Mother to Child Transmission

When GHARP set out to recruit new service providers [for preventing mother-to-child transmission], it faced a dilemma. Due to the limited supply of health workers in Guyana, the project needed to avoid recruiting health care providers already working for the MOH. Hiring existing health workers away from their jobs would simple reshuffle the distribution of health workers, rather than add new ones. To address the problem, GHARP staff decided to recruit retired nurses to fill the positions. [from author’s description]

This article discusses a program that established primary health centers in remote villages and trained literate women in these villages as birth attendants to offer antenatal care, low-risk delivery, and triage of high-risk mothers to larger health facilities. In 2002, the birth attendants were trained to provide Prevention of Maternal-to-Child HIV Transmission (PMTCT) services, including counseling, voluntary testing, performing oral rapid HIV tests, posttest counseling, and administering single-dose nevirapine to HIV-positive women, to be taken in labor, and to their newborns. Ongoing supervision is provided by nurse supervisors. [adapted from abstract]

This presentation was part of the ECSA Regional Health Ministers’ Conference. The objective is to identify issues to be considered in expanding prevention of mother to child transmission of HIV services in relation to Human Resource Development.


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Women with HIV have much the same reasons to have children or to prevent pregnancy as everyone else, but they have important additional issues to consider. These women’s health care providers have the responsibility to help them make well-informed and well-considered choices and carry out their decisions with the least risk. With the help of this issue of Population Reports, family planning and HIV-care providers can: understand how HIV affects women’s reproductive health and childbearing decisions; learn the latest, evidence-based information to help women with HIV think through their family planning choices; and inform women with HIV who are thinking about having children of the risks of transmitting HIV to the infant and/or uninfected partner and how they can reduce these risks.

This document evaluates the Support and Treatment for Antiretroviral Therapy project (START) program, a joint initiative of Family Health International (FHI) and the Government of Ghana, to integrate antiretroviral therapy into comprehensive care for people living with HIV/AIDS in Ghana. START helped establish voluntary counseling and testing centers, prevention of mother-to-child transmission activities and clinical care services. Key components of the START program include home-based care (HBC), referral networks and linkages to such existing services as spiritual and social support, and support for orphans and other vulnerable children (OVC).

Infant feeding is a subject of worry in prevention of mother to child transmission (pMTCT) programmes in settings where breastfeeding is normative. Nurse-counsellors, expected to counsel HIV-positive women on safer infant feeding methods as defined in national/international guidelines, are faced with a number of challenges. This study aims to explore the experiences and situated concerns of nurses working as infant feeding counsellors to HIV-positive mothers enrolled in pMTCT programmes in the Kilimanjaro region, northern Tanzania. [abstract]

This brief discusses the Capacity Project’s work to train health workers to help prevent mother to child transmission of HIV.

To maximize program impact with current resources, integration of Family Planning into existing HIV/AIDS programs is a very cost effective and an excellent point of entry. This is a study of an intervention program focused on initiating and also strengthening existing integration of FP into functional VCT, ART and PMTCT sites. The intervention encompassed an orientation on integration benefits to heads of health facilities; identification of challenges of integration and drawing of plan of action on how to overcome the challenges and improve integration. Major challenges identified were related both to health workers, such as high workload, staff burnout and turnover, as well as to efforts in scaling up of facilities operations to adequately incorporate integration activities. [from abstract]

In Mozambique, [Health Alliance International] HAI has been working closely with the MOH for more than fifteen years to support the development and implementation of MOH programs in reproductive health, the response to HIV/AIDS, and malaria control… HAI works with the MOH to implement the nationally designed model of HIV care, and has supported the implementation of voluntary counseling and testing centers, prevention of mother-to-child transmission of HIV (PMTCT) PROGRAMS, and HIV treatment centers integrated into this public sector model of care. [publisher’s description]

Within the Southern African prevention of mother to child transmission (PMTCT) programmes, counsellors talk with pregnant mothers about a number of interrelated decisions and behaviour changes. Current counselling has been characterised as ineffective in eliciting behaviour change and as adopting a predominantly informational and directive approach. Motivational interviewing (MI) was chosen as a more appropriate approach to guide mothers in these difficult decisions, as it is designed for conversations about behaviour change. MI has not previously been attempted in this context. This paper reflects on how MI can be incorporated successfully into PMTCT counselling and what lessons can be learnt regarding how to conduct training with counsellors.

Every year a million women infected with HIV deliver babies without professional help. This article suggests that traditional birth attendants could be involved in preventing perinatal transmission of HIV by offering services such as HIV testing and counseling and short courses of antiretroviral drugs. [publisher’s description]

In response to the HIV/AIDS crisis, Namibia’s public health sector is carrying out a comprehensive strategy to rapidly hire and deploy professional and non-professional health workers with the aim of providing comprehensive care, counseling and testing, as well as antiretroviral therapy (ART) and prevention of mother-to-child transmission (PMTCT). [from executive summary]

This report describes the second phase of a study that developed and tested an integrated program of counselor job aids, mother take-home materials, and counselor training in a healthcare site providing counseling for the prevention of mother-to-child transmission of HIV (PMTCT) in Moshi District in the Kilimanjaro Region of Tanzania. [from executive summary]

This report presents the findings of a study conducted at 16 healthcare sites in Zambia offering voluntary counseling and testing (VCT), prevention of mother-to-child transmission of HIV (P-MTCT), and antiretroviral (ARV) therapy. The study period, including design, implementation, and data analysis, was April to June 2003. The purpose of the study was to assist the Government of Zambia in determining whether it will have sufficient staff to be able to scale up VCT, P-MTCT, and ARV treatment to reach its targeted numbers of clients. The report analyzes the time taken to carry out the prescribed tasks involved in each of the services, analyzes the extent to which the services are following the national service delivery standards, describes the present workforce involved in providing these services, and analyzes the human resource costs associated with the present workforce arrangements.