Professor Atiene Solomon Sagay - University of Jos Institutional ...

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Figure 5: Level of PMTCT Services by LGAs in Plateau State 2004 In 2006, this drive snowballed to HIV/AIDS comprehensive treatment and care program through additional funding from Harvard PEPFAR. Services were decentralization to all the 17 local government areas of Plateau State. Service provision in the following areas were supported: Adult antiretroviral therapy, PMTCT, Paediatric antiretroviral therapy, Infant feeding and nutrition counseling, Family planning, Cervical cancer screening, Malaria prophylaxis interventions, Tuberculosis screening and Orphans and vulnerable children (OVC) support. The diagram below shows the activity pyramid of the program. 47 Activity Pyramid 14 1 20 APIN JUTH SATELLITES SITES PRIMARY HEALTH CARE FACILITIES COMMUNITY Figure 6: Activity Pyramid of PMTCT Decentralization in Plateau State, Nigeria
Figure 7: Hub and Spoke Illustration of PMTCT Sites in Plateau State, Nigeria The mapping exercise reported that in 2004, 71,655 pregnant women booked for antenatal care and 22,640 women delivered in the 193 health facilities providing maternity services in the 17 LGAs of Plateau State. In 2004, only 5,500 pregnant women in 2 LGAs accessed PMTCT services, giving PMTCT coverage of 6.5%. Subsequent PMTCT expansion efforts supported principally by APIN and also by other partners, led to the availability of PMTCT services in all 17 LGAs by 2007. In 2008, 42,120 pregnant women accessed PMTCT interventions across Plateau State giving coverage of 47.5% according to 2006 population census. From conservative estimates based on these figures, about 300 infant HIV infections were averted in Plateau State in 2008 alone. About 300 infant HIV infections are averted each year in Plateau State through PMTCT interventions HIV testing and counseling in labour as entry point for PMTCT The highest risk of mother-to-child transmission (MTCT) of HIV-1 infection occurs during labour and delivery. Findings from clinical trials show that antiretroviral (ARV) prophylaxis, given to the mother during labour and delivery and to the neonate immediately after birth, can reduce MTCT of HIV by as much as 50% (Moodley D et al 2003). Thus, provision of routine HIV testing to women with unknown HIV status during labour and delivery can contribute in reducing MTCT. We demonstrated the feasibility of providing rapid HIV testing and counselling, using the “opt out” approach, in the labour ward of JUTH (Sagay et al 2006). Among 164 women with unknown HIV status before labour, 14 (8.6%) were detected to be HIV positive in labour. In all, a total of 340 (99.8%) of the 431 pregnant women who were offered HIV testing in labour accepted testing. Of the 235 women who previously tested HIV negative during pregnancy, 5 (2.1%) were found to be HIV positive in labour (see Table 3). The practice of rapid HIV testing and counselling in labour provides a final opportunity to detect 21
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Professor Atiene Solomon Sagay - University of Jos Institutional ...

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