Program Management

The management of programs that aim to prevent mother-to-child transmission (PMTCT) of HIV involves special knowledge and skills to ensure programs are implemented effectively and provide quality care and services to those they serve. Program management involves a variety of responsibilities and activities such as:  managing logistics and commodities to ensure the supplies needed to provide services are always available; and program monitoring and evaluation to assess the strengths, weaknesses, gaps and opportunities for improvment within a program. Program managment can also include integrating health services. All of these core functions of program management are addressed in this section of the toolkit, with relevant resources specific to PMTCT.

The WHO Phase 2 Toolkit: Program, District and Facility-Level Planning for Implementation of the 2010 Revised WHO Guidelines is intended as a resource to support people engaged in program, district, and facility-level planning for implementation and roll-out of the 2010 revised WHO guidelines. This toolkit is the second of three integrated toolkits to support country teams in adaptation and implementation of the revised WHO recommendations in the four linked technical areas: ARV drugs for treatment of pregnant women living with HIV and prevention of HIV infection in infants, infant and young child feeding in the context of HIV, antiretroviral therapy for HIV infection in infants and children, and antiretroviral therapy for HIV infection in adults and adolescents.

 

Implementation and Quality (17 resources)

To implement well functioning and efficient PMTCT programs that provide quality services and are accessible and affordable, programs need to be well thought out and be based on informed decision-making. That is, program planners should refer to the most current national and sub-national guidelines on PMTCT and guidelines for all related services that may be offered, such as family planning and reproductive health services. This section of the toolkit includes resources that will provide program planners with guides and tools for PMTCT program planning and implementation.

    Managing Logistics and Commodities (8 resources)

    A well functioning supply chain system is a recommended prerequisite for an effective PMTCT intervention. The system of forecasting, procurement and distribution of commodities needed for PMTCT needs to be streamlined with the existing supply system of HIV/AIDS commodities. It is therefore necessary to review national supply systems and policies early in the planning process of the PMTCT program in order to establish a sustainable system of supplies when starting to implement more efficacious regimens while at the same time going to scale. Additionally, procurement and logistics must be strengthened in order to improve access and quality of PMTCT services. Most resource-limited countries receiving funding support for procurement of HIV/AIDS and contraceptive supplies from multiple partners with different funding cycles. Limited experience and capacity of country programs, coupled with inconsistent funding cycles, complicate the establishment of a continuous procurement management system. Deliberate efforts need to be made to harmonize procurement and distribution of HIV/AIDS and family planning commodities, as traditionally these have existed as parallel systems.

      Monitoring and Evaluation (13 resources)

      Monitoring and evaluation is a critical component of effective management of prevention of mother-to-child transmission (PMTCT) programs. In the context of PMTCT, M&E plays the following roles: helps determine whether existing health services are adequately prepared for the introduction of PMTCT interventions; identifies gaps for the integration of PMTCT services into antenatal care and maternal and child health services; identifies weaknesses in the management information system (MIS) and tracking system of PMTCT services; provides guidance on ways to provide and maintain high-quality services; and supports implementation by providing ways to learn from experience, improve health activities, and promote better planning.

        Integrating Family Planning/Reproductive Health and HIV Services (15 resources)

        Offering multiple health care services through a program can benefit clients, providers and programs. For example, integrating services can address a wider range of health needs conveniently for clients. It also can be more efficient for programs and so can serve more people for the same expenditures. Services commonly integrated with HIV care and prevention include family planning; and maternal, newborn, and child health care. Some key resources for integrating family planning and reproductive health services with HIV services, to better address PMTCT, are provided in this section of the toolkit. For a more comprehensive selection of resources related to integrating family planning and reproductive health services with HIV services go to K4Health's Family Planning and HIV Services Integration Toolkit.