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Evaluation of United Nations-supported pilot projects for the prevention of mother-to-child transmission of HIV. Overview of findings.
New York, New York, UNICEF, 2003. 47 p. (HIV / AIDS Working Paper)This overview report presents key findings from an evaluation of UN- supported pilot PMTCT projects in eleven countries, including: Botswana, Burundi, Cote d'Ivoire, Honduras, India, Kenya, Rwanda, Tanzania, Uganda, Zambia, and Zimbabwe. Key findings discuss: feasibility and coverage; factors contributing to programme coverage; programme challenges; scaling-up; the special case of low prevalence countries; and recommendations. Recommendations include: To increase coverage and improve infant feeding counseling: supplement clinic staff with lay counselors; introduce rapid HIV tests so women can receive same day counseling, HIV testing, and test results; improve the quality of HIV and infant feeding counseling by providing job aids and active supervision; offer support to PMTCT providers including material support and peer psychosocial support; partner with community groups to offer community education and outreach; and expand the vision of PMTCT to encompass an active role for fathers and male partners. To strengthen postnatal support and follow up of HIV- infected women and their infant to assist them with infant feeding, getting care for themselves and their families, and to evaluate the program: establish national infant feeding guidelines; establish postnatal follow-up protocols; forge partnerships between the PMTCT program and NGO care and support groups; Enhance referral links between PMTCT programs and HIV care; New measurement tools and systems should be developed. To scale up PMTCT programs the findings suggest: expand to new sites but enlarge the scope of activities within existing sites to reach more women; and provide a comprehensive package of HIV prevention and care. The pilot experience has shown that introducing PMTCT programs into antenatal care in a wide variety of settings is feasible and acceptable to a significant proportion of antenatal care clients who have a demand for HIV information, counseling, and testing. As they go to scale, PMTCT programs have much to learn from the pilot phase, during which they successfully reached hundreds of thousands of clients. (author's)
Southern Africa HIV / AIDS Action. 2003 Jun; (56):10.Because Antiretroviral drugs are very expensive and unaffordable most people think that it is not feasible to use antiretrovirals in resource poor settings. However, use of antiretrovirals is feasible in developing countries. This is an important lesson that has been learnt from the pilot phase of the UNAIDS HIV Drug Access Initiative. The Drug Access Initiative (DAI) was launched in November 1997, designed to develop innovative, effective models to improve access to needed drugs to treat HIV and its opportunistic infections. The initial phase of the Initiative has been designed to set up the necessary infrastructure and systems to increase access to HIV related drugs on a small but sustainable scale. (excerpt)