24101 - PREVENTION OF MOTHER TO CHILD TRANSMISSIONOF HIV IN...

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Unformatted text preview: PREVENTION OF MOTHER TO CHILD TRANSMISSIONOF HIV IN INDIA: ISSUES AND CHALLENGES Dr . S.K CHATURVEDI UNICEF DR. KANUPRIYA CHATURVEDI LESSON OBJECTIVES TO HAVE AN UNDERSTANDING OF THE SERVICES RELATED TO PREVENTION MOTHER TO CHILD TRANMISSION OF HIV( PMTCT) TO APPRECIATE THE ISSUES AND CHALLENGES TO UNDERSTAND THE SCALING UP OF SERVICES TO IDENTIFY KEY ACTIONS POINTS RELATED TO SCALING UP Global HIV/AIDS IN 2004 Effect on Children 39.4 -40.0 million people are living with HIV/AIDS 2.2 million are children under 15 years 6,40,000 children were newly infected with HIV in 2004 5,10,000 children died of HIV in 2004 NEW CHALLENGES . NEW OPPORTUNITIES Pond iche ry G u ja ra t K a rna taka G oa Lakshw adep D ad ra N aga r H ave li M aha rash tra M adhya P radesh K e ra la Tam il N adu A ndh ra P radesh Pun jab R a jas than D am an & D iu Jam u & K ashm ir H a ryana U ta r P radesh H im acha l P radesh D e lh i C hand iga rh B iha r W es t B enga l O r isa A ndam an & N icoba r M izo ram M egha laya A sam S ik im M an ipu r T r ipu ra A runacha l P radesh N aga land HIV + U5MR Adult HIV Prevalence High Prevalence States INDIA : MCH PROFILE Total Population 1027 M Crude Birth Rate 25/1000 Sex Ratio (F:M) 933 Annual Pregnancies 27 M ANC Coverage 65.4 % Institutional Deliveries [12.1% to 79.3%] 35.6 % Deliveries attended by skilled birth attendants 42.3 % Feasibility studies PPTCT Feasibility Study AZT: March 2000 - August 2001 AZT 300 mg BD from 36 weeks onward AZT 300 mg / 3 hours during labour No AZT to the baby PPTCT Feasibility Study NVP: October 2001 - June 2002 NVP 200 mg single dose to mother at onset of labour NVP 2 mg/kg single dose to newborn within 72 hours Some Lessons Learnt: Reduced transmission of HIV from mother to infant 33 8 5 10 15 20 25 30 35 % No ARV W ith ARV who acquired HIV P roportion of infants of HIV (+) mothers LESSONS LEARNT 50.3 35.7 85.1 87.8 20 40 60 80 100 Before counselling After counselling Proportion of women who know how to avoid: acquiring HIV/AIDS transmitting HIV/AIDS to baby MTCT in 100 HI V+ Mothers- The majority of children do not get infected even w hen w e do nothing 10 20 30 40 50 60 70 80 90 100 # uninfected # infected during BF for 2 yrs # infected during delivery # infants infected during pregnancy 63 uninfected 15 15 7 Unicef role in PPTCT 1. C apacity building - w hich includes training 2. Q uality assurance : M onitoring inputs provided through training, counseling and A nti-R etro V iral( N evirapine). F acilitates N V P donation from C ipla. 3. M onitoring and evaluation - Supporting N A C O in D ata collection, com pilation and analysis - D issem ination of results 4. R esearch: w hich focuses on: D istrict Integrated A pproach: L inking Institution based PP T C T services w ith prim ary prevention am ong young w om en and w ith com m unity based services for care and support Infant feeding - to support developm ent on a India specific Policy PPT C T Plus .....
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24101 - PREVENTION OF MOTHER TO CHILD TRANSMISSIONOF HIV IN...

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