Assessing four prong strategies to improve ART quality and coverage for preventing vertical transmissions in six countries - case study on the failures and challenges in policy development and implementation of prevention of vertical transmission programmes in Argentina, Cambodia, Moldova, Morocco, Uganda and Zimbabwe
A. Ngoksin, Childhood for all (Moldova), HEPS (Uganda), Argentinian Network of Women Living with HIV (Argentina), ALCS (Morocco), Working Group on Health (Zimbabwe), CCW (Cambodia)
International Treatment Preparedness Coalition, Secretariat, Communication, Bangkok, Thailand
Issues: Challenges in implementation of prevention of vertical transmission programs in 6 countries.
Description: The study focuses challenges in PVT to reach the very group it was designed for - HIV positive pregnant women. One of the key reasons for failure is the emphasis has been narrowly focused on providing ART to newborns and not on the other essentials. Civil society activists in six countries conducted on-the-ground research used a standardized research template to interview 15 -25 key informants in each of their countries, including current and former MoH,ministries,representatives of medical organizations aids activists who are the health consumers themselves. The study is aimed at analyzing the situation based on four-prong strategy -the comprehensive approach adopted in 2003 by the UN.
a) the emphasis of governments and UN agencies has been on providing ART to new borns rather than essential prevention and treatment services for women and girls;
b) there is dangerous inconsistency between national policies and actual practice and the UN's global infant feeding guidelines;
c) health services are not designed or delivered to meet the needs;
d) inadequate integration between PVT programs, ART services, maternal and child health.
In Argentina, many pregnant women visit health centers in their late pregnancy while a majority of births occur outside medical facilities in Cambodia.
Next steps: With national governments and other international institutions acknowledging the importance of the problem, the community has called to measure and report progress at UNGASS in June 2010, increase access to triple-dose prophylaxis regimen, revise national infant feeding policies, increase funding for PVT, better integrate PVT programme with family planning, sexual and reproductive, maternal and child health. This presentation will discuss the particular experimental challenges and how they overcome-including specifics on how the six teams pursue their follow up advocacy in different settings.
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