Objective="To prevent parent to child HIV transmission."
Details for Reform Option "Prevention of Parent to Child HIV Transmission, Manipur"
Of the estimated 38.6 million people living with HIV/AIDS worldwide more than 2 million are children (under 15 year). In 2005 alone, 630,000 children were newly infected with the AIDS virus. The most significant source of HIV infection in children and infants is the transmission of HIV from mother to child during pregnancy, child birth or breast feeding. A comprehensive Prevention of Mother to Child Transmission (PMTCT) program can significantly reduce the number of infected infants and promote better health for their mothers and families by integrating PMTCT in mother and child health programs. In India, the program has been termed as ‘Prevention of Parent to Child Transmission (PPTCT)’ of HIV to emphasize the role of father in both the transmission of the virus and management of the infected mother and child.
As the epidemic of HIV/AIDS moves on, it leaves behind orphans and widows with a tremendous social and economic burden to the families. Therefore, PPTCT of HIV/AIDS becomes very important for immediate intervention in the society.
Since 1997, the HIV prevalence rate among pregnant women in Manipur is persistently high and above 1% and in the last Sentinel Survey (2004) it was 1.67%. This means for every 100 pregnant women attending hospital or health centres for ante natal check up nearly two women are found HIV positive in Manipur.
National Aids Control Organization (NACO), Ministry of Health and Family Welfare, Government of India (GOI) and UNICEF collaborated for the PPTCT feasibility study which was initiated in 1999 in the high prevalence States of India including Manipur.
Under the PPTCT programme, PPTCT centres have been started. These centres are providing the following services:
i) Counselling and testing services for all pregnant women;
ii) Counselling services for Negative women to remain free from HIV/AIDS;i
ii) Counselling and testing services for their spouses;
iv) Prevention of unintended pregnancy in positive women;
v) Free Navirapine (NVP) prophylaxis to protect the babies from HIV/AIDS;
vi) Infant feeding counselling and
vii) Care and support facilities including nutrition support, treatment of mother, baby and spouses.
41 PPTCT centres (RIMS, JNH, District hospitals, Community Health Centres and some selected Primary Health Centres) have been started in Manipur. The following are the main results of these centres:
No. of Antenatal Clinic Attendees: 26,208
o. of Clinic attendees counselled: 15,174 (57.89%)
No. of clinic attendees tested: 7,994 (52.68%)
No. of clinic attendees found positive: 173 (2.16%)
No. of pregnant women who received NVP: 36 (21.97%
No. of babies who received NVP: 38 (21.97%)
The programme is marching forward. NVP prophylaxis to the positive mothers and their babies has increased from 6% to 13% of the total estimated positive mothers.
Wide coverage: 41 PPTCT centres have been started and efforts are being to expand the services up to the PHC level.
Concerted efforts: Efforts are being made to give all the negative pregnant women a chance to get knowledge and skills to remain free from HIV/AIDS.
Practical alternative: NVP prophylaxis is a practical alternative in the resource constraint setting like India.
Coverage of NVP: Though the percentage of NVP prophylaxis to the positive mothers and children has increased but it is still poor compared to the estimated positive mothers.
Home deliveries: More than 50% of the deliveries are taking place in home and reaching out to these women is a big challenge.
Good collaboration between partners.
Who needs to be consulted
Manipur State AIDS Control Society.
Programme is sustainable as funds are available under the Global Fund for AIDS, TB and Malaria.
Chances of Replication
Programme has been replicated in other high prevalence States of India.
Prabha Sati, Research Consultant, European Commission Technical Assistance, New Delhi, March 2007.