The Department of Health has published a report on the evaluation of the effectiveness of the national PMTCT programme on infant HIV. This is the first evaluation of the effectiveness of the PMTCT programme in reducing transmission of HIV from mothers to babies. It provides a baseline against which progress will be measured in follow-up evaluations to be conducted in 2010 and 2011.
The evaluation found that uptake of PMTCT services is high. More than 98% of pregnant women are tested during pregnancy and 91.7% of HIV-positive mothers are receiving ARV treatment or prophylaxis. The current rate of MTCT is 3,5%. However, the rate varies between provinces from 1.4% to 5.9%. The rate of CD4 testing of mothers is low at 78,3%, and early infant diagnosis is even lower at 35.1%. The programme has proven to be effective, but could be even more effective with intensified effort and through recognising and using the lost opportunities for CD4 count testing of mothers, repeat testing and couple-testing after the infant is born, and testing of all infants, not only those that are known to be HIV-exposed.
A major concern raised in the evaluation is the low rate of exclusive breastfeeding among HIV-positive women. Only 20% were practicing exclusive breastfeeding, 62% were formula feeding and 18% were practising high-risk mixed feeding. There is thus a clear need for a robust communications and support campaign to support optimal infant feeding practices – not only among HIV-positive, but all mothers.
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