Playing the Catch-Up Game: Accelerating the Scale-Up of Prevention of Mother-To-Child Transmission of HIV (PMTCT) Services to Eliminate New Pediatric HIV Infection in Nigeria

PLoS One. 2017 Jan 3;12(1):e0169342. doi: 10.1371/journal.pone.0169342. eCollection 2017.

Abstract

Introduction: As the world is making progress towards elimination of mother-to-child transmission of HIV, poor coverage of PMTCT services in Nigeria remains a major challenge. In order to address this, scale-up was planned with activities organized into 3 phases. This paper describes the process undertaken in eight high burden Nigerian states to rapidly close PMTCT coverage gaps at facility and population levels between February 2013 and March 2014.

Methods: Activities were grouped into three phases-pre-assessment phase (engagement of a wide range of stakeholders), assessment (rapid health facility assessment, a cross sectional survey using mixed methods conducted in the various states between Feb and May 2013 and impact modelling), and post-assessment (drawing up costed state operational plans to achieve eMTCT by 2015, data-driven smart scale-up).

Results: Over a period of 10 months starting June 2013, 2044 facilities were supported to begin provision of PMTCT services. This increased facility coverage from 8% to 50%. A 246% increase was also recorded in the number of pregnant women and their families who have access to HIV testing and counselling in the context of PMTCT. Similarly, access to antiretrovirals for PMTCT has witnessed a 152% increase in these eight states between October 2013 and October 2014.

Conclusion: A data-driven and participatory approach can be used to rapidly scale-up PMTCT services at community and facility levels in this region. These results present us with hope for real progress in Nigeria. We are confident that the efforts described here will contribute significantly to eliminating new pediatric HIV infection in Nigeria.

MeSH terms

  • Child
  • Female
  • HIV Infections / prevention & control*
  • Health Facilities
  • Humans
  • Infectious Disease Transmission, Vertical / prevention & control*
  • Local Government
  • Maternal Health Services*
  • Mothers*
  • Nigeria

Grants and funding

This paper is based on work supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through United States Agency for International Development (USAID) under the terms of cooperative agreement AID-620-A-00002 of the Strengthening Integrated Delivery of HIV/AIDS Services (SIDHAS) project managed by FHI 360 and other partners. All the authors except CA and MO work with FHI 360.