PITC in an inpatient ward setting - the sticker method

For many large and busy health facilities, it can be hard to ensure that all inpatients are offered an HIV test before being discharged. Baylor supported the pediatric ward at Kamuzu Central Hospital in Lilongwe, Malawi, to implement a unique system to ensure all pediatric in-patients were tested for HIV. CHWs within the facility screened the department at various times throughout the day by checking each child’s HIV status on their patient chart and/or asking guardians about the child’s status. If the patient had a known HIV status (positive OR negative), a green sticker was put on the chart indicating that screening had taken place. If not, the patient was escorted to HTC as indicated by the flow chart.

To ensure all staff participated in the process, counselors provided a report on PITC coverage in the weekly staff morning report. This presentation included a report on the percentage of patients with an ascertained status (the number of patients with an ascertained status/total number of in-patient enrollments)
in addition to the number of HIV-positive patients found that week. Reporting on their progress, including both successes and challenges, motivated the in-patient HTC team to work harder and improve their coverage. After implementing this process, the percentage of patients discharged with a known HIV status increased to almost 100% every week.