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SOUTH RIFT VALLEY PREVENTION OF MOTHER TO CHILD TRANSMISSION OF HIV INFECTION (PMTCT) PROGRAM
HIV Overview | HIV Programs

 

PMTCT interventions uptake showing the number of pregnant women who presented for ANC, and the uptake of the various PMTCT interventions.

 

 

 

 

 

 

Of the estimated 700,000 children in 2005 who became infected with Human Immunodeficiency Virus type 1 (HIV-1), 90 % were from sub-Sahara Africa.  The overwhelming majority of infected children acquire the infection through mother-to-child transmission, which can occur during pregnancy, delivery, the post-partum period, or during breastfeeding.  In the absence of intervention, rates of mother-to-child transmission of HIV-1 infection vary from 15% to 45%.  The discovery that single-dose nevirapine therapy reduced the risk of perinatal transmission of HIV by 47% brought the first real opportunity to reduce mother-to-child transmission of HIV-1 in resource-poor settings and has led to a scaling up of prevention of mother-to-child transmission (PMTCT) of HIV programs.

 

 

 

 

 

 

 

Based initially in Kericho District, the Walter Reed Project HIV program helped initiate PMTCT programs in the southern Rift Valley Province of Kenya in August 2001.  As one of the first PMTCT programs in the country, the Walter Reed Project PMTCT program brought the first opportunities for HIV counseling and testing in the region.  The program commenced in three hospitals, has expanded to 55 health facilities, and will exceed 100 by 2007.  Over 54,000 women have been seen in the Walter Reed Project PMTCT program, and over 28,000 deliveries have been conducted in PMTCT health facilities during the past 4 ½ years.  Of the approximate 54,000 pregnant women presented for their first prenatal care, 82% were offered PMTCT counseling:  96% of those counseled consented to HIV testing, and 95% of those tested received their results, of which 7 % were informed that they were HIV positive.  Among the HIV positive pregnant women, 75% were given nevirapine at onset of labor.  Fifty-two percent of their infants were given nevirapine.

PMTCT interventions uptake showing the number of pregnant women who presented for ANC, and the uptake of the various PMTCT interventions

 

Number of new ANC seen, counseled, tested and given results from August 2001 to December 2005

 

 

 

 

 

 

 

 

Milestones in program implementation have included:

  • Capacity building through in-service training to 114 health care workers using of the Ministry of Health standardized training manual
  • Integration of PMTCT services into existing health care facilities /reproductive health services
  • Providing voluntary counseling and testing for pregnant women, their partners, and their children
  • Strengthening comprehensive antenatal, intra-partum, and postpartum care for mothers and their children
  • Provision of antiretroviral prophylaxis (nevirapine tablets and syrup) to HIV positive mothers and their infants, respectively
  • Supply chain management of expendable commodities including test kits, nevirapine, and other program supplies 
  • Supportive supervision and management
  • Infrastructure development through minor renovations and furniture provision

The program has grown from providing counseling and testing for only pregnant women to providing these services to the entire family; from providing only single dose nevirapine prophylaxis to more utilizing more complex regimes such dual and triple therapy; and, from exclusive breastfeeding to replacement feeding for those who chose this infant feeding option.  Highly active anti-retroviral therapy (or standard of care triple therapy) is now available for pregnant women and members of her family who qualify for treatment according to the national guidelines.

 
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