Background on Mother-to-Child Transmission (MTCT)
Of the 37.8 million people living with HIV/AIDS worldwide at the end of 2003, 2.1 million were children under 15. Last year alone, 630,000 children were newly infected with the AIDS virus, with 90% of these infections occurring in sub-Saharan Africa. The most significant source of HIV infection in children and infants is transmission of HIV from mother to child during pregnancy, childbirth, or breastfeeding. The availability and use of short-course antiretroviral (ARV) prophylaxis-a safe and well-tolerated regimen-can contribute significantly to PMTCT during childbirth. A comprehensive prevention of MTCT (PMTCT) program can significantly reduce the number of infected infants by providing guidelines for improving clinical care for women and their children.
Ethiopia is the second most populous country in Africa, with a 2003 population estimated at 70 million people. As reported in the 5th edition of “AIDS in Ethiopia” published in June 2004, the national adult prevalence of HIV for 2003 is estimated at 4.4%, with a 12.6% urban rate and a 2.6% rural rate. The corresponding figures in the earlier report for 2001 were 6.6% (national), 13.7% (urban), and 3.7% (rural). Developing and implementing a PMTCT program-complete with strategies for ARV prophylaxis, safer childbirth, and safer infant feeding practices-is a complex process. The healthcare managers must determine which elements of a comprehensive program should be given special attention, and they must ensure that appropriate policy and legislation support chosen interventions. They should mobilize resources and establish a systematic approach to implementing interventions. Finally, all healthcare providers working in the program must be trained. To compound the complexity of PMTCT efforts, the existing maternal and child health infrastructure might require strengthening before the PMTCT program can operate.
The interventions recommended in this reference manual is supported by evidence from pilot projects in several countries that demonstrated the feasibility of implementing various PMTCT interventions-including short-course ARV prophylaxis-in resource-constrained setting like Ethiopia. Many of those nations are now shifting from pilot projects to national programming, integrating PMTCT interventions into antenatal care (ANC) and reproductive healthcare settings.
The rapidly growing HIV/AIDS epidemic in Ethiopia requires an effective and coordinated approach to training and collaboration to maximize the resources available for capacity building. Growing support for PMTCT is evident in various new funding initiatives. The World Health Organization (WHO) 3 by 5 initiative aims to distribute treatment for 3 million people in developing countries by 2005. Training healthcare workers is essential to effective PMTCT programs, which serve as a critical entry point to ARV therapy and supportive care.
The U.S. government also has offered further support to Ethiopia and several other countries in Africa in the fight against HIV/AIDS with the President’s Emergency Plan for AIDS Relief (PEPFAR), a program for providing treatment and care in developing countries. PEPFAR funding will support the rapid scale up of HIV treatment programs through 2005 in an effort to treat 2 million people, prevent 7 million infections, and provide care for 10 million people. PEPFAR also will provide for the development of prevention initiatives, including PMTCT, palliative care, and service for orphans and vulnerable children. In the collaborative effort against the HIV/AIDS epidemic, PMTCT plays a central role by preventing new infections and by providing the services needed to ease the burden on HIV-infected women.
PMTCT
Knowledge Update Course, Trainer’s Guide [Guide] (5.98 MB pdf
format 
)
Published by: Ministry of Health (MOH)
This trainer’s guide is designed to support the implementation of the
prevention of mother-to-child transmission (PMTCT) of HIV training course. The
trainer’s guide contains all sorts of information related to PMTCT and
HIV as well as pretest, posttest and evaluation questionnaires.
PMTCT
Knowledge Update Course, Participant’s Handbook [Handbook] (296
KB pdf format )
Published by: Ministry of Health (MOH)
This PMTCT training participant’s handbook is designed to prepare service
providers (doctors, nurses, midwives, laboratory technicians, pharmacists, social
workers, outreach workers, counselors, and program managers) to contribute to
effective PMTCT programs in their health facilities and communities. The course
builds on each participant’s past knowledge and takes advantage of the
individual’s high motivation to accomplish the learning tasks in the minimum
time.
PMTCT
Knowledge Update Course, Reference Manual [Reference] (3.88 MB pdf format
)
Published by: Ministry of Health (MOH)
This reference manual was adapted from a generic training curriculum developed
jointly by WHO and the Centers for Disease Control and Prevention (CDC) in collaboration
with University Technical Assistance Project and the University of Medicine
and Dentistry of New Jersey, Francois-Xavier Bagnoud Center; and JHPIEOG an
affiliate of Johns Hopkins University, and was field tested in Ethiopia.
