program outcomes were reported.

RESULTS: Of the 185 mother-infant pairs in the clinics, 98.4% of mothers were on antiretroviral therapy (ART) and 30.3% used modern contraception at enrollment. At 18 months post-partum, 98.4% of mothers were retained and linked back to adult HIV program. All mothers were on ART and 72.0% on modern contraception. For infants, 93.0% completed follow-up. Two (1.1%) infants tested HIV positive.

CONCLUSION AND GLOBAL HEALTH IMPLICATION: An integrated clinic was successfully implemented in rural Rwanda with high mother retention in care and low mother to child HIV transmission rates. This model of integration of services may contribute to improved mother-infant retention in care during post-partum period and should be considered as one approach to addressing this challenge in similar settings.

Keywords: ART; Africa; Antiretroviral Therapy; Combined Clinic; HIV; Integrated Clinic; Linkages; Option B+; PMTCT; Post-partum Retention

Conflict of interest statement

Conflict of interest: The authors declare that they have no competing interests.

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