Mother-to-child HIV transmission under spotlight
MASERU – Many women lack access to health facilities, particularly facilities with obstetric emergency services, Health Director General, Dr ’Nyane Letsie has said. Dr Letsie adds that no child must be born with HIV, or be infected at birth because preventive treatment is readily available and accessible.
She said despite the launch of the Mother-To-Child Transmission (MTCT) programme that prevents transmission of HIV from mothers to children in 2003, to date there are still children that are born with HIV. Dr Letsie further notes that this is the first gap that needs to be closed in HIV prevention. “No child must be born with HIV after 20 years of the programme,” she said.
Pregnancy is a critical moment of engagement in health care setting in a woman’s life. Where health facility visits are made, pregnancy is a moment when women feel compelled to ensure their good health and the health of their children. In this moment of engagement, it is vital to test, counsel and treat women for HIV, especially in high burden settings, according to health experts. The Lesotho Population-based HIV Impact Assessment (LePHIA) 2020, shows that over 90 percent of new infections among infants and young children occur through Mother-to-Child-Transmission.
Without any interventions, between 20 and 45 percent of infants, the report indicates that many become infected with HIV, with an estimated risk of five to 10 percent during pregnancy, 10 to 20 percent during labour and delivery, and five to 20 percent through breastfeeding. In 2010, global targets were set to reduce new HIV infections in children and reduce mortality among mothers living with HIV, including a 90 percent reduction in child HIV infections, a 50 percent reduction in AIDS-related maternal deaths and virtual elimination of mother-to-child transmission.
To prevent mother to child transmission, World Health Organisation (WHO) recommends a comprehensive four-pronged approach, including primary prevention of HIV infection among women of childbearing age 15 to 49 years and preventing unintended pregnancies among women of childbearing age living with HIV. WHO also recommends providing appropriate treatment, care and support to mothers living with HIV and their children and families.
The broader health goal is to deliver an integrated package of care for mothers and infants that includes maternal, newborn and child health and prevention of mother-to-child transmission services. To achieve the elimination of mother-to-child transmission goal, the LePHIA report says 95 percent of mothers need to know their status, 95 percent of HIV-positive women need to be on ART and 95 percent need to achieve viral load suppression. With such high targets, the report says countries can ill-afford to miss any women of childbearing age in need of services.