Cost-effectiveness of an intervention to improve integration of maternal and child HIV services in Ruvuma Region, Tanzania
USAID is supporting provision of services to people with HIV or those at substantive risk of acquiring it in Tanzania through the PEPFAR program (1). To succeed in addressing the UNAIDS goal of having 90% of people with HIV knowing their status, 90% of HIV-positive on ART, and 90% of those on ART with viral suppression, HIV services need to be delivered effectively and efficiently (2). The USAID Applying Science to Strengthen and Improve Systems (ASSIST) collaborated with the Ministry of Health, Health Community Development Gender Elderly and Children (MOHCDGEC) and other implementing partners to improve HIV/AIDS service quality in Tanzania. In the Ruvuma Region, the USAID ASSIST Project supported the Regional Health Management Team (RHMT), Council Health Management Teams (CHMTs) and the implementing partner, Henry Jackson Foundation Medical Research International – Walter Reed Program (HJFMRI-WRP) to integrate services for prevention of mother-to-child HIV transmission (MTCT) and maternal, neonatal, and child health (MNCH) services using quality improvement methods. Work in Ruvuma began in March 2015 and as of March 2016 was going through its third phase of harvesting best practices after the preparation and implementation phases. This short report presents the evaluation of the effectiveness and cost-effectiveness of the intervention. We compared changes seen in the intervention sites to a control group of sites that did not apply an improvement intervention. This was to account for any secular changes in the improvement indicators that may have occurred and thereby strengthen the case for attribution of the changes to the ASSIST-supported intervention. The evaluation focused on uptake of family planning methods among HIV-positive clients and HIV testing of women attending family planning clinics.