World AIDS Day is held annually on Dec. 1. This moment is used to raise awareness about HIV/AIDS and support people living with HIV (PLHIV).
This year, the World Health Organization (WHO) adopted the theme “Take the rights path: My health, my right!” to call on the global community to prioritize universal access to healthcare services, especially for HIV prevention, treatment, and care without discrimination.
HIV management, particularly the elimination of mother-to-child HIV transmission, is one of the main priorities in Indonesia. The national prevalence of HIV among pregnant women in Indonesia continues to rise.
“Currently, the figure stands at 0.3 percent, with an estimated 230,000 mothers living with HIV,” explained Professor Ari Probandari, Wednesday (Dec. 4), the principal investigator of the MENJAGA Study team, a collaboration between UGM’s Center for Tropical Medicine (PKT), Sebelas Maret University, the London School of Hygiene & Tropical Medicine (LSHTM), and the University of New South Wales.
In the context of HIV elimination, antenatal care (ANC) services play a crucial role as the primary platform for the prevention, diagnosis, and treatment of HIV in pregnant women.
“Mother-to-child HIV transmission can be prevented. The condition is that pregnant women must undergo HIV testing early and start antiretroviral therapy (ARV) if necessary,” stated Professor Probandari.
Adequate ANC coverage can help achieve the 95-95-95 initiative set by WHO. The goal is 95% ANC coverage, 95% HIV/syphilis/hepatitis B testing coverage for pregnant women, and 95% treatment coverage for those who test positive for HIV/syphilis/hepatitis B.
The MENJAGA Study was conducted in Bandung City and Bogor Regency. Its aim is to help the research team assess the effectiveness and cost-efficiency of continuous quality improvement (CQI) interventions in increasing antenatal testing coverage for HIV, syphilis, and hepatitis B.
The core of CQI is actively involving healthcare providers to identify issues in the service process and find simple solutions that can be directly implemented.
“Many of our colleagues from the health department and community health centers (puskesmas) have been actively involved,” explained Ira Dewi Jani, MD, Head of Disease Prevention and Control (P2P) at the Bandung City Health Office.
In early November, CQI meetings were held in both areas to discuss progress during the seven-month intervention phase.
Bandung City’s Rusunawa Community Health Center reported that in June 2024, HIV/syphilis/hepatitis B testing coverage for pregnant women reached 34%, targeting 339 pregnant women.
The CQI team at the health center aimed to raise this coverage to 75% by the end of the intervention in September 2024. At the end of the intervention, the health center exceeded the target, achieving 85% coverage.
This success was attributed to interventions such as partnerships with private health networks or independent midwifery practices within the health center’s service area.
The health center provided reagents in this collaboration, while the network reported the tests conducted at their locations.
As a result, Rusunawa Health Center increased its coverage numbers and improved its record-keeping and reporting systems, making them more organized and systematic. Other health centers experienced similar benefits.
“We are grateful to be one of the health centers directly involved in this study,” said Ike Puri Purnama Dewi, MD, Head of UPTD Kopo Health Center, Bandung City.
She noted that they gained a deeper understanding of problem analysis. Moreover, the key success indicators of the planned activities became easier to identify.
The MENJAGA Study is currently in the end-line data collection stage and is evaluating the intervention processes implemented at each health center. The goal of this study is to assist healthcare services in increasing HIV, syphilis, and hepatitis B testing coverage.
“Through this study, we hope the research team can contribute to achieving triple elimination—eliminating HIV, syphilis, and hepatitis B in Indonesia,” said Professor Probandari.
Author: Lazuardi
Editor: Gusti Grehenson
Photo: PKT UGM
Post-editor: Afif