Country Experiences

This section contains reports of countries that have introduced, are implementing or have scaled up services for prevention of mother-to-child transmission (PMTCT) of HIV. These country experiences are intended to inform health policy makers, program managers, and service providers of the strategies, challenges and lessons learned from initiatives that address PMTCT within programs and communities. The country-specific resources in this section include:

Program Experiences
National Experiences in Policy, Guidelines and Advocacy Addressing PMTCT
PMTCT Country Factsheets
Feasibility Studies

Have a suggested resource or comment about this section? Please visit our Discussion Board on PMTCT.

Program Experiences

Integrating Family Planning and HIV Services: Programs in Kenya and Ethiopia Lead the Way

2011 | John Snow Inc (JSI) | 16 p

English

In regions of high fertility and HIV prevalence, integration of family planning and HIV services has emerged as a promising strategy to prevent transmission of HIV, particularly from mother to child. This interactive case study explores different models of integration and how they have been realized in Kenya and Ethiopia, two pioneers in family planning and HIV service integration.

2010 | Elizabeth Glaser Pediatric AIDS Foundation | 12 p

English

There are approximately 940,000 people living with HIV in Uganda, 130,000 of whom are children. Adult HIV prevalence is estimated at 5.4% and more than half of the people living with HIV in the country are women. Despite the availability of services to prevent mother-to-child transmission of HIV, only 50% of pregnant women are currently receiving this critical intervention, leaving an estimated 40,000 women at risk of transmitting the virus to their infants.

2009 | World Health Organization (WHO) | 24 p

English

The process of linking sexual and reproductive health and HIV/AIDS needs to work in both directions: traditional sexual and reproductive health services need to integrate HIV/AIDS interventions, and programmes set up to address the AIDS epidemic need to integrate more general services for sexual and reproductive health.

2009 | BMC Public Health

English

Safety and effectiveness of efficacious antiretroviral (ARV) regimens beyond single-dose nevirapine (sdNVP) for prevention of mother-to-child transmission (PMTCT) have been demonstrated in well-controlled clinical studies or in secondary- and tertiary-level facilities in developing countries. This paper reports on implementation of and factors associated with efficacious ARV regimens among HIV-positive pregnant women attending antenatal clinics in primary health centers (PHCs) in Zambia.

2009 | Elizabeth Glaser Pediatric AIDS Foundation | 17

English

This document describes the key elements and principles of the district approach, including how implementation of this approach can be supported through a series of specific steps. Key elements of the district approach include building technical capacity at the district level, ensuring financial sustainability of programme activities, and creating mechanisms for ongoing supportive supervision and monitoring. Suggestions are also provided on how to monitor the impact of such an approach and how to embark on the next steps beyond initial implementation.

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Caring for Pregnant Women with HIV

2008 | FHI

English

FHI's Zambia Prevention, Care and Treatment Partnership (ZPCT) embarked on a groundbreaking effort to test CD4 counts and provide complex antiretroviral regimens for pregnant women seeking prevention of mother-to-child transmission services (PMTCT) at their community health centers. In this PMTCT project, ZPCT's major innovations at the primary health center level have included procurement of CD4 count machines and creation of a blood sample referral system. ZPCT has supplied motorbikes and fuel allowances to transport specimens from PMTCT centers for testing.

2008 | Elizabeth Glaser Pediatric AIDS Foundation | 33

English

The Foundation’s program was initiated with the goal of increasing coverage of PMTCT services to 90% of HIV-positive women delivering in St. Petersburg, focusing especially on women who had not accessed ANC during pregnancy.

2008 | Population Council | 46 p

English

Recognizing the need to improve the care and follow up of mothers and infants in the postpartum period, the Lesotho Ministry of Health and Social Welfare (MOHSW), with technical support from the Frontiers in Reproductive Health Program (FRONTIERS) of Population Council and funding from PEPFAR/RHAP/USAID, carried out an operations research project to strengthen the existing postpartum care services.

2008 | Elizabeth Glaser Pediatric AIDS Foundation | 12 p

English

With a growing number of employees at Société des Caoutchoucs de Grand Béréby (SOGB) missing work as a result of HIV infection and other workers dying of AIDS related illnesses, the prominent Ivorian rubber and palm oil producer recognized it needed to respond decisively to institute HIV/AIDS services for its employees and their families.

2008 | The World Health Organization (WHO) | 24 p

English |

French

2008 | World Health Organization (WHO) | 24 p

English

2005 | World Health Organization [WHO] | 1309-1315

English

To determine the population effectiveness of a city-wide perinatal HIV prevention program. DESIGN: An anonymous surveillance of newborn cord blood for HIV serology and nevirapine (NVP).

2005 | World Health Organization [WHO] | 489-494

English

The aim of this study was to estimate the field efficacy of the first routine programme for the prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) initiated in South Africa, in the subdistrict of Khayelitsha. METHODS: A consecutive sample of 658 mother-infant pairs, identified from the PMTCT register from 1 March to 30 November 2003, were identified for enrolment in this study. Details of the regimen received were established and HIV status of the infants at between 6 and 10 weeks of age was determined by qualitative DNA polymerase chain reaction.

2005 | Pathfinder International | 36 p

English

This document describes Pathfinder’s innovative PMTCT model and our evolving collaboration with public, private, and faith-based partners in Kenya. Key activities, achievements, and challenges at the facility and community levels are shared and lessons are distilled, based on Pathfinder’s last three years of experience. Suggestions on the way forward are offered so that we may plan together how to prevent HIV transmission and ensure healthy lives for all Kenyan women, babies, and families.

2004 | Int Conf AIDS

English

This abstract addresses the financial constraints most Prevention of Mother to Child Transmission (PMTCT) programs and services face by highlighting the Kericho PMTCT of HIV infection Program in Western Kenya. Monitoring of the program found that in spite of a track record of delivering good-quality services, the costs of PMTCT Projects in rural Kenya, including staff and supplies, exceeds what could likely be supported through user fees.

2002 | AIDS | 953-959

English

To describe the development, components, and initial uptake of Thailand's national program for preventing mother-child HIV transmission.

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National Experiences in Policy, Guidelines and Advocacy Addressing Prevention of Mother-To-Child Transmission

Guidelines for Prevention of Mother-to-Child Transmission of HIV in Ethiopia

2008 | Federal HIV/AIDS Prevention and Control Office

English

The National PMTCT Guidelines areintended as a hands-on tool providing guidance for individuals working on PMTCT in different sectors (public, private or NGO) on how to provide standardized and high-quality services. The guidelines were developed through a collaborative, consensus-building process involving stakeholders from a broad cross-section of organizations and individuals working in the field of PMTCT. The guidelines are updated based on in-country experience and internationally acclaimed standard recommendations. The specific objectives of the guidelines are to assist:

2008 | Alliance of Mayors and Municipal Leaders on HIV/AIDS in Africa AMICAALL Namibia Programme | 19

English

This short guide presents the case for local government addressing HIV/AIDS. It shows, in practical terms, what you, as local leaders - no matter the size of your city, town or village - can do to advocate for effective responses to HIV/AIDS at the local authority level.

2008 | South Africa National Department of Health | 81 p

English

The primary aim of the PMTCT programme was to decrease the number of HIV infected babies born to HIV positive mothers.

2003 | Ministry of Health, Uganda | 1-25

English

Mother-to-Child HIV Transmission (MTCT) is the second major mode of spread of the virus in Uganda and is the main route by which children get infected.

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PMTCT Country Factsheets

In the absence of any interventions, the transmission rate of HIV from an HIV-positive mother to her child during pregnancy, labor, delivery or breastfeeding ranges from 15-45%. This rate can be reduced to levels below 5% with effective interventions. The global community has committed itself to accelerate progress for the prevention of mother-to-child HIV transmission through an initiative with the goal to eliminate new pediatric HIV infections by 2015 and improve maternal, newborn and child survival and health in the context of HIV. Listed below are a series of factsheets published by UNICEF in 2010 on the status of national PMTCT responses in the most affected countries.

Preventing Mother-to-Child Transmission (PMTCT) of HIV: Factsheets on the status of national PMTCT responses in the most affected countries, 2010

2010 | UNICEF

Angola |

Botswana |

Cameroon |

Chad |

Cote D'Ivôire |

Democratic Republic of the Congo |

Ethiopia |

Ghana |

India |

Kenya |

Lesotho |

Malawi |

Mozambique |

Namibia |

Nigeria |

South Africa |

Swaziland |

Tanzania |

Uganda |

Zambia |

Zimbabwe

Each of these 22 country-specific factsheets sets out strategic information on the state of PMTCT service-delivery and policy development, while also highlighting bottlenecks that must be tackled to reach national targets.

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Feasibility Studies

Integration of Family Planning and Preventing Mother to Child Transmission Services in Kenya: Results of a Rapid Assessment

2010 | FHI360 | 34 p

English

This study assessed the feasibility of existing Kenyan health facilities to meet the family planning (FP) needs of HIV+ women by strengthening FP services in maternal and child health service delivery settings. Meeting unmet needs of contraception for HIV+ women is a highly effective PMTCT strategy that is often overlooked.

2009 | FHI 360 | 38 p

English

This study is an assessment to describe the current status of PMTCT and FP integration in order to provide the Ministry of Health and the national AIDS program with information needed to improve integrated FP-PMTCT services. Eligible health facilities were selected and the research was undertaken in antenatal care, postnatal care and child welfare services.

2008 | FHI360 | 46 p

English

This formative research study in South Africa studied the family planning needs and preferences of PMTCT clients as well as the readiness of antenatal care services, postpartum services and child health services to provide a larger role in family planning services. The study also assessed the extent to which the existing family planning services serve women living with HIV/AIDS.

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