Prevention of Mother-to-Child Transmission of HIV and Paediatric HIV Care and Treatment Monitoring: From Measuring Process to Impact and Elimination of Mother-to-Child Transmission of HIV

Priscilla Idele,Awandha Mamahit,Mary Mahy,Chika Hayashi,Tyler Porth

doi:10.1007/s10461-016-1670-9

Abstract

Progress towards achievement of global targets for the prevention of mother-to-child transmission of HIV (PMTCT) and paediatric HIV care and treatment is an integral part of global and national HIV and AIDS responses. This paper documents the development of the global and national monitoring and reporting systems for PMTCT and paediatric HIV care and treatment programmes, achievements and remaining challenges. A review of the development of the monitoring and reporting process since 2002–2016 was conducted using existing published literature and taking into account changes in WHO HIV treatment guidelines, global HIV goals and targets, programmatic and methodological developments, and increased need for interagency partnerships, coordination and harmonization of global monitoring and reporting mechanisms. The number and type of indicators reported increased and evolved from monitoring of existence of national policies and guidelines, service delivery sites and trained health workers and coverage of PMTCT and paediatric HIV interventions to measuring outcomes and impact in reducing new HIV infections and AIDS related deaths, including efforts to validate elimination of mother-to-child transmission of HIV. These changes were required to mirror changes in WHO and national PMTCT and HIV treatment guidelines. The number of countries reporting PMTCT coverage increased from 53 in 2003 to over 130 in 2015. National monitoring processes have also expanded in scope and the capacity to report on disaggregated data by type of ARV regimen and for paediatric HIV care and treatment has increased. Monitoring of PMTCT and paediatric HIV programmes has contributed a rich body of evidence that helped monitor how quickly countries were adopting and implementing the latest WHO HIV treatment guidelines for pregnant and breastfeeding women and children. The reported data and experiences were instrumental in shaping global policies, national programmes, and investment choices.

Highlights

Background and ObjectivesIn 2000, member states committed to Millennium Development Goals (MDG) 4, 5, and 6 on health for women and children: reduce child mortality, improve maternal health and halt and begin to reverse the spread of HIV and AIDS by 2015 [1]
Under the leadership of World Health Organization (WHO) and United Nations International Children’s Fund (UNICEF), the IATT on prevention of mother-to-child transmission of HIV (PMTCT) monitoring and evaluation (M&E) formed in 2005 has played a major role in reviewing methodologies and technical issues and providing guidelines related to monitoring of PMTCT and paediatric HIV care and treatment [8]
This work is undertaken through thematic sub-groups established within the IATT mechanism that brings together more than 30 specialized organizations and numerous experts

Summary

Introduction

Background and ObjectivesIn 2000, member states committed to Millennium Development Goals (MDG) 4, 5, and 6 on health for women and children: reduce child mortality, improve maternal health and halt and begin to reverse the spread of HIV and AIDS by 2015 [1]. AIDS Behav (2017) 21:S23–S33 on Preventing HIV Infection in Women, Mothers, and their Children (IATT), together with governments, donors and implementing partners resulted in a Call to Action for the Elimination of HIV Infection in Infants and Children [3]. Since 2001, the HIV/AIDS monitoring and evaluation reference group (MERG), that brings together UN agencies, donors, implementing partners, government and civil society, played a critical role as a coordinating body for all HIV monitoring and a common and harmonized M&E framework for global and national reporting and monitoring of progress. The Global Plan Towards the Elimination of New HIV Infections Among Children by 2015 and Keeping Their Mothers Alive adopted in 2011 (The Global Plan) includes a monitoring and evaluation (M&E) framework with specific targets, indicators and baselines against which progress is assessed [6]. The 2011 Political Declaration on HIV and AIDS: Intensifying Our Efforts to Eliminate HIV and AIDS included a target of elimination of mother to child transmission of HIV [7]

Methods

Results

Conclusion