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HIV MTCT in Uganda

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Posted on Jun 07, 2015

HIV MTCT in UgandaAccording to the World Health Organization, 35 million people were living with HIV in 2013. That number includes 16 million women and 3.2 children. Additionally, there were 2.1 million new infections that year while AIDS was responsible for 1.5 million deaths. Though HIV is a global epidemic, almost 70% of cases and 80% of deaths occur in sub-Saharan Africa.

Last year, Unicef reported that as of 2013 an estimated 7.4% of Ugandans were living with HIV. This translates into 1.6 million individuals, including 790,000 women. These alarming statistics do not account for the 190,000 children living with HIV.

Approximately 90% of pediatric infections occur as a result of mother-to-child transmission (MTCT). Transmission can happen during pregnancy, labor, delivery or breastfeeding. In untreated pregnancies, there is a 15-45% chance of a mother passing the virus on to her child. In Uganda in 2013 alone, an estimated 16,000 babies tested positive for HIV. Because of these alarming numbers, First Lady Hon. Janet Kataaha Museveni declared MTCT a national emergency.

Uganda was already among the first nations to take an organized preventative approach to MTCT, implementing the World Health Organization’s Option B+ program. The Option B+ approach aims to minimize MTCT while maximizing healthcare quality for mothers by providing lifetime access to a simplified antiretroviral treatment (ART) regimen of one pill a day.

This approach successfully increased the number of pregnant and breastfeeding women receiving treatment by 700% globally. The treatment itself has effectively reduced MTCT rates to 5% and also protects the health of mothers, prevents transmission of the virus to sexual partners and helps stem the number of orphaned children. This last point is particularly critical in Uganda where one million children are orphaned as a result of AIDS—a significant portion of the 2.4 million total children without parents.

Although the Option B+ approach is backed by both the World Health Organization and by the US President’s Emergency Plan for AIDS Relief (PEPFAR), the Ugandan Ministry of Health (MOH) needed a way to collect data about the program in order to assess its effectiveness. As stated by former Uganda Country Director for the CDC, Dr. Tadesse Wuhib, “The key to this entire concept is the generation, management, and dissemination of data that quickly demonstrate the results we are achieving.”

In order to accomplish this, the MOH collaborated with several national healthcare organizations such as the CDC and United States Agency for International Development (USAID) to utilize Uganda’s Emergency Operations Center to collect pertinent data. The healthcare organizations identified nine points for weekly report by local healthcare providers, which they sent in via SMS text message to be assessed weekly.

On a local level, weekly reporting enables healthcare providers to keep track of missed appointments and low inventory. On a national level, the data reported allows policymakers to identify geographical areas of strength and weakness for the program as well as to assess its effectiveness on the whole.

Ultimately, this system of information monitoring demonstrates the usefulness of constant data reporting via real-time technology in order to constantly assess the effectiveness of healthcare programs and adjust appropriately on a national level.

For more information on HIV and AIDS in Uganda, see this AVERT page.