HIV can be transmitted from an HIV-positive woman to her child during pregnancy, childbirth and breastfeeding. Mother-to-child transmission (MTCT) accounts for over 90% of new HIV infections among children. Prevention of mother-to-child transmission (PMTCT) programmes aims to reduce or eliminate this risk. Without treatment, the likelihood of HIV passing from mother-to-child is 15% to 45%. (Or without interventions 3 out of 10 women infect their children). However antiretroviral treatment and other effective PMTCT interventions can reduce this risk to below 5%.
In 2012, in Uganda, up to 30,000 out of the annual 130,000 new infections were a result of mother to child transmission; this added to a burden to the already overstretched health systems in the country and worsened the maternal, infant and child indicators that were already lagging behind the rest of the world. There is a national and global drive to stem new HIV infections, particularly through mother to child transmission of HIV (MTCT). Science has revealed that MTCT can be virtually eliminated if countries address the unmet need for family planning among women and men of reproductive age and early enrolment of expectant positive women together with their partners on antiretroviral drugs (ARVs).
The above statistics raised a concern of the First Lady, who decided to mobilize stakeholders for a high level national stakeholder’s consultative meeting coordinated by OAFLA UG and Ministry of Health to analyze the eMTCT national status report and strategize on an effective and well coordinated eMTCT response in the country.
It was at this high level national stakeholder’s consultative meeting in August 2012 that the First Lady of Uganda was nominated the National EMTCT Champion. Thereafter she embarked on Regional Campaigns organized and coordinated with OAFLA UG and Ministry of Health to:
1. Provide a strategic platform for stakeholder engagement and mutual accountability to ensure effective EMTCT service delivery.
2. Contribute to increased access to EMTCT services through scaled up service provision and community mobilization.
3. To promote EMTCT best practices through demonstration and showcasing of antenatal, HIV prevention, care and treatment interventions to create awareness about EMTCT.
These Campaigns were organized and coordinated by OAFLA Uganda in partnership with the Ministry of Health (MOH), the Uganda AIDS Commission (UAC), HIV/EMTCT stakeholders and the political leadership at all levels of society.
The Campaigns under the theme “Stand Out, Participate and be Counted – Towards an HIV Free Generation”, created general awareness about effective HIV/EMTCT service delivery and specifically the need for leadership involvement, starting with male involvement in the reproductive health of a family.
The National EMTCT Champion successfully traversed the whole country in 11 regions based on the sero-survey regions in the country together with different stakeholders of MOH, UAC, Implementing partners, Development Partners, leadership at all levels of the society. The campaigns succeeded in engaging key stakeholders in EMTCT. The major achievements include:
1. Infections in babies fell almost tenfold, from 30,000 in 2012 to less than 3500 in 2015
2. Establishment of the message clearing house at Uganda Aids Commission
3. Option-B plus was adopted as a more efficacious intervention for averting vertical infections and by end of 2015, over 95% of HIV-infected pregnant women were enrolled onto treatment;
4. Real time monitoring of the roll out of option B+ through the use of the dash board was introduced, and availability of data to inform programme planning and evaluation improved.
The ministry of health with key stakeholders in the health sector is planning to convene eMTCT national stakeholders meeting to come up with strategies on how to consolidate the gains made in eMTCT.