(PMTCT_ARV_NAT / SUBNAT) Number and percentage of HIV-positive pregnant women who received antiretroviral medicine (ARV) during pregnancy to reduce the risk of mother-to-child transmission
The risk of mother-to-child transmission can be significantly reduced by providing ARVs for the mother during pregnancy and delivery, with antiretroviral prophylaxis for the infant, and antiretroviral medicines to the mother or child if breastfeeding, and the use of safe delivery practices and safer infant feeding. The data will be used to track progress towards global and national goals of eliminating mother-to-child transmission; to inform policy and strategic planning; for advocacy; and for leveraging resources for accelerated scale-up. It will help measure trends in coverage of antiretroviral prophylaxis and treatment, and when disaggregated by regimen type, will also assess progress in implementing more effective antiretroviral therapy regimens. As the indicator usually measures ARVs dispensed and not those consumed, it is not possible to determine adherence to the regimen in most cases.
This indicator is harmonized with GARPR indicator 3.1 (https://aidsreportingtool.unaids.org/static/docs/GARPR_Guidelines_2016_E...).
Number of HIVpositive pregnant women who delivered and received ARV to reduce the risk of mother-to- child transmission during pregnancy and delivery.
Estimated number of HIV- positive pregnant women who delivered within the past 12 months
For the numerator: the source of this information is national program records aggregated from program monitoring tools, such as patient registers and summary reporting forms . The numerator can be generated by counting the number of HIV-positive pregnant women who received anti-retrovirals to reduce MTCT in the reporting period, by regimen.
Disaggregation of regimen definitions:
For the denominator: Two methods can be used to estimate the denominator: an estimation model, such as Spectrum, using the output, number of pregnant women needing PMTCT; or, if Spectrum estimates are not available, by multiplying the number of women giving birth in the past 12 months (which can be obtained from estimates of the central statistics office, United Nations Population Division or pregnancy registration systems with complete data) by the most recent national estimate of HIV prevalence in pregnant women (which can be derived from HIV sentinel surveillance in ANC and appropriate adjustments related to coverage of ANC surveys).
Disaggregated data is required. The numerator should be disaggregated by the three categories below for HIVpositive pregnant women for the prevention of mother-to-child transmission:
1. Newly initiated on antiretroviral therapy during the current pregnancy (New on ART, includes Maternal triple ARV prophylaxis)
2. Already on antiretroviral therapy before the current pregnancy (Already on ART)
3. Other: All other optionsincluding
- Maternal AZT (prophylaxis component during pregnancy and delivery of WHO Option A or WHO 2006 guidelines)
- Single dose nevirapine (with or without tail) only
- Any other regimen not listed above
The number of HIV positive pregnant women who delivered within the past 12 months is also referred to as the number of pregnant women living with HIV needing antiretrovirals for preventing mother-to-child transmission (i.e. the number)
To adequately plan the PMTCT program, these numbers are needed from both the National and subnational level. The subnational level is considered that in which the country team has prioritized their program (PSNU; District, province etc.). This data should be entered for all SNUs, regardless of PEPFAR funding supporting these geographical area; so that the total of the subnational number should equal the total number of National number.
This data should be entered by the PEPFAR country team at both National and subnational level.
Narratives should include information on how National and SNU estimates have been derived for both results and targets.
Host country teams often set targets by OU, and SNU level to plan their programs (please describe the target setting process that the host country employs in the narratives). Targets should aligned with the START free, STAY free, AIDS-free super-FAST TRACK initiative. If the host country does not develop targets for this indicator, then for planning purposes, data should be entered that includes MOH results from the previous reporting with the PEPFAR planned targets (at the least) should constitute the host country targets.