Prevention of Mother to Child Transmission

© UNICEF/NEP2927/SaShrestha

Services aimed at prevention of mother-to-child transmission (PMTCT) of HIV/ AIDS were first implemented in Nepal in 2005, and now extend to nine sites in district and zonal hospitals. In 2007, 80 per cent of women attending antenatal care (ANC) clinics at eight of these sites received counselling, and 0.2 per cent were found
to be HIV positive. PMTCT services need to be strengthened to ensure that all women attending antenatal clinics receive proper counselling, and all women and babies who test positive are followed up with prophylaxis and treatment as required. The many women who do not receive antenatal care, however, must be reached by building on existing maternal and newborn health initiatives.

Activities

• Ensure pregnant women attending antenatal care in 16 districts have access to PMTCT services, by developing a new training package for healthcare providers, producing informative materials, procuring test kits and drugs, structures are in place for proper follow up care, and strengthening linkages with anti-retroviral therapy for HIV positive mothers.
• Ensure pregnant women in targeted communities of two districts not attending antenatal care clinics receive PMTCT counselling and referral, by developing new training package for healthcare providers and volunteers, integrating counselling into other maternal and neonatal healthcare activities, and strengthening community-based interventions.
• Ensure all identified HIV positive pregnant women and babies receive antiretroviral prophylaxis in health facilities in 16 districts, by training healthcare providers, strengthening counselling systems, and developing follow-up mechanisms.
• Ensure all identified HIV positive pregnant women with advanced HIV infection are receiving anti-retroviral combination therapy in 16 districts, by training healthcare providers and volunteers, strengthening laboratory capacity by linking to CD4 testing, and strengthening linkages to existing PMTCT sites.

Expected results

By 2010, there will be increased capacity, skills and knowledge for delivery of comprehensive PMTCT services in 16 districts. Some 80 per cent of pregnant women attending antenatal clinics at health facilities will receive HIV/AIDS counselling and testing from trained healthcare providers. All pregnant women identified as HIV positive and their babies will receive anti-retrovial prophylaxis.

In addition, 60 per cent of pregnant women in targeted communities who are not attending antenatal care will receive counselling and referral through other maternal and neonatal healthcare services. Follow-up and treatment mechanisms will be functioning smoothly. All HIV positive pregnant women identified with advanced HIV infection will receive anti-retroviral combination therapy in accordance with nationally approved treatment protocols in 16 districts.