Meet the CIPHER grantees

Dorina Onoya

Year awarded: 2016
Institution: Wits Health Consortium
Research site: Health Economics and Epidemiology Research Office, Wits Health Consortium, Johannesburg, South Africa
Primary mentor: Gayle Sherman, National Institute of Communicable Diseases, Johannesburg, South Africa

Dorina Onoya is an epidemiologist with more than 18 years of experience in HIV prevention and surveillance work, as well as assessing ART outcomes and retention for adult and paediatric patients.

More information on Dorina | Email

“Obtaining funding for a self-initiated project is a great confidence booster … the submission to CIPHER became my template for a successful proposal, and I am building on it.”

Research project: Understanding predictors of early antenatal care initiation and patterns of postpartum maternal mobility in relation to paediatric HIV diagnosis and linkage to HIV care in Gauteng Province, South Africa

The issue

Coverage of South Africa’s prevention of mother-to-child transmission (PMTCT) programme is high. However, to meet the 90-90-90 targets for children, postpartum retention of women in the programme must be strengthened, and uptake of repeat HIV tests for HIV-exposed children and mothers who initially test HIV negative in antenatal care must be improved. The mobility of postpartum women is generally thought to significantly contribute to maternal disengagement from HIV care, resulting in delayed HIV diagnosis among HIV-exposed children and ART initiation of those who test HIV positive. However, this is poorly understood and rarely examined in detail due to the challenges associated with community-based follow-up activities.

The CIPHER project

Dr Onoya’s project is a randomized controlled trial of three postpartum tracing approaches among new mothers in the Gauteng province of South Africa. Specifically, the aim is to assess the effect of a telephonic tracing and counselling support intervention on postpartum retention and completion of the PMTCT cascade steps by mother-child pairs.

The impact

Even though the project has yet to impact on actual policy, initial data highlighted the need to strengthen the links between midwife obstetric units responsible for birth PCR testing and primary care clinics where postnatal care is accessed to improve the implementation of the current policy on the delivery of birth HIV PCR results. These early results were well received, with health managers from Gauteng’s Tshwane district committing to stepping up efforts to ensure that mothers receive the birth PCR results timeously so that newborns living with HIV receive necessary care and treatment as early as possible.

The project has given Dr Onoya the chance to train a research team in qualitative and quantitative data analysis, as well as manuscript development. Her submission to ICASA 2017 won the best abstract award. “This was very exciting and encouraging, and we hope to produce more relevant outputs in the future,” she says.