ArticlePloS one2019
Cost-effectiveness of integrating postpartum antiretroviral therapy and infant care into maternal & child health services in South Africa.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 3 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Do oral antidiabetic medications alter the risk of Parkinson's disease? An updated systematic review and meta-analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2023 · on this mapPooled it
- Integrating HIV services and other health services: A systematic review and meta-analysis.PLoS medicine · 2021Pooled it
- Improving retention in antenatal and postnatal care: a systematic review of evidence to inform strategies for adolescents and young women living with HIV.Journal of the International AIDS Society · 2021Pooled it
- Healthcare resource use among participants in a randomized trial of partner-based HIV treatment for seroconcordant couples in antenatal and postnatal care in rural Mozambique.BMC research notes · 2026Trial
- Provider- and patient-level costs associated with providing antiretroviral therapy during the postpartum phase to women living with HIV in South Africa: A cost comparison of three postpartum models of care.Tropical medicine & international health : TM & IH · 2020Trial
- Long-Acting Antiretroviral Therapy for Breastfeeding Women With HIV Experiencing Barriers to Adherence in Zimbabwe: Modeling Clinical Impact and Cost-effectiveness.The Journal of infectious diseases · 2026Article
- The impact of tobacco smoking and smoking cessation on lung cancer and stroke incidence among people with HIV on antiretroviral therapy in South Africa: a simulation modeling study.BMJ global health · 2024Article
- Novel Approaches to Postnatal Prophylaxis to Eliminate Vertical Transmission of HIV.Global health, science and practice · 2023Article
- Article
- Costs and cost-effectiveness of HIV early infant diagnosis in low- and middle-income countries: a scoping review.Infectious diseases of poverty · 2022Article
- Modeling Adherence Interventions Among Youth with HIV in the United States: Clinical and Economic Projections.AIDS and behavior · 2021Article
- Optimizing infant HIV diagnosis with additional screening at immunization clinics in three sub-Saharan African settings: a cost-effectiveness analysis.Journal of the International AIDS Society · 2021Article
- Accelerating progress towards the elimination of mother-to-child transmission of HIV: a narrative review.Journal of the International AIDS Society · 2020Review
- A Practitioner-Led Approach to Understanding Multi-Professional Working Across Health and Care: Co-Constructing the Integrated-Component Assessment Framework (I-CAF) and the Development Matrix for Integration (DMI).International journal of integrated careArticle
Corrections and comments
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Authors and funding
13 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundPoor engagement in postpartum maternal HIV care is a challenge worldwide and contributes to adverse maternal outcomes and vertical transmission. Our objective was to project the clinical and economic impact of integrated postpartum maternal antiretroviral therapy (ART) and pediatric care in South Africa.
methodsUsing the CEPAC computer simulation models, parameterized with data from the Maternal and Child Health-Antiretroviral Therapy (MCH-ART) randomized controlled trial, we evaluated the cost-effectiveness of integrated postpartum care for women initiating ART in pregnancy and their children. We compared two strategies: 1) standard of care (SOC) referral to local clinics after delivery for separate standard ART services for women and pediatric care for infants, and 2) the MCH-ART intervention (MCH-ART) of co-located maternal/pediatric care integrated in Maternal and Child Health (MCH) services throughout breastfeeding. Trial-derived inputs included: 12-month maternal retention in care and virologic suppression (SOC: 49%, MCH-ART: 67%), breastfeeding duration (SOC: 6 months, MCH-ART: 8 months), and postpartum healthcare costs for mother-infant pairs (SOC: $50, MCH-ART: $69). Outcomes included pediatric HIV infections, maternal and infant life expectancy (LE), lifetime HIV-related per-person costs, and incremental cost-effectiveness ratios (ICERs; ICER <US$903/YLS considered "cost-effective").
resultsCompared to SOC, MCH-ART increased maternal LE (SOC: 25.26 years, MCH-ART: 26.20 years) and lifetime costs (SOC: $9,912, MCH-ART: $10,207; discounted). Projected pediatric outcomes for all HIV-exposed children were similar between arms, although undiscounted LE for HIV-infected children was shorter in SOC (SOC: 23.13 years, MCH-ART: 23.40 years). Combining discounted maternal and pediatric outcomes, the ICER was $599/YLS.
conclusionCo-located maternal HIV and pediatric care, integrated in MCH services throughout breastfeeding, is a cost-effective strategy to improve maternal and pediatric outcomes and should be implemented in South Africa.
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