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Dr . Agnes Mahomva ( MBChB , MPH) Country Director XIX International AIDS Conference

Innovative rapid scale-up of effective PMTCT services to achieve virtual elimination of new pediatric HIV infections: A Zimbabwe experience. Dr . Agnes Mahomva ( MBChB , MPH) Country Director XIX International AIDS Conference Washington DC 22/07/2012. Background.

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Dr . Agnes Mahomva ( MBChB , MPH) Country Director XIX International AIDS Conference

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  1. Innovative rapid scale-up of effective PMTCT services to achieve virtual elimination of new pediatric HIV infections: A Zimbabwe experience Dr. Agnes Mahomva (MBChB, MPH) Country Director XIX International AIDS Conference Washington DC 22/07/2012

  2. Background • Population of 12 million • Health system challenged by • Depressed economy • HIV prevalence 14.3% in adults • HIV prevalence 16.1% in Pregnant women attending antenatal care (ANC) clinics

  3. National Roll-Out of Effective PMTCT Services • Roll-out of PMTCT services for elimination of new pediatric HIV infections is underway supported by: • Strong political commitment (3% AIDS levy) • Existing health infrastructure - a total of 1,560 health facilities provide ANC • All ANC facilities providing PMTCT services but mainly single-dose nevirapine by the end of 2006

  4. Roll-Out of the 2010 PMTCT Guidelines • In 2011, EGPAF with USAID and CIFF funding collaborated with MOHCW to roll-out revised national PMTCT guidelines through • Stakeholder consultations on WHO PMTCT option selection (Option A chosen) • Integrated national PMTCT training curriculum and M&E tools • Health care worker training • Strategies and innovations for rapid scale-up

  5. Launch of the Zimbabwe national program on elimination of new HIV infections in children, January 2011 Minister of Health and Child Welfare speaking

  6. Innovative Strategies • Introduction of PMTCT District Focal Persons • Coordination of all district PMTCT activities • Deployment of point-of-care CD4 machines • Support early CD4 testing and ART for pregnant women in ANC • Targeted advocacy and community engagement • Promote early ANC and minimize mother-baby loss to follow-up • Coordination of three sub-grantees • Rapid roll-out of health care worker trainings nation wide

  7. All EGPAF-Supported Districts Implementing 2010 PMTCT Guidelines by End of 2011

  8. PMTCT Results (1) (by end of December 2011) • 1,344 (86%) of 1,560 MOHCW ANC facilities implementing WHO 2010 PMTCT guidelines • Up from 134 (9%) in 2010 • 5,890 (37%) identified ART-eligible pregnant women received ART in ANC • Up from 2,498 (17%) in 2010

  9. Proportion of ANC facilities (N=1,560) implementing the 2010 versus the 2006 PMTCT guidelines

  10. PMTCT Results (2) (by end of December 2011) • A total of 367,498 pregnant women enrolled in 1,344 EGPAF supported sites • 96% (351,867) tested for HIV and received results • 12% (43,758) HIV-positive • 84% (36,760) of HIV-positive women received ARV prophylaxis (not including ART) • 56% (24,696) of HIV-exposed infants received ARV prophylaxis per 2010 guidelines (extended NVP)

  11. Conclusions Rapid scale-up of effective national PMTCT services require: • MOHCW leadership for coordination and national program strategic direction • Meaningful collaboration with partners and donors as an essential component • Use of innovative approaches and strategies

  12. Acknowledgements • Zimbabwe Ministry of Health and Child Welfare • U.S. President’s Emergency Plan for AIDS Relief through USAID • UK Department for International Development • The Children’s Investment Fund Foundation • EGPAF-FAI partners • J.F. Kapnek Trust, • OPHID Trust • ZAPP-UZ

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