5-year results of PMTCT integrated into community based services
P. Brunache, F. Guillaume, C. Trout, J. Pollock
Management Sciences for Health, Center for Health Services, Cambridge, United States
In Haiti, 25% of births occur in a health-care setting but 85% of pregnant
women attend at least one pre-natal visit (EMMUS-IV), which is an opportunity to
provide HIV testing and prophylaxis for Prevention Mother to Child Transmission
(PMTCT) of HIV. Poverty, transportation
costs, food insecurity, cultural factors, stigma and discrimination, are
barriers to uptake of HIV testing and successful prophylaxis for HIV+ pregnant
women. Less than 50% of pregnant women in Haiti recieved an HIV test in 2009. (MESI
database). In 2008, only 43% of HIV+ pregnant women received prophylaxis for
PMTCT. (UNAIDS/WHO, 2009).
Intervention response: Since
October 2004, Management Sciences for Health (MSH) has promoted a complete
package of primary health care including PMTCT to all pregnant women in its
USAID-funded network. PMTCT is nested within antenatal and postnatal services.
The strategy combines community mobilization, promotion of services, use of traditional birth attendants and community
health workers as well as adherence. This is coupled to a prepaid package that
covers transportation fees for monthly visits, fees for lab tests, incentives
for Traditional Birth Attendants, and the cost of delivery in the health
Since October, 2004, 175,648 pregnant women were tested for HIV and received
their results in the MSH network in Haiti and 6,991 HIV+ pregnant women
received propylaxis. HIV+ mothers have
become an advocacy group for other HIV+ pregnant women.
PMTCT is best provided within an integrated and holistic package of
Maternal-Child health care.
Back to the Programme-at-a-Glance