Prevention of Mother to Child Transmission of HIV (PMTCT) and Paediatric HIV Care Guidelines. Second Edition, July 2008 - Malawi
(2008; 60 pages)


Mother-to-Child Transmission (MTCT) is the main source of HIV infection in children. An estimated 90% of children acquire HIV infection during pregnancy, labour and delivery or through breastfeeding (UNAIDS 2004). Approximately 50% of these children will die before their second birthdays. The PMTCT programme is the primary prevention intervention of MTCT of HIV from pregnant women to infants. It is also the pillar for the provision of care and treatment for members of the family living with HIV through the family-centred care model that is being implemented in Malawi.

In 2007, the HIV prevalence rate among pregnant women was 12.6% (MOH 2008). It reduced from 15% in 2005 (MOH 2006). However, to reduce paediatric HIV infection in children and ensure an HIV free generation in Malawi, all pregnant women should have access to comprehensive quality PMTCT services as outlined in this Second Edition PMTCT and Paediatric HIV Care Guidelines 2008. Therefore, a concerted effort by all stakeholders from the household to policy making level is needed to reduce HIV infection in children.

The Government of the Republic of Malawi is committed to providing equitable access to cost effective and quality HIV prevention, care and treatment services, bringing them, as close to the family as possible through existing structures in the public sector, the Christian Health Association of Malawi (CHAM) and the private sector with linkages to community-based organizations (CBOs), households and communities. PMTCT and paediatric HIV care has been integrated into routine Maternal and Child Health (MCH) services. Therefore, the MoH will continue to provide leadership, policy and technical guidance to ensure access to PMTCT and paediatric HIV services at every health facility and in the community.

PMTCT is effective in reducing paediatric HIV infections through the four pronged approach:

  1. primary prevention of HIV infection among women of child bearing age,
  2. prevention of unintended pregnancies among HIV-positive women;
  3. prevention of HIV transmission from HIV positive mothers to the infants; and
  4. provision of continuous care and treatment for infected mothers, partners and their children.

These guidelines have outlined the skills required to implement the four PMTCT prongs and ensure sustainable continuum of care and referral system for pregnant women, mothers, infants, children and family members infected and affected by HIV. The Second Edition PMTCT Guidelines 2008 are comprehensive and user friendly for all health workers providing maternal and child health services (MCH), PMTCT and paediatric HIV care services for women in child bearing age, their children and families. The Ministry of Health urges all health workers to use the guidelines in the provision of comprehensive PMTCT and Paediatric HIV care services.

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