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Prevention of MTCT: Pilot Projects

In view of the high risk of MTCT in sub-Saharan Africa, the first pilots are being implemented in areas with high HIV prevalence among women of child bearing age and where the local health system has the capacity to deliver the package of interventions.

Botswana Cote d'Ivoire Kenya Rwanda Tanzania Uganda Zambia Zimbabwe

A total of approximately 10,300 pregnant women in Botswana, Cote d'Ivoire, Rwanda, and Zimbabwe have been counselled, of which approximately 6,300 have been tested and, if infected, have been offered short course antiretroviral therapy together with support for counselling on feeding options.

The Inter-Agency Task Force has assisted these efforts with support in consensus building, planning, developing strategies, guidelines, training, provision of drugs and test kits, and with the implementation of a monitoring system to determine the impact of this intervention in a routine antenatal care setting. UNICEF has worked with governments and other partners in Kenya, Tanzania, Uganda and Zambia for the last year to introduce MTCT interventions. The training of staff and other preparations are underway and implementation is expected to start early in 2000. UNICEF is also working with governments in South Africa, Burkina Faso, Malawi, Mozambique, Namibia, Cambodia, Haiti and Honduras to develop plans for the implementation of efforts to reduce MTCT. The pilots are intended to assess the feasibility, sustainability and impact of interventions to reduce MTCT of HIV in a variety of operational health care settings. Lessons learned from the pilots will be used to refine the approach before wider scale implementation. In at least two sites-in Kenya and Uganda-information is also being collected about women who do not participate in the project, to identify barriers to access. In Zimbabwe, the long-term health consequences for children of HIV-positive mothers who do not breastfeed will be studied, to ensure that the intervention does not increase overall infant mortality.