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Center for Social Expertise

“Analysis of different models of provision of services aimed at preventing mother-to-child transmission of HIV”, implemented by the Center for Social Expertise, comissioned by Children’s Fund for the Organization of United Nations

Project Manager: Trofymenko O.V.

Implementation period: July – September 2017

Customer: UNICEF Children’s Fund for the Organization of United Nations.

The purpose of the study was to determine the most effective model for the provision of PMTCT services in the context of reforming the health care system and the current regulatory framework of Ukraine to eliminate mother-to-child transmission of HIV (PMD).

Objectives of the study:

  1. assessment of the completeness and quality of provision of medical services for HIV-infected pregnant women in various models of provision of services aimed at preventing mother-to-child transmission of HIV, based on the provisions of the current regulatory framework.
  2. analysis of the economic efficiency of different models of provision of medical services for HIV-infected pregnant women and determination of the cost of prevention of one case of mother-to-child transmission of HIV.

The research design is combined and based on the use of qualitative and quantitative research methods, and work with both primary and secondary information.

It is planned to conduct desk analysis.

Qualitative research methods using primary information, namely:

  1. In-depth interviews with key informants at the national level:
  2. In-depth interviews with medical staff;
  3. In-depth interviews with HIV-infected pregnant women.

Quantitative research methods using secondary information, namely:

  1. Collection of information from medical records:
  • HIV-infected women;
  • Children with HIV-negative status;
  • Children with HIV-positive status.
  1. Economic analysis by assessing the cost of the PMTCT service package, analysis of medical profiles based on existing models of provision of services for pregnant women and children with positive and negative HIV status.

Geography of the research: 6 regions – city of Kyiv, Dnipropetrovsk, Odessa, Cherkasy, Kyiv and Kirovograd regions. In each region, 4 healthcare facilities were selected – the regional AIDS Center, private consulting room, the Obstetric and Gynecologic Service (ACS) and the Primary Health Care (PHC).

In each institution, 1 expert will be polled, in total for one oblast – 4 experts. In this way, 24 respondents will be interviewed.

Sample for implementation of qualitative research methods

Target group

Research method

 

Sample

KeyInformants

IDI

5

Medicalworkers

IDI

48

HIV-infectedpregnantwomen

IDI

60

Total

 

113

Secondary data. Economic evaluation:

With the implementation of a research block on economic efficiency, the standard cost of a package of medical services for HIV-infected pregnant women and children within the framework of the Unified clinical protocol of primary, secondary (specialized) and tertiary (highly specialized) medical care “Prevention of mother-to-child transmission of HIV” will be calculated, approved by the order of the Ministry of Health of Ukraine No. 449 from May 16, 2016 (subject to the provision of various service packages and 100% of the provision of the necessary services).

According to the results of the study, an analytical report will be prepared, and the results will be presented at the round table.