Criteria for Identification of Poorly-performing Districts in line with EMTCT Pre-validation Requirements and the Accelerated Action Plan for Nationwide Scale-up of Infant, Pediatric and Adolescent ART (AAP)

Overview

Mother-to-child transmission (MTCT) of HIV is an important contributor to HIV transmission. In 2012 an estimated 260,000 children globally were newly infected with HIV, and an estimated 3.3 million children were living with HIV1 . Without prophylactic treatment, approximately 15–30% of infants born to HIV-positive women will become infected with HIV during gestation and delivery, with a further 5–15% becoming infected through breastfeeding2 . HIV infection of infants creates a life-long chronic condition that potentially shortens life expectancy and contributes to substantial human, social, and economic costs. Primary prevention of HIV, prevention of unintended pregnancies, and effective access to testing, counselling, antiretroviral therapy (ART), safe delivery practices, and appropriate infant feeding practices all contribute to prevention of mother-to-child transmission (PMTCT) and reduce child mortality. Syphilis is transmitted sexually and across the placenta during pregnancy. If the disease remains untreated, adverse pregnancy outcomes are frequent. Over half of women with active syphilis will have a stillbirth, perinatal death, pre-term or low-birth-weight infant, or serious neonatal infection3 . Maternal syphilis screening early in pregnancy and prompt treatment of seropositive mothers with intramuscular Benzathine penicillin or another effective regimen cures syphilis in both mother and infant and prevents most complications associated with MTCT of syphilis.