Operational Issues and Barriers to Implementation of Prevention of Mother-to-Child Transmission of HIV (PMTCT) Interventions in Sub- Saharan Africa

Title:Operational Issues and Barriers to Implementation of Prevention of Mother-to-Child Transmission of HIV (PMTCT) Interventions in Sub- Saharan Africa

Volume: 11 Issue: 2

Author(s): Jim Aizire, Mary G. Fowler and Hoosen M. Coovadia

Affiliation:

Keywords: Prevention of mother-to-child transmission, human immunodeficiency virus, Sub-Saharan Africa

Abstract: Over the past 10 years substantial progress has been made in the implementation of prevention of mother-tochild transmission of HIV (PMTCT) interventions in Sub-Saharan Africa (SSA). In spite of this, new pediatric infections remain unacceptably high, contributing the majority (>90%) of the estimated 390,000 infections globally in 2010; and yet prolonged breastfeeding remains the norm and crucial to overall infant survival.

However, there is reason for optimism given the 2010 World Health Organization PMTCT recommendations: to start HIV infected pregnant women with CD4 cell counts less than 350 cells/mm3 on lifelong antiretroviral therapy (ART); and for mothers not eligible for ART to provide efficacious maternal and/or infant PMTCT antiretroviral (ARV) regimens to be taken during pregnancy, labor/delivery and through breastfeeding. Current attention is on whether to extend maternal ARVs for life once triple ARV PMTCT regimens are started.

To dramatically reduce new pediatric infections, individual countries need to politically commit to rapid scale-up of a multi-pronged PMTCT effort: including primary prevention to reduce HIV incidence among women of reproductive age; increased access to family planning services; HIV screening of all pregnant and breastfeeding women followed by ART or ARVs for PMTCT; and comprehensive care for HIV affected families. Efforts to achieve population-level success in SSA need to critically address operational issues and challenges to implementation (health system) and utilization (social, economic and cultural barriers), at the country, health centre and client level that have led to the relatively slow progress in the scale-up of PMTCT strategies.

Cite this article as:

Aizire Jim, G. Fowler Mary and M. Coovadia Hoosen, Operational Issues and Barriers to Implementation of Prevention of Mother-to-Child Transmission of HIV (PMTCT) Interventions in Sub- Saharan Africa, Current HIV Research 2013; 11 (2) . https://dx.doi.org/10.2174/1570162X11311020007

DOI https://dx.doi.org/10.2174/1570162X11311020007	Print ISSN 1570-162X
Publisher Name Bentham Science Publisher	Online ISSN 1873-4251