Regional minimum standards for guidance on Prevention of Mother to Child Transmission (PMTCT) in the SADC region

The main aim of this project was to develop regional harmonized minimum standards for policies, protocols and guidelines for prevention of mother to child transmission (PMTCT) of HIV and AIDS in the Southern African Development (SADC) region. This is consistent with Article 10 of the SADC Protocol on Health, which calls for the harmonization of policies on disease prevention and control. Several approaches were followed in developing these minimum standards. Firstly, an extensive literature review of both published and unpublished literature on PMTCT in the SADC region and globally was conducted as well as analysis of PMTCT policies, protocols and guidelines. Secondly, a technical meeting was held in Gaborone from 15-16 December 2008 with PMTCT experts and implementers from the region. The objective of the meeting was to discuss and share experiences on current national policies and programmes for PMTCT, and to give guidance on the approach for developing minimum standards. Thirdly, policy discussions were held in 14 SADC Member States with representatives of Ministries of Health and National AIDS authorities, and local and international stakeholders, to gain more understanding on how the programmes work, and to identify major achievements, challenges and best practices. Based on information collected from the Member States, individual PMTCT reports were developed for each of the Member States. These were subsequently sent back to the Member States for verification. Based on a review and assessment of PMTCT policies, protocols and guidelines in the Member States and global recommendations, minimum standards were developed. These include: a) Minimum standards for prevention of HIV infection in women; b) Minimum standards for preventing unintended pregnancies in HIV infected women; c) Minimum standards for preventing transmission from an HIV-infected woman to her infant; and d) Minimum standards for providing care and support for HIV-infected women, their infants and their families; e) Minimum standards for access to PMTCT; f) Minimum standards for integration of PMTCT into maternal and child health (MCH) and sexual and reproductive health (SRH) services. This document guides Member States on mechanisms and institutional arrangements for implementation of the minimum standards. It also guides MS on resources for implementation and systems for monitoring implementation.