Mother to Child Transmission (MTCT) of HIV is by far the main source of HIV
infection in children. UNAIDS estimates that more than 90% of children acquire
HIV through MTCT during pregnancy, labour, delivery and breast feeding. Since a
significant proportion of HIV infected infants die in the first year of life,
Prevention of Mother to Child Transmission (PMTCT) of HIV services provide an
opportunity for securing Lesotho’s posterity.
The high HIV prevalence among pregnant women in Lesotho (27.7%) indicates
that if interventions are not scaled up, paediatric HIV infections will continue
to reverse the gains made through child survival programmes. In light of this,
the government of Lesotho through the MOHSW is committed to provide universal
access to high quality, integrated PMTCT interventions. Such interventions
should be provided in the context of comprehensive, fully-utilized quality
Maternal and Child Health (MCH) and Sexual and Reproductive Health (SRH)
services to ensure a reduction in maternal and childhood morbidity and
mortality. It is for these reasons that the Ministry of Health and Social
Welfare (MOHSW) developed the National Guidelines for Prevention of Mother to
Child Transmission of HIV which promote a four pronged approach consisting of:
- Primary prevention of HIV infections among women of child-bearing age
- Prevention of unintended pregnancies among HIV infected women
- Prevention of HIV transmission from infected mothers to their children
- Provision of continuous care, treatment and support for infected
mothers, their partners and children.
These guidelines incorporate the 2010 WHO PMTCT recommendations which reflect
the most current and up to date evidence and place increased emphasis on
improving the mother’s health while at the same time providing maximum
protection against HIV infection to her infant. For the first time since
implementation of the PMTCT programme, HIV positive women can now safely
breastfeed their infants without fear of transmitting the virus as ARV
prophylaxis will be provided for the duration of the breastfeeding period.
The guidelines promote the integration of PMTCT services with maternal,
newborn and child health services, provision of ART, family planning, STI and TB
services and will equip service providers with the knowledge and skills required
to provide consistently high-quality, client-sensitive services. Implementation
of a PMTCT programme therefore involves the establishment of necessary linkages
to other support programmes within the framework of a continuum of care for
people infected and affected by HIV. It is my hope that these guidelines will
help to strengthen such linkages in a bid to deliver high quality services to
all mothers in the country.
This document has been mainly developed for use by health care providers and
provides guidelines on how to implement integrated and comprehensive PMTCT
services at health facilities.