Prevention of mother-to-child transmission during breastfeeding
Export Indicator
While indicator 3.1 captures whether programmes are reaching mothers during pregnancy and delivery, indicator 3.1a captures whether women are receiving prophylaxis for themselves or for their babies during the breastfeeding period.
For women who are breastfeeding and not on antiretroviral therapy, the risk of transmitting HIV to the child during breastfeeding remains substantial. This risk can be reduced by providing prophylaxis to the mother or the baby during the entire duration of breastfeeding. The data will be used to track progress toward global and national goals towards elimination of mother-to-child transmission, to inform policy and strategic planning, for advocacy, and leveraging resources for accelerated scale up.
Number of women living with HIV who were breastfeeding who received antiretroviral prophylaxis for themselves or their infants to reduce the risk of mother-to-child transmission during breastfeeding during the past 12 months
Estimated number of women living with HIV who were breastfeeding in the past 12 months
Numerator / Denominator
For the numerator: national programme records aggregated from programme monitoring tools, such as patient registers and summary reporting forms. The data for the numerator can be collected at the infant’s six-week Early Infant Diagnosis (EID) visit or DPT3 immunization visit (two to three months)
and distinguished from ARV interventions given to prevent peripartum transmission. Data on whether maternal or infant antiretrovirals to reduce post-natal transmission were provided should be recorded for breastfeeding infants. HIV-infected pregnant women who are eligible for lifelong antiretroviral therapy, are receiving a treatment regimen and whose infants therefore benefit from the prophylactic effect of ART in reducing the risk of transmission through breastfeeding are also included in the numerator.
For the denominator: estimation models such as Spectrum, or antenatal clinic surveillance surveys in combination with demographic data and appropriate adjustments related to coverage of ANC surveys. The denominator should represent the number of women living with HIV who are breastfeeding. In settings where most HIV positive women breastfeed, the estimated number of HIV-positive pregnant women could be a proxy for the denominator (with some adjustment of infant deaths before the time point for measurement if available). In other settings, where a sizable population of HIV-exposed infants may not be breastfeeding, it will be necessary to estimate the number of HIV-exposed infants who are breastfeeding.
Annual
This indicator allows countries to monitor the coverage of programmes to reduce transmission to children during breastfeeding. As the indicator measures antiretroviral drugs dispensed and not those consumed, it is not possible to determine adherence to the regimen.
This indicator should not be confused with indicator 3.7 (Percentage of infants born to HIV-infected women provided with ARV prophylaxis to reduce the risk of early mother-to-child transmission in the first six weeks).
It is important to assess antiretroviral coverage throughout the breastfeeding period, but in many settings there is significant loss to follow-up after the six-week visit so it is difficult to get an accurate estimate of antiretroviral coverage at a later time point. In breastfeeding populations, effort should be made to ensure antiretroviral coverage during the breastfeeding period beyond six weeks or DPT3 as captured by this indicator.
If the data submitted for this indicator are not nationally representative, please state this in the comments field and describe the sample.
The prevention of mother-to-child transmission is a rapidly evolving programmatic area. Methods for monitoring coverage of this service are therefore also evolving. To access the most current information available please consult the following links:
www.who.int/hiv/pub/mtct/en www.who.int/hiv/pub/me/en/index.html