Improving Maternal and Newborn Health Using the HIV/AIDS Program Platform in Tanz

描述(申请人提供)：针对PAR-10-038，我们建议测试调整已建立的艾滋病毒/艾滋病项目支持平台以加强孕产妇和新生儿健康(MNH)服务是否将增加对这些服务的接受，从而改善HIV阴性和HIV阳性妇女及其新生儿的结局。NIAID的关键战略优先事项之一是通过使用转化研究来减少健康差距和改善健康。坦桑尼亚是东非最大的国家，艾滋病毒感染率为5.7%，是世界上孕产妇和新生儿死亡率最高的国家之一。在美国总统艾滋病紧急救援计划(PEPFAR)的支持下，坦桑尼亚在提供艾滋病毒服务方面取得了显著进展，仅在2009年就避免了7500名新生儿感染艾滋病毒。相比之下，扩大对降低孕产妇和新生儿死亡率所需的基本孕产妇和新生儿保健服务的吸收就不那么成功了。尽管存在明确的政策和指导方针，但坦桑尼亚只有不到一半的妇女和新生儿使用高质量的保健保健服务。我们的初步数据表明，服务利用率较低可能是由于服务质量较差。糟糕的服务质量反过来又会导致糟糕的健康结果。为了在同样脆弱的卫生系统中取得成功，艾滋病毒项目开创了一种创新的方法来升级基础设施，提供培训和质量保证，并与当地社区合作。这一最初为艾滋病毒项目制定的三管齐下的卫生系统支持战略是否可以扩大，以提高卫生保健服务的质量和接受度？尽管它的临床和

DESCRIPTION (provided by applicant): In response to PAR-10-038, we propose to test whether adapting an established HIV/AIDS program support platform to strengthen maternal and newborn health (MNH) services will increase uptake of these services and thus improve outcomes for both HIV-negative and HIV-positive women and their newborns. One of NIAID's key strategic priorities is to reduce health disparities and improve health by using translational research. Tanzania, the largest country in East Africa, has an HIV prevalence of 5.7% and some of the highest maternal and neonatal mortality rates in the world. With the support of the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), Tanzania has made remarkable progress in providing HIV services, averting 7,500 newborn HIV infections in 2009 alone. In contrast, expanding uptake of basic maternal and newborn health (MNH) services needed to reduce maternal and newborn mortality has been less successful. Fewer than half of Tanzania's women and newborns utilize high-quality MNH services, despite the existence of well-defined policies and guidelines. Our preliminary data suggest that low service utilization may be due to poor quality of services. Poor quality of services in turn results in poor health outcomes. To succeed in the same weak health systems, HIV programs have pioneered an innovative approach to upgrade infrastructure, provide training and quality assurance, and work with local communities. Could this three-pronged health system support strategy originally developed for HIV programs be expanded to improve the quality and uptake of MNH services? Despite its clinical and