Service Delivery

The comprehensive approach to service delivery for prevention of mother-to-child transmission (PMTCT) of HIV recommended by the World Health Organization (WHO) and UNAIDS has four components:

  1. Primary prevention of HIV among women of childbearing age
  2. Prevention of unintended pregnancies among women living with HIV
  3. Prevention of HIV transmission from a women living with HIV to her infant
  4. Provision of appropriate treatment, care, and support to women living with HIV and their children and families

Service delivery issues are different for each intervention, but an optimal evidence-based PMTCT package can reduce the overall risk of maternal to child transmission to less than 2%. These interventions include:

  • Optimal detection of HIV infection among pregnant women through effective testing and counseling
  • Assessment of the eligibility of pregnant women living with HIV for lifelong anti-retroviral therapy (ART)
  • Provision of highly active ART (HAART) to those eligible for lifelong ART
  • Provision of the most highly feasible antiretroviral (ARV) prophylactic regimen
  • Safe obstetrical practices, including Cesarean-section when indicated and feasible
  • Safe infant feeding options, including complete avoidance of breastfeeding

The resources provided in this section of the PMTCT Toolkit will help providers offer quality services for the range of needs experienced by mothers, families and children infected with or at risk for HIV, including manuals to help with service provision and resources on counseling and testing, family centered care, antiretroviral treatment and prophylaxis for PMTCT, infant feeding in the context of HIV, and integrating delviery of services.

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