Barriers to the implementation of HIV, syphilis and hepatitis B testing in antenatal services in Indonesia have been identified, including a lack of standard operating procedures at the clinic level.

Continuous quality improvement (CQI) is an approach to develop healthcare providers’ capacity to improve quality of care processes and improve adherence to clinical guidelines. The MENJAGA study is the first cluster-randomized trial to evaluate a multi-faceted CQI to improve antenatal testing and treatment of HIV/syphilis/hepatitis B among public and private providers in Indonesia. This economic evaluation comparing CQI interventions versus standard of care will explore the long-term cost-effectiveness using a decision analytic model and incorporate equity considerations with a distributional cost-effectiveness analysis.