HEI not identified and tested | HEI not receiving results and completing testing algorithm | HIV+ infants not enrolling in care at HIV/ART Clinic | HIV+ infants not started on ART & retained in chronic care | |
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EID Clinic Systems and Patient Flow | • EID fragmented across multiple clinics that are poorly equipped to test, follow-up and provide care for HEI • Ad-hoc and ineffective flow of caregivers, samples, results, and data within the health facility | |||
Referral and Data Management Systems | • No referral mechanisms to link HEI from entry points to EID testing | • No longitudinal tracking tools or appointment systems for HEI | • No referral mechanisms to link HIV+ infants from EID to HIV/ART Clinic | |
Clinical Care and Visit Schedule | • Poor clinical care and HEI not visiting every month: prevents early identification of opportunistic and other HIV-associated infections • Clinical care not integrated into EID services: undermines importance of HEI returning regularly to clinic | |||
Counseling Messages, Materials and Techniques | • Caregivers not convinced to get their HEI tested | • Caregivers not convinced to return to the clinic | • Caregivers not convinced to enroll HIV+ infant | • Caregivers hesitant to start & adhere to ART |
Knowledge and Awareness of Health Workers | • Many HWs do not know how to screen and identify HEI | • Many HWs not proficient in HEI testing and feeding algorithm | • Many HWs not proficient in testing/feeding algorithm | • Many HWs do not know ART criteria; uncomfortable initiating infants on ART |
DBS Sample-Result Turnaround Time | • Test results not back in time for caregiver visits |