Background Since 2012 ICAP has been working to assist Cameroon to enact its national mother-to-child transmission (MTCT) elimination strategy for HIV, focusing on strengthening the national monitoring and evaluation (M&E) system for prevention of mother-to-child transmission (PMTCT) to provide policy makers and health leaders with high quality data to guide the scale-up of HIV services for women and children.

Goals and Objectives •  Strengthen M&E system in Cameroon to advance the national strategy to eliminate MTCT •  Improve the national integrated PMTCT/maternal, neonatal and child health (MNCH) M&E system •  Promote and strengthen PMTCT/MNCH data quality and data use •  Strengthen the capacity of health care workers at national, regional, district and facility levels on data

collection, data quality improvement, aggregation, analysis and data use •  Support roll out of PMTCT/MNCH M&E tools in four regions (Northwest, Southwest, Littoral,

Centre) in Cameroon

Methods and Strategy •  Conducted situational analysis of existing M&E tools in consultation with the national Technical

Working Group (TWG) •  Developed, piloted, incorporated feedback and recommendations of end users and validated

integrated PMTCT/MNCH tools •  Developed standard operating procedure (SOP) to guide health care workers in entering patient data in

PMTCT/MNCH registers and how to use national data reporting forms •  Developed training-of-trainer (TOT) curriculum, facilitated training materials, trained trainers,

mentored end users to manage and use data in health facilities •  Printed and disseminated revised integrated PMTCT/MNCH M&E tools •  Established new data aggregation and data quality assurance tools to be used nationally in all 183

health districts

Accomplishments •  Standardized national integrated PMTCT/MNCH M&E tools •  Integrated critical antenatal care (ANC) and PMTCT care components into one comprehensive

longitudinal ANC register which facilitates continuum of care •  Established system for unique patient IDs and patient handheld card to support tracking patients across

services •  Standardized reporting form with SOP to facilitate the monitoring of progress towards global targets •  Pregnancy follow-up card developed to improve continuum of care •  Piloted new integrated PMTCT/MNCH tools in 26 health facilities in four regions. •  Printed and distributed 3,250 registers and 600 SOPs in four regions •  Trained 41 national-level master trainers, 90 regional trainers/supervisors (NW and SW), 50 regional-

level PMTCT coordinators, and 106 end users from 84 health facilities in SW region   

Challenges •  PMTCT/MNCH M&E unmet need is pronounced in Cameroon for the six regions not currently

receiving PEPFAR support thus impacting on the overall quality of data for the country •  Cameroon has a three-tier health system with six categories of health facilities; this requires use of

multiple approaches for data aggregation and conducting quality checks of the data

Way Forward •  Continue to roll out the revised PMTCT/MNCH M&E tools in PEPFAR regions •  Pilot and roll out Data Quality Assurance and data aggregation tools •  Support DHIS2 in 18 health districts in the NW and SW regions •  Continue to work in partnership with government to support national PMTCT program monitoring •  Support the government to improve data collection, analysis and utilization to guide program

performance and ultimately improve PMTCT coverage and quality

Conclusion Since 2012 ICAP has been a key partner in Cameroon’s plan to eliminate MTCT of HIV by supporting the launch of new PMTCT/MNCH data collection and management tools and systems. The result of these activities is to generate more accurate information about PMTCT patients, to use the data to detect challenges in service delivery, and, ultimately, to improve patients care. A strengthened M&E system will provide key information to inform the country's approach to preventing and eventually eliminating pediatric HIV, and keeping mothers healthy.

PMTCT/MNCH: An entry point to health information systems strengthening in Cameroon

E Mesmey, B Elul, C Gwynn, F Tsiouris, A Wolfington, E Temgoua, J Nkfusai, J Akenji

Figure 2: ICAP Cameroon

Figure 3: Situational Analysis of Existing Tools

Figure 4: New PMTCT / MNCH M&E Training Manual

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Figure 1: Providers Trained on M&E Tools, by Health System Level, June – September 2013

ICAP REGIONS

ICAP Cameroon