In close collaboration with the National Department of Health (NDOH), CDC will provide overall HIV and

AIDS programmatic support to the national and provincial prevention of mother-to-child transmission

(PMTCT) program. In addition, NDOH relies on CDC to implement activities that address NDOH-emerging

priorities, provide financial and technical support quicker than the NDOH systems allow. PEPFAR PMTCT-

specific activities are represented on the NDOH operational plan, and contribute to the overall

implementation of the national PMTCT program.

SUMMARY:

At the request of the NDOH, CDC in collaboration with FXB has been asked to review the national PMTCT

and Infant Feeding Curriculum for Health Care Workers, identify gaps and develop a revised PMTCT and

Infant Feeding Curriculum that can be used by the province to ensure that all health care workers are

adequately trained and can rollout quality PMTCT services. The major emphasis area is training. Minor

emphasis areas include development of network/linkages/referral systems, policy development, local

organization capacity development, quality assurance, and strategic information. Target populations for

these activities include policy makers, National AIDS Control Program staff, other NDOH staff, other

healthcare workers, women, family planning clients, pregnant women, people living with HIV, HIV-infected

pregnant women and their infants.

BACKGROUND:

The goal of the National PMTCT program is to reduce mother-to-child transmission of HIV by improving

access to HIV counseling and testing in antenatal clinics, improving family planning services to HIV-infected

women, and implementing clinical guidelines to reduce transmission during childbirth and labor. In addition,

the National program is responsible for ensuring follow-up of infants born to HIV-infected mothers and

ensuring that these infants are identified early and referred to treatment if necessary. The purpose of this

project is to build human capacity through the development of a quality PMTCT Training Curriculum.

ACTIVITIES AND EXPECTED RESULTS:

ACTIVITY 1: Capacity Building

In FY 2005, PEPFAR and the NDOH finalized the PMTCT and Infant Feeding Curricula and PEPFAR

funding produced a trainers_uide, participants_uide and course directors_uide. In FY 2006, course directors

and trainers were updated on the finalized curriculum and provincial training coordinators were assisted in

developing provincial training plans to implement the curriculum at the provincial level. FY 2007 funding was

used to ensure expansion of the PMTCT training throughout the country. Particular support was given to

expand training on PCR implementation and monitoring and evaluation of the PMTCT program. FY 2007

Plus up funding will be used to align the existing PMTCT and Infant Feeding Curricula with the important

policy shift in the area of PMTCT ARV prophylaxis. As of FY 2008 the national PMTCT policy will no longer

be single dose nevirapine, but the provision of dual therapy to all HIV-infected pregnant women. It is

anticipated that the regimen will be AZT from 24-28 weeks and nevirapine at the onset of labor. FY 2008

PEPFAR funds will be used to work with the National PMTCT Technical Task team to update the current

PMTCT and Infant Feeding Training Curriculum. These activities will contribute to the PEPFAR goal of

averting seven million new infections, as healthcare workers will be trained to integrate PMTCT into routine

service, and more pregnant women will receive PMTCT services.

ACTIVITY 2: Development of job-aids

At the request of the NDOH, FXB will use FY 2008 PEPAR funding to develop specific job-aids for health

care providers and community health workers. The purpose of the job-aids will be to ensure that health

care providers and community health workers/lay counselors have pocket-sized resource materials that

they can refer to when working with HIV positive pregnant women. This will ensure improved PMTCT

service delivery.

The updating of the PMTCT and Infant Feeding Training Curriculum and the development of specific job-

aids plays a pivotal role in the implementation of the national PMTCT program. By ensuring that the training

curriculum is updated, these activities will assist the NDOH and provincial departments of health in the

rollout of the updated PMTCT policy guidelines. Funding will ensure that the new PMTCT policy is

disseminated throughout the country and that health care workers are trained in accordance with the NSP.

This program will contribute to 2-7-10 goals by ensuring implementation of quality PMTCT services and by

preventing vertical transmission.