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Journal of Public Health Policy

, Volume 34, Issue 1, pp 2–16 | Cite as

Scaling up early infant diagnosis of HIV in Rwanda, 2008–2010

  • Agnes Binagwaho
  • Placidie Mugwaneza
  • Ange Anitha Irakoze
  • Sabin Nsanzimana
  • Mawuena Agbonyitor
  • Cameron T Nutt
  • Claire M Wagner
  • Alphonse Rukundo
  • Anita Ahayo
  • Peter Drobac
  • Corine Karema
  • Ruton Hinda
  • Lucinda Leung
  • Sachini Bandara
  • Elena Chopyak
  • Mary C Smith Fawzi
Original Article

Abstract

More than 390 000 children are newly infected with HIV each year, only 28 per cent of whom benefit from early infant diagnosis (EID). Rwanda's Ministry of Health identified several major challenges hindering EID scale-up in care of HIV-positive infants. It found poor counseling and follow-up by caregivers of HIV-exposed infants, lack of coordination with maternal and child health-care programs, and long delays between the collection of samples and return of results to the health facility and caregiver. By increasing geographic access, integrating EID with vaccination programs, and investing in a robust mobile phone reporting system, Rwanda increased population coverage of EID from approximately 28 to 72.4 per cent (and to 90.3 per cent within the prevention of mother to child transmission program) between 2008 and 2011. Turnaround time from sample collection to receipt of results at the originating health facility was reduced from 144 to 20 days. Rwanda rapidly scaled up and improved its EID program, but challenges persist for linking infected infants to care.

Keywords

early infant diagnosis HIV testing children Rwanda 

Notes

Acknowledgements

Authors thank the health professionals and development partners involved in scaling up pediatric HIV service in Rwanda, and gratefully acknowledge the financial support of PEPFAR and The Global Fund to Fight AIDS, Tuberculosis, and Malaria that made this possible.

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Copyright information

© Palgrave Macmillan, a division of Macmillan Publishers Ltd 2012

Authors and Affiliations

  • Agnes Binagwaho
    • 1
    • 2
  • Placidie Mugwaneza
    • 3
  • Ange Anitha Irakoze
    • 3
  • Sabin Nsanzimana
    • 3
  • Mawuena Agbonyitor
    • 4
  • Cameron T Nutt
    • 5
    • 6
  • Claire M Wagner
    • 6
  • Alphonse Rukundo
    • 3
  • Anita Ahayo
    • 3
  • Peter Drobac
    • 2
    • 3
    • 7
    • 8
  • Corine Karema
    • 3
  • Ruton Hinda
    • 1
  • Lucinda Leung
    • 2
  • Sachini Bandara
    • 2
  • Elena Chopyak
    • 2
  • Mary C Smith Fawzi
    • 2
  1. 1.Ministry of Health of RwandaKigaliRwanda
  2. 2.Department of Global Health and Social MedicineHarvard Medical SchoolBostonUSA
  3. 3.Rwanda Biomedical CenterKigaliRwanda
  4. 4.University of Maryland School of MedicineBaltimoreUSA
  5. 5.Dartmouth Center for Health Care Delivery ScienceHanoverUSA
  6. 6.Global Health Delivery PartnershipBostonUSA
  7. 7.Partners In Health – Inshuti Mu BuzimaRwinkwavuRwanda
  8. 8.Division of Global Health EquityBrigham and Women's HospitalBostonUSA

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