***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : This cluster r and omized trial was performed to test whether one-stop service could better prevent congenital syphilis than the conventional antenatal screening service in Mongolia . Methods : Out of 14 antenatal clinics in 6 districts of Ulaanbaatar , 7 were r and omly selected for the one-stop service and the remaining for the conventional service .  Intervention clinics provided on-site rapid syphilis testing and immediate treatment for positive cases and their partners . In control clinics , syphilis screening services with routine off-site rapid plasma regain testing and case management were followed . Analysis was intention to treat . Results : Of 3850 antenatal women recruited in each group , the proportion of syphilis testing at the first visit and third trimester was over 99 % in the intervention group and 79.6 % and 61.5 % in the control group , respectively ( P < 0.001 for both periods ) . Correspondingly , syphilis cases detected in the intervention group were 73 ( 1.9 % ) and 20 ( 0.5 % ) for the first visit and third trimester , respectively , and 27 ( 0.9 % ) and 2 ( 0.08 % ) in the control group ; and 98.9 % ( 92/93 ) of the detected cases in the intervention group and 89.6 % ( 26/29 ) in the control group were adequately treated ( P = 0.02 ) . The corresponding treatment rates for sexual partners were 94.6 % and 55.2 % ( P < 0.001 ) . One congenital syphilis case out of 3632 deliveries in the intervention group , compared to 15 of 3552 in the control group , was diagnosed , a reduction of 93.5 % ( 95 % confidence interval , 66.0%–98.6 % ) . Conclusions : One-stop services increased the detection rate of syphilis , treated more positive women and their partners , and effectively reduced the rate of congenital syphilis Background Despite strong evidence for the effectiveness of anti-retroviral therapy for improving the health of women living with HIV and for the prevention of mother-to-child transmission ( PMTCT ) , HIV persists as a major maternal and child health problem in sub-Saharan Africa . In most setting s antenatal care ( ANC ) services and HIV treatment services are offered in separate clinics . Integrating these services may result in better uptake of services , reduction of the time to treatment initiation , better adherence , and reduction of stigma . Methodology /Principal Findings A prospect i ve cluster r and omized controlled trial design was used to evaluate the effects of integrating HIV treatment into ANC clinics at government health facilities in rural Kenya . Twelve facilities were r and omized to provide either fully integrated services ( ANC , PMTCT , and HIV treatment services all delivered in the ANC clinic ) or non-integrated services ( ANC clinics provided ANC and basic PMTCT services and referred clients to a separate HIV clinic for HIV treatment ) . During June 2009– March 2011 , 1,172 HIV-positive pregnant women were enrolled in the study . The main study outcomes are rates of maternal enrollment in HIV care and treatment , infant HIV testing uptake , and HIV-free infant survival . Baseline results revealed that the intervention and control cohorts were similar with respect to socio-demographics , male partner HIV testing , sero-discordance of the couple , obstetric history , baseline CD4 count , and WHO Stage . Challenges faced while conducting this trial at low-re source rural health facilities included frequent staff turnover , stock-outs of essential supplies , transportation challenges , and changes in national guidelines . Conclusions / Significance This is the first r and omized trial of ANC and HIV service integration to be conducted in rural Africa . It is expected that the study will provide critical evidence regarding the implementation and effectiveness of this service delivery strategy , with important implication s for programs striving to eliminate vertical transmission of HIV and improve maternal health . Trial Registration Clinical Trials.gov NCT00931216 NCT00931216 Background The follow-up of HIV-exposed infants remains a public health challenge in many Sub-Saharan countries . Just as integrated antenatal and maternity services have contributed to improved care for HIV-positive pregnant women , so too could integrated care for mother and infant after birth improve follow-up of HIV-exposed infants . We present results of a study testing the viability of such integrated care , and its effects on follow-up of HIV-exposed infants , in Tete Province , Mozambique . Methods Between April 2009 and September 2010 , we conducted a mixed- method , intervention-control study in six rural public primary healthcare facilities , selected purposively for size and accessibility , with r and om allocation of three facilities each for intervention and control groups . The intervention consisted of a reorganization of services to provide one-stop , integrated care for mothers and their children under five years of age .  We collected monthly routine facility statistics on prevention of mother-to-child HIV transmission ( PMTCT ) , follow-up of HIV-exposed infants , and other mother and child health ( MCH ) activities for the six months before ( January-June 2009 ) and 13 months after starting the intervention ( July 2009-July 2010 ) . Staff were interviewed at the start , after six months , and at the end of the study . Quantitative data were analysed using quasi-Poisson models for significant differences between the periods before and after intervention , between healthcare facilities in intervention and control groups , and for time trends . The coefficients for the effect of the period and the interaction effect of the intervention were calculated with their p-values . Thematic analysis of qualitative data was done manually . Results One-stop , integrated care for mother and child was feasible in all participating healthcare facilities , and staff evaluated this service organisation positively . We observed in both study groups an improvement in follow-up of HIV-exposed infants ( registration , follow-up visits , serological testing ) , but frequent absenteeism of staff and irregular supply of consumables interfered with healthcare facility performance for both intervention and control groups . Conclusions Despite improvement in various aspects of the follow-up of HIV-exposed infants , we observed no improvement attributable to one-stop , integrated MCH care . Structural healthcare system limitations , such as staff absences and irregular supply of essential commodities , appear to overshadow its potential effects . Regular technical support and adequate basic working conditions are essential for improved performance in the follow-up of HIV-exposed infants in peripheral public healthcare facilities in Mozambique Objective : Prevention of Mother-to-Child Transmission of HIV programs require follow-up of HIV-exposed infants ( HEI ) for infant feeding support , prophylactic medicines , and HIV diagnosis for at least 18 months . Retention in care and receipt of HIV services are challenging in re source -limited setting s. This study compared infant follow-up results when HEI services were provided within Maternal and Child Health ( MCH ) clinics or in specialized HIV Comprehensive Care Clinics ( CCCs ) in Kenya . Methods : This observational prospect i ve cohort study enrolled HEI at 6–8 weeks of age in 2 purposively selected hospitals with similar characteristics but different models of service delivery . In the CCC model , HEI received immunization and growth monitoring in MCH but cotrimoxazole prophylaxis and infant HIV testing in the CCC . In the MCH model , all services were provided in the MCH . Data were collected at enrollment , 14 weeks , and 6 , 9 , and 12 months . Results : From April 2008 to April 2009 , 184 HEI were enrolled in the CCC cohort and 179 in the MCH cohort . Infants in MCH were 1.14 , 1.42 , 1.95 , and 1.29 times more likely to attend 14-week , 6- , 9- , and 12-month postnatal visits , respectively , and 2.24 times ( 95 % confidence interval : 1.57 to 3.18 ) more likely to attend all 4 visits . Although infants in MCH were 1.33 times ( 95 % confidence interval : 1.10 to 1.62 ) more likely to have HIV antibody testing at 1 year than CCC , there were no differences for polymerase chain reaction test or cotrimoxazole initiation at 6–8 weeks . Conclusions : HIV services integrated in MCH yield better follow-up of HEI than CCC Abstract A cluster r and omized controlled trial was initiated in Kenya to determine if full integration ( FI ) of HIV care , including HAART , into antenatal care ( ANC ) clinics improves health outcomes among HIV-infected women and exposed infants , compared to a non-integrated ( NI ) model . This article examines ANC clients ' satisfaction with and preferences regarding HIV-integrated services . In this cross-sectional study , pregnant women attending five FI clinics ( n=185 ) and four NI clinics ( n=141 ) completed an interviewer-administered question naire following an ANC visit . By self-report , 55 women ( 17 % ) were HIV(+ ) , 230 ( 71 % ) were HIV(− ) , and 40 ( 12 % ) did not know their HIV status . Among HIV-infected women , 79 % attending FI clinics were very satisfied with their clinic visit compared to 54 % of women attending NI clinics ( P=0.044 ) ; no such difference was found among HIV-uninfected women . In multivariate analysis , overall satisfaction was also independently associated with satisfaction with administrative staff , satisfaction with health care providers , positive evaluation of wait time , and having encountered a receptionist . Full integration of HIV care into antenatal clinics can significantly increase overall satisfaction with care for HIV-infected women , with no significant decrease in satisfaction for HIV-uninfected women served in the same clinics 
    Output:
    
Limited evidence , with moderate- to high-risk of bias , suggests that integrated service delivery results in improved uptake of essential health services for women , earlier initiation of treatment , and better health outcomes .
Women also reported improved satisfaction with integrated services .