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Table 2 Critical path logical framework

From: Using the critical path method to rollout and optimise new PMTCT guidelines to eliminate mother-to-child transmission of HIV in Zimbabwe: a descriptive analysis

Critical path impact goal

To reduce the MTCT rate from an estimated 30% in 2010 to less than 12 in 2015


Critical path indicators (CPIs)

➢ Number and % women booked for first ANC visit (ANC booking is attending at least one ANC visit and is counted at the 1st ANC visit)

➢ Number and % women tested for HIV in ANC

➢ Number and % HIV-positive women started on AZT prophylaxis in ANC

➢ Number and % pregnant women eligible for ART by CD4 count in ANC

➢ Number and % eligible pregnant women initiated on ART in ANC

➢ Number and % HIV-exposed infants started on Nevirapine prophylaxis

➢ Number and % infants (< 2 months age) tested for HIV using DNA PCR


Programme management indicators (PMIs)

➢ Number of sites offering comprehensive PMTCT services (HIV testing and ARVs for PMTCT)

➢ Number of sites offering ART services on-site (in MNCH or ART clinic)

➢ Number of sites offering CD4 testing on-site (using point-of-care machine or on-site laboratory CD4 testing machine)

➢ Number of sites offering EID services on-site (collecting dried blood spot and sending to a central laboratory for testing)

➢ Number of health facility nurses trained on PMTCT, ART, EID etc.

➢ Number of sites with an interruption in HIV testing for at least one day (due to absence of trained rapid HIV testers or stock-out of HIV test kits)

➢ Number of sites with a stock-out of maternal and infant ARVs

➢ Number of sites visited for supportive supervision


Critical path activities

➢ Supporting programme coordination, adaptation of global PMTCT guidelines, developing training materials, technical working groups etc.

➢ Supporting rapid roll-out of new PMTCT guidelines in health facilities

➢ Training and mentoring health facility nurses on PMTCT guidelines and use of PDSA cycles to improve PMTCT service delivery 

➢ Providing and maintaining POC devices for CD4 testing in ANC

➢ Supporting EID and CD4 specimen courier services

➢ Supporting HIV test-kit and ARV stock management and redistribution