Investment in HIV services may improve quality of prenatal and postnatal care. At the facility level, the mere presence of HIV treatment services was associated with higher quality prenatal and postnatal care, shows a new study in the American Journal of Public Health.
Researchers from Columbia University, the CDC and Kenyan public health institutions, analyzed data from 560 hospitals and clinics in Kenya, a country with a high maternal mortality ratio, to compare the quality of prenatal, postnatal, and delivery services in facilities that had HIV treatment services and those that did not. The researchers found that the existence of PMTCT and ART treatment programs was associated with significantly increased quality in prenatal and postnatal care, irrespective of HIV status. However, quality of delivery care was similar across the two settings.
Driving this association is the fact that “the introduction of PMTCT and ART programs may have brought with it better tools, resources, and infrastructure for outpatient maternal health, services,” shared Dr. Margaret Kruk, lead author on the paper, now at the Harvard T.H. Chan School of Public Health.
What does this mean for the Kenyan woman? “HIV monies that have poured into Kenya from the U.S., and from a number of other partners, including the Kenyan government, are making a difference to some aspects of her [health care] experience, even if she’s HIV-negative,” shared Kruk.
Limitations to the research include the inability to show a relationship between HIV services and maternal health outcomes and the inability to show causality since the research was cross-sectional and not prospective.
Moving forward, this research shows that donors can stretch the effects of their investments. Kruk shares, “I think the big takeaway is, if we had planned for these collateral benefits, we could have done more with the investment to benefit the entire facility, to benefit more services.” As the world gears up for the Sustainable Development Goals and new funding mechanisms such as the Global Financing Facility, these lessons can be leveraged to create synergies between health sectors in order to strengthen the entire system.