Delivering integrated and standardised services to eliminate mother-to-child transmission of sexually transmitted infections: experience of the E-clinic model in a Chinese pilot district.

Abstract

Eliminating mother-to-child transmission (EMTCT) of syphilis and Hepatitis B Virus (HBV) is crucial for preventing and reducing new pediatric infections. Timely and standardized EMTCT interventions for maternal infections have been demonstrated to be highly cost-effective and efficient. Regrettably, healthcare providers have encountered challenges in delivering these interventions due to the complexity of multi-department referrals. Baoan district in Shenzhen, Guangdong province, where serves as one of the six national pilot district tasked with exploring effective EMTCT strategies, has pioneered the integration of infection management into antenatal care by establishing the E-Clinic (short for the Elimination of mother-to-child transmission Clinic) within the Obstetrics department. The E-Clinic, through its provision of integrated services, has witnessed increased coverage of syphilis treatment for pregnant women living with syphilis, as well as increased coverage of antiviral treatment for high-risk pregnant women living with HBV. The E-Clinic has been recognized as a best practice for EMTCT by the World Health Organization, and has been widely adopted and adapted in over 100 maternal and child healthcare institutions across Guangdong province. The success of the E-Clinic underscores the importance of government leadership, innovation, and multi-level engagement in promoting standardized EMTCT services, providing insights for implementing EMTCT strategies in other regions worldwide.