SAIA-PMTCT: Optimizing the prevention of mother-to-child HIV transmission
HAI faculty at the UW led the research that established the effectiveness, adaptability, and scalability of the Systems Analysis and Improvement Approach (SAIA) to improve service delivery for the prevention of mother-to-child transmission of HIV (PMTCT).
SAIA HAS TRANSFERRED TO CSM
As of October 2021, HAI fully transferred all global operations and active Mozambique programs to CSM, an independent local NGO with a board, leadership, and staff that reflects the communities they serve.
Stay up to date on all SAIA projects and follow CSM’s full portfolio by clicking any CSM logo on this website.
Mother-to-child HIV transmission rates can be reduced to <1% using known prevention and treatment regimens. Unfortunately, effective implementation of and adherence to these regimens have been uneven in practice in sub-Saharan Africa, often due to the complexity of the PMTCT cascade, which requires multiple sequential, conditional visits over 2+ years for HIV-positive women and their infants.
The Systems Analysis and Improvement Approach (SAIA) is an evidence-based multi-step implementation strategy that systematically identifies barriers and facility-level solutions to health care delivery and patient flow using a systems engineering approach. Designed by HAI faculty at the University of Washington, SAIA was initially piloted in Mozambique, and later evaluated through a cluster randomized trial in Mozambique, Côte d’Ivoire and Kenya to test the effectiveness of the approach on PMTCT service delivery. Over 9 months, 18 facilities tested 158 workflow modification resulting in substantial increases in ARV initiation (3-fold increase in intervention facilities compared with control) and HIV screening among HIV-exposed infants (17-fold increase in intervention facilities compared with controls).
A follow-on study (SAIA-SCALE), based in Mozambique is evaluating the scalability and effectiveness of the SAIA strategy when implemented by public sector health providers, rather than by research nurses.
HAI-LIGHTS
Since April 2018, the SAIA-SCALE project has been supporting district managers in all 12 districts of Manica province to introduce and support the SAIA approach to strengthen prevention of mother-to-child HIV transmission services in three health facilities in each district. Notably, the first 30 months of implementation demonstrated enduring enthusiasm for the approach and, that with modest financial support and practical tools, district managers can enhance their routine work with creative, testable, facility-level micro-interventions.
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Publications
Tools
Funding
[2017-2021] Scaling up the Systems Analysis and Improvement Approach for pMTCT in Mozambique (SAIA-SCALE) [project transferred to CSM for continuation]
This project received funding support from the National Institutes of Health under award number R01MH113435, via a subagreement from the University of Washington.
[2016-2019] Usability and Feasibility of a Phone-based Decision Support Tool for Option B+
This project received funding support from the National Institute of Allergy and Infectious Dieases of the National Institutes of Health under award number R21AI124399, via a subagreement from the University of Washington.
[2012-2015] Systems Analysis and Improvement to Optimize pMTCT: A Cluster Randomized Trial.
This project received funding support from the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under award number R01HD075057, via a subagreement from the University of Washington.
For additional SAIA project funding information, visit the SAIA main page.
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WHAT IS SAIA?
HYPERTENSION
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Our Mission
Our mission is to promote policies and support programs that strengthen government primary health care and foster social, economic, and health equity for all. Our vision is a just world that promotes health and well-being, including universal access to quality health care.
Our History
Health Alliance International began in 1987 as a US-based international solidarity organization committed to supporting the public sector provision of health care for all. Over 35 years, HAI conducted programs in 17 countries, with flagship programs in Mozambique, Côte d'Ivoire, and Timor-Leste.
Our Evolution
In line with HAI’s commitment to support and strengthen local public health leadership, as of October 2021, HAI fully transitioned global operations and active programs to locally-based, locally-led NGOs. Learn more about this shift toward local autonomy and equity in global health.
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