Reduction of Maternal, Newborn and Child Mortality.
Mother to child transmission (MTCT) is the main mode of contamination of children with the HIV virus and is responsible for more than 90% of childhood HIV infection.
Transmission can occur during:
- delivery or
Prevention of mother-to-child transmission of HIV (PMTCT) is a common term for programs, services and interventions designed to reduce the risk of MTCT. Without PMTCT, the risk of transmission of HIV from mother-to-child can be as high as 35-45%. Effective PMTCT interventions can reduce this risk to below 5%.
These interventions include:
- antenatal services and HIV testing during pregnancy,
- providing antiretroviral treatment (ART) to pregnant women living with HIV,
- safe childbirth practices,
- appropriate infant feeding methods,
- HIV exposed infant testing (early infant diagnosis) and other post-natal healthcare services
These services can only be offered to women if they go to the health facilities.
Since 2001 the Ministry of health (MOH) has been aligning to the WHO PMTCT guidelines and presently Option B+ is implemented country wide. The current guidelines recommend that all HIV infected pregnant and breastfeeding women receive lifelong antiretroviral treatment regardless of their CD4 count or WHO clinical stage known as Option B+.
The HIV exposed infant should receive a course of antiretroviral treatment (once-daily nevirapine) as soon as possible after birth, no matter the infant feeding method. This prophylaxis is given for a duration of four to six weeks if the mother received more than one month of ART before delivery and for 12 weeks if she received ART for less than one month before delivery. At four to six weeks of age, EID (early infant diagnosis) testing should be done. HIV serology is done at 18 months to provide the final HIV status of the infant.
PMTCT therefore provides a golden opportunity for HIV pregnant women to be tested for HIV and to have access to care and treatment for herself and her entire family.
The implementation of these measures faces many challenges with one of the main bottle necks being low ANC (ante-natal care) uptake. However there has been continues improvement in the ANC uptake over the years with the help of Community health workers and mass sensitization. The uptake was at 74% in 2015.
Proper implementation of PMTCT strategies will permit us to attain the global target of eliminating mother to child transmission of HIV. This will lead to reduction in new HIV infection in children by above 90% which is an essential step in ensuring an AIDS free generation and also improve maternal health.