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Preventing Mother to Child HIV Transmission through Community Based A pproach in Nepal

Preventing Mother to Child HIV Transmission through Community Based A pproach in Nepal. Nafisa Binte Shafique Chief, HIV and AIDS Section UNICEF Nepal. About Nepal. Total Population – 28,810,000 Estimated annual births – 780,000

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Preventing Mother to Child HIV Transmission through Community Based A pproach in Nepal

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  1. Preventing Mother to Child HIV Transmission through Community Based Approach in Nepal NafisaBinteShafique Chief, HIV and AIDS Section UNICEF Nepal

  2. About Nepal • Total Population – 28,810,000 • Estimated annual births – 780,000 • Maternal mortality ratio – 380 per 100,000 live births • Contraceptive prevalence rate – 48% • Unmet need for family planning – 24.6% • ANC coverage (at least 1 visit) - 87% • ANC coverage (4 or more visits) – 50%

  3. About Nepal • Skilled attendant at delivery – 29% • Institutional delivery – 28% • Exclusive breastfeeding for infant <6 months – 53% • Infant mortality rate (per 1,000 live births) - 39 • Under 5 mortality rate (per 1,000 live births) - 48

  4. HIV situation in Nepal – a brief overview • First HIV case reported in 1988 • Evolved from low prevalence to ‘concentrated epidemic’ among the most at risk population IDU, FSW, MSM and TG, Labourmigrant • Estimated HIV infections – 55,626 • Identified cases – 18,396 • Adult (15 – 49) HIV prevalence – 0.33%(one of the highest in South Asian Region) • Proportion of women 15 – 49 living with HIV – 28% • Proportion of young girls(15 – 24) living with HIV – 6.2% • Average number of new infections per day – 6 • Average number of new infections amongst children (0 – 14) per year – 460 • Average number of average deaths among children (0 – 14) per year – 284 • Estimated number of children affected by AIDS - 24,000+

  5. PMTCT Situation • Government of Nepal initiated PMTCT services in 2005 however, only at district level hospitals • Accessibility by most disadvantaged pregnant women living in remote areas remained as a challenge • In 2009, GoN with UNICEF’s support and in collaboration with CBOs introduced a community based PMTCT service integrated with MNCH, in one of the highest HIV burden districts of Nepal.

  6. Method

  7. Results

  8. Conclusions • Utilization of PMTCT by pregnant women dramatically increased by taking services at the community level • The volunteers and WLHIV created demand for PMTCT services and care practices • The integration of PMTCT in MNCH services is an efficient, cost effective and sustainable approach

  9. Conclusions • Because of the proven efficacy of the intervention Government is keen to scale up the model in 7 districts with GFATM funding • In order to improve the service utilization, HTC services should be decentralized up to the community level • It is also imperative to address stigma and discrimination and change social norms to ensure equitable access to services by KAP

  10. Thank youAny Question?

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