This post comes to us from Betty Kagoro and Erik Friedly, CDC-Uganda. You can read more about Uganda’s efforts here.
Identifying opportunities to improve global health sometimes requires creative thinking and new collaborations. Today in Uganda, creative approaches are helping eliminate mother-to-child HIV transmission (MTCT) and leading to fewer and fewer babies being born HIV-infected. That’s awesome news! But what’s even better? They’re also transforming Uganda’s overall health systems.
When Uganda’s First Lady declared MTCT a national emergency, then CDC-Uganda Country Director Wuhib Tadesse, MD, MPH was struck with an idea: could the Emergency Operations Center (EOC) in Kampala – established with CDC’s assistance in 2013 – serve the needs of this public health emergency? “The EOC seemed ideally equipped to support the systems needed to collect and report data that would monitor the rollout and ongoing implementation of the national strategy to eliminate MTCT,” said Dr. Wuhib.
This unique leveraging of a proven HIV prevention strategy and existing resource is not only helping to keep newborns in Uganda HIV-free, but it is also proving the value of having systems that collect health information and using the data to respond quickly to improve programs and achieve greater public health impact. Data are gathered weekly to monitor progress toward achieving set targets and identify any bottlenecks or follow-up actions.
Results, to date, show that real-time data play a pivotal role in public health decision-making. In Uganda, where shifts in the national MTCT strategy have resulted in increased maternal antiretroviral treatment (ART) coverage (65% in 2012 to 87% in 2014), facilities have been able to increase monitoring of women tested and started on ART, and districts now use the data to monitor their MTCT programs and make timely adjustments that not only save time and money but lives. At the national level, the data are used to monitor how various district are performing and identify any gaps in how service is being delivered.
As the U.S President’s Emergency Plan for AIDS Relief (PEPFAR) along with CDC’s Division of Global HIV & TB* (DGHT*; proposed) focus more on epidemic control, effective surveillance and program monitoring and evaluation become even more important. Preventing Uganda’s children from acquiring HIV at birth is achievable, but requires an organized, accessible, and well-functioning information system as a key component of the nation’s overall health system. CDC’s cost-effective experiment in leveraging the EOC to improve the nation’s HIV response may have demonstrated an unexpected yet incredibly effective way to achieve just that.