This study tests strategies for improving PrEP implementation in maternal and child health clinics using a difference-in-difference approach.
This study aims to improve integrated delivery of PrEP to women seeking health services in maternal and child health clinics by piloting and evaluating four strategies or bundles of strategies for optimized PrEP delivery. Strategies to be tested include a pre-developed package of strategies (video counseling, HIV self-testing, and optimized delivery).
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
1,958
A bundle of strategies (video-based PrEP counselling, HIV Self-Testing \[HIVST\] for women undergoing repeat HIV testing, and optimized PrEP delivery and prescription processes) will be implemented in the intervention group.
Kendu Sub-District Hospital
Homa Bay, Kenya
Ober Health Center
Homa Bay, Kenya
Masogo Sub-County Hospital
Kisumu, Kenya
Nyahera Sub Sub County Hospital
Kisumu, Kenya
PrEP Penetration
Proportion of women who are screened for PrEP / total women receiving antenatal or postnatal services
Time frame: 6 months
PrEP Fidelity
Proportion of women who receive all PrEP specific steps in a visit: HIV testing, HIV risk screening, PrEP counseling
Time frame: 6 months
Timeliness of Services
Time (minutes) spent receiving services from health care works
Time frame: 6 months
Waiting Time
Time (minutes) spent waiting to receive services
Time frame: 6 months
HCW Acceptability
Total on 4 item Acceptability of Intervention Measures (AIM) score, 1 (Completely disagree) to 5 (Completely Agree) Likert scale. The minimum score on the 4 items is 4 points (scoring 1 on each of the 4 items) while the maximum is 20 points (scoring 5 on each of the 4 items). A higher score indicates a better outcome. The sub-scores on each of the 4 items are summed.
Time frame: 6 months
Health Care Worker (HCW) Appropriateness
Total on 4 item Intervention Appropriateness Measure (IAM) score, 1 (Completely disagree) to 5 (Completely Agree) Likert scale. The minimum score on the 4 items is 4 points (scoring 1 on each of the 4 items) while the maximum is 20 points (scoring 5 on each of the 4 items). A higher score indicates a better outcome. The sub-scores on each of the 4 items are summed.
Time frame: 6 months
Client Satisfaction
Total on 6 item exit survey of clients to assess their satisfaction with services received at the facility, 1 (worse) to 4 (better) scale. The minimum score on the 6 items is 6 points (scoring 1 on each of the 6 items) while the maximum is 24 points (scoring 4 on each of the 6 items). A higher score indicates a better outcome. The sub-scores on each of the 4 items are summed.
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Bondo County Referral Hospital
Siaya, Kenya
Madiany Sub County Hospital
Siaya, Kenya
Malanga Health Center
Siaya, Kenya
Uyawi Sub County Hospital
Siaya, Kenya
Time frame: 6 months
PrEP Uptake
Proportion of women who accept PrEP among those offered
Time frame: 6 months
PrEP Continuation
Proportion of women who present for a refill among those initially prescribed PrEP
Time frame: 6 months
PrEP Adherence
Proportion of women who have \>80 percent adherence to PrEP by pill count among those initially prescribed PrEP
Time frame: 6 months
PrEP Efficiency
Patient flow mapping to identify more efficient client flows with fewer transitions between physical spaces and providers
Time frame: 6 months
Client PrEP Knowledge
Number of participants with perfect knowledge on PrEP information questions based on content covered in counseling sessions
Time frame: 6 months