Abstract:

The pediatric HIV burden is significant, with 46% of 1.7 million affected children lacking treatment in 2020. In sub-Saharan Africa, up to 49% of HIV-infected children remain undiagnosed, contributing to high AIDS-related mortality. In Zambia, early infant diagnosis (EID)coverage for HIV-exposed infants (HEI) is suboptimal with  71%  receiving timely virologic testing, indicating gaps in case identification. We explored healthcare workers' perceptions of Early Infant Diagnosis, appointment systems and associated challenges. Respondents were selected in two stages: Firstly, facilities were purposively sampled based on high HIV-Exposed Infants volumes. Secondly, 19 respondents were purposively sampled within the province (1), district (2) and facilities(16)based on their roles within the PMTCT department. All Content and thematic analyses were done using NVivo 10 software. Healthcare providers reported using registers to identify and track HIV-exposed infants’ appointments, leveraging routine immunization visits for identification across the cascade up to 9 months old and utilizing an integrated electronic medical records system (SmartCare) for appointment and service tracking. However, health care providers highlighted challenges that include cumbersome paper-based registers, leading to incomplete documentation and difficulties in tracking HIV-exposed infants’ appointments, Loss to follow-up rises after 9 months, attributed to decreased attendance post-routine immunizations and SmartCare’s dual documentation add to workload, leading to incomplete records, hindering appointment tracking due to time-consuming data entry and lack of critical information. Our study, recommends streamlining appointment systems to cover the entire infancy period, enhancing register design, and providing additional training for electronic medical record systems to healthcare providers to improve efficiency.

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