No child should be born with HIV; however, the reality is that half a million children are born each year with the virus, mostly in sub-Saharan Africa. Although drug therapies can be highly successful in preventing mother-to-child transmission (PMTCT), access and adherence to these drugs is still limited in many parts of the world owing to a variety of social and economic factors. Furthermore, children living with HIV often are not diagnosed until it is too late for them to begin treatment, which leads to illness and death.
Population Council focus
The Council has evaluated PMTCT services in different settings, including Botswana, India, Kenya, South Africa, and Swaziland, with the overall goal of strengthening services and increasing uptake. This includes studying the quality of post-test counseling services, postnatal care services, psychosocial support services, and adherence to drug therapies. Council researchers have conducted situation analyses in Kenya and South Africa to better understand the barriers that exist to pediatric testing and treatment—even when treatment is available—and developed strategies to address these barriers.
Population Council impact
- A training curriculum, educational materials, and information system created during Council research in Kenya were subsequently adopted by the National AIDS Control Program for its nationwide PMTCT program.
- The Council evaluation of the mothers2mothers program in South Africa provided quantitative evidence of the benefits of peer psychosocial support and contributed to the expansion of the program to several sub-Saharan African countries.
- The Ministry of Health and Social Welfare in Swaziland built upon on a Council pilot program to expand postnatal care services with the goal of reducing the vulnerability of HIV-positive mothers and their infants during this critical period.
Future directions
Council researchers are testing strategies for increasing HIV testing for at-risk children, such as the Caregiver Project in South Africa that targets elderly caregivers of children with HIV testing information and support, and the Family-Centered Approach that targets family members of people living with HIV.
Projects
HIVCore: Strengthening HIV and AIDS Treatment, Care, and Support, and Prevention of Mother-to-Child Transmission Service-delivery Programs (more)
To address critical service-delivery issues in global HIV and AIDS PMTCT and treatment, care, and support programs, HIVCore will evaluate programs, promote user of research results in program decisionmaking, and build local capacity to improve programs' efficiency, effectiveness, and quality of care.
(10/2011 - 9/2014)
Global
Enabling Access to High-quality PMTCT Services by Community and Facility Strengthening in Zimbabwe (more)
Through intensive facility and community-level interventions, the Council and its partners seek to increase prevention of mother-to-child transmission of HIV in the Mashonaland Central Province, Zimbabwe.
(9/2010 - 2/2013)
Zimbabwe
AIDS, Population, and Health Integrated Assistance (APHIA II) Operations Research Project (more)
The APHIA II OR project worked with local partners in Kenya to test innovative interventions to ensure high-quality reproductive health, family planning, and HIV/AIDS and related services to better address Kenya’s health needs.
(10/2008 - 10/2011)
Kenya
Identifying and Testing Children at Increased Risk for HIV Through Caregivers: The Caregiver Project (more)
The Caregiver Project addresses the need for increased pediatric HIV testing and early diagnosis in South Africa.
(10/2007 - 9/2010)
South Africa
Pilot-testing the KwaZulu-Natal Integrated Antenatal and Postnatal Policy and Guidelines (more)
Council researchers are conducting a trial of the KwaZulu-Natal ANC/PNC guidelines in three priority districts in South Africa: Amajuba, Zululand, and Umkhanyakude.
(10/2007 - 9/2010)
South Africa
Sexual and Reproductive Health Needs of Women Living with HIV in Mexico (more)
The Population Council conducted a qualitative study among HIV-infected women and their health care providers in Mexico.
(1/2008 - 6/2009)
Mexico
Extending Prevention of Mother-to-Child Transmission (PMTCT) of HIV Through Postpartum Family Planning (more)
In Lesotho, Council researchers tested the feasibility and effect of a strengthened postpartum care program.
(5/2006 - 5/2008)
Lesotho
Creating Conditions for Implementing a Province-wide Comprehensive, Evidence-based Antenatal and Postnatal Care Package in KwaZulu-Natal (more)
Council researchers assisted in the development of policy to improve antenatal and postnatal care in South Africa.
(12/2004 - 12/2007)
South Africa
Barriers to Uptake of Pediatric HIV Treatment and Care in Kenya: A Diagnostic Study (more)
Researchers with the Council’s Horizons program examined community awareness about pediatric HIV treatment in Kenya and barriers to caregivers in seeking treatment and care for their HIV-infected children in order to guide the development of a project to improve the uptake of pediatric treatment and care.
(3/2007 - 7/2007)
Kenya
Repositioning Postnatal Care in a High HIV Prevalence Environment: Operations Research in Swaziland (more)
Council operations research tested whether a change in the Swaziland National Guidelines for postnatal care strengthened postnatal care attendance and follow-up of mothers and infants.
(1/2006 - 7/2007)
Swaziland
Evaluation of mothers2mothers in KwaZulu-Natal, South Africa (more)
The Council’s Horizons program conducted an operations research study to examine the impact of mothers2mothers in KwaZulu-Natal, South Africa, on the use of key prevention of mother-to-child transmission of HIV (PMTCT) services and on key PMTCT indicators by pregnant and postpartum HIV-positive women.
(7/2006 - 6/2007)
South Africa
Community-based Approaches to Preventing Mother-to-Child Transmission of HIV (more)
Council researchers examined the effectiveness of three community-based strategies in increasing women’s utilization of key PMTCT services in Kibera, an urban slum of Nairobi, Kenya.
(5/2004 - 4/2007)
Kenya
Situation Analysis of the Integration of Family Planning Services in Postpartum, Postabortion, and Prevention of Mother-to-Child Transmission Programs in the Dominican Republic (more)
This Council project was designed to assess the use of contraception within services for postpartum care, postabortion care, and prevention of mother-to-child transmission of HIV.
(11/2005 - 4/2007)
Dominican Republic
Situation Analysis of the Use of Contraception in Postpartum, Postabortion, and Prevention of Mother-to-Child HIV Transmission (PMTCT) Programs (more)
Council researchers assessed the use of family planning in postpartum, postabortion, and prevention of mother-to-child transmission of HIV services in Nicaragua.
(11/2005 - 4/2007)
Nicaragua
From PPTCT to PPTCT Plus: Improving Access to Treatment, Care, and Support for HIV-positive Women and Their Families (more)
Council researchers explored the extent to which and how parent-to-child HIV transmission services are linked to other HIV and sexual and reproductive health services for HIV-infected mothers.
(7/2005 - 2/2007)
India
Situation Analysis of the Use of Contraception in Postpartum, Postabortion, and Prevention of Mother-to-Child HIV Transmission (more)
Council researchers with the FRONTIERS program collaborated on an assessment of the use of family planning in postpartum, postabortion, and prevention of mother-to-child transmission of HIV services in Haiti.
(1/2006 - 1/2007)
Haiti
Evaluation of Adherence to Short Course Antiretroviral Prophylaxis for PMTCT in Francistown, Botswana (more)
Council researchers assessed the quality of the post-test counseling and education women receive regarding HIV, antiretroviral prophylaxis, and therapy and explored barriers to starting and completing antiretroviral prophylaxis among women in Botswana.
(8/2005 - 12/2006)
Botswana
Exploring Current Practices in Pediatric ARV Rollout and Integration with Early Childhood Programs in South Africa (more)
This study identified successful program strategies in pediatric HIV treatment in South Africa and recommended priority knowledge gaps to be addressed by operations research.
(11/2004 - 2/2006)
South Africa
Resources
"The Population Council's HIV and AIDS program," fact sheet (PDF)
Population Council
Publication date: 2012
Making HIV services more responsive to young children and infants in Nyanza (PDF)
Wanjiru,Monica
APHIA II Operations Research Project in Kenya Programme Brief
Publication date: 2011
Service improvements and community education lead to increase in uptake of HIV services for infants and young children (PDF)
APHIA II Operations Research Project in Kenya OR Summary (no. 8)
Publication date: 2011
Shaping policies and programs to reduce mother-to-child transmission of HIV (PDF)
Population Briefs 17(1)
Publication date: 2011
Implementing programs for the prevention of mother-to-child HIV transmission in resource-constrained settings: Horizon studies, 1999-2007 (abstract)
Baek,Carolyn; Rutenberg,Naomi
Public Health Reports 125(2): 293-304
Publication date: 2010
Looking back, moving forward: Implementing PMTCT programs in resource-constrained settings, Horizons studies 1999 to 2007 (PDF)
Baek,Carolyn; Rutenberg,Naomi
Horizons Synthesis Background Papers
Publication date: 2010
Looking back, moving forward: Improving the lives of orphans and other children affected by AIDS, Horizons studies 1998 to 2007 (PDF)
Schenk,Katie D.; Michaelis,Annie P.; Nelson,Tobey C.; Brown,Lisanne; Weiss,Ellen
Horizons Synthesis Background Papers
Publication date: 2010
Evaluation of HIV counseling and testing in ANC settings and adherence to short course antiretroviral prophylaxis for PMTCT in Francistown, Botswana (PDF)
Baek,Carolyn; Creek,Tracy; Jones,Lee Ann; Apicella,Louis; Redner,Jennifer; Rutenberg,Naomi
Horizons Final Report
Publication date: 2009
Family centred approach for HIV services: Pilot study in South Africa (PDF)
Sheehy,Meredith; Mini,Nomtandazo Patricia; Mophanga,Tonica; Kellerman,Scott E.
Horizons Research Summary
Publication date: 2009
HIV and children (PDF)
Momentum, June
Publication date: 2009
Integrating quality postnatal care into PMTCT in Swaziland (abstract)
Mazia,Goldy; Narayan,I.; Warren,Charlotte; Mahdi,Mohammed; Chibuye,P.; Walligo,A.; Mabuza,P.; Shongwe,Rachel; Hainsworth,M.
Global Public Health 4(3): 253-270
Publication date: 2009
Developing comprehensive and evidence-based policy and guidelines for antenatal and postnatal care in KwaZulu-Natal (PDF)
Ditlopo,Prudence; Menziwa,Mantshi; Mullick,Saiqa; RamaRao,Saumya; Dalton,Janet; Nyasulu,Dolly; Beksinska,Mags; Kunene,Busi
FRONTIERS Final Report
Publication date: 2008
Extending prevention of mother-to-child transmission through postpartum family planning in Lesotho (PDF)
Warren,Charlotte; Phafoli,Semakaleng; Majara,Bosielo; Tsukuluet,Thato
FRONTIERS Final Report
Publication date: 2008
'If you build it, will they come?' Kenya healthy start pediatric HIV study: A diagnostic study investigating barriers to HIV treatment and care among children (PDF)
Kiragu,Karusa; Schenk,Katie D.; Murugi,Julie; Sarna,Avina
Horizons Final Report
Publication date: 2008
Situation analysis of the integration of family planning services in postpartum, postabortion and prevention of mother to child transmission programs in Haiti (PDF)
Rivero-Fuentes,M.Estela; Vernon,Ricardo; Boulos,Michaelle; Boulos,Louis-Marie
FRONTIERS Final Report
Publication date: 2008
Situation analysis of the integration of family planning services in postpartum, postabortion and prevention of mother to child transmission programs in Nicaragua (PDF)
Solis,Freddy; del Carmen Rojas,Ana; Gadea,Adilia; Rivero-Fuentes,M.Estela; Vernon,Ricardo
FRONTIERS Final Report
Publication date: 2008
Situation analysis of the integration of family planning services in postpartum, postabortion and prevention of mother to child transmission programs in the Dominican Republic (PDF)
Quiterio,Gisela; Molina,Maritza; Miric,Marija; Vernon,Ricardo; Rivero-Fuentes,M.Estela
FRONTIERS Final Report
Publication date: 2008
Community-based approaches to prevention of mother-to-child transmission of HIV: Findings from a low-income community in Kenya (PDF)
Kaai,Susan; Baek,Carolyn; Geibel,Scott; Omondi,Peter; Ulo,Benson; Muthumbi,Grace; Nkatha,Carol; Rutenberg,Naomi
Horizons Final Report
Publication date: 2007
Continuum of care for HIV-positive women accessing programs to prevent parent-to-child transmission: Findings from India (PDF)
Mahendra,Vaishali Sharma; Mudoi,Rupa; Oinam,Archana; Pakkela,Venkat; Sarna,Avina; Panda,Sucheta; Rau,Ashok; Birendrajit Singh,L.; Rutenberg,Naomi
Horizons Final Report
Publication date: 2007
Examining the rollout of pediatric antiretroviral treatment in South Africa (PDF)
Population Briefs 13(1)
Publication date: 2007
Key findings from an evaluation of the mothers2mothers program in KwaZulu-Natal, South Africa (PDF)
Baek,Carolyn; Mathambo,Vuyiswa; Mkhize,Sibongile; Friedman,Irwin; Apicella,Louis; Rutenberg,Naomi
Horizons Final Report
Publication date: 2007
Acceptability and feasibility of introducing the WHO focused antenatal care package in Ghana (PDF)
Birungi,Harriet; Nyarko,Philomena; Armar-Klemesu,Margaret; Arhinful,Daniel; Deganus,Sylvia; Odoi-Agyarko,Henrietta; Brew,Gladys
FRONTIERS Final Report
Publication date: 2006
Expanding pediatric access to antiretroviral therapy in South Africa (PDF)
Michaels,Desiree; Eley,Brian; Ndhlovu,Lewis; Rutenberg,Naomi; Khan,Hena
Horizons Research Summary
Publication date: 2006
Field experiences integrating family planning into programs to prevent mother-to-child transmission of HIV (abstract) (PDF)
Rutenberg,Naomi; Baek,Carolyn
Studies in Family Planning 36(3): 235-245
Publication date: 2005
Integrating family planning and prevention of mother-to-child HIV transmission in resource-limited settings (abstract)
Duerr,Ann; Hurst,Stephen; Kourtis,Athena P.; Rutenberg,Naomi; Jamieson,Denise J.
Lancet 366(9481): 261-263
Publication date: 2005
Review of antenatal-linked voluntary counseling and HIV testing in sub-Saharan Africa: Lessons and options for Ghana (abstract)
Baiden,Frank; Baiden,Rita; Williams,John; Akweongo,Patricia; Clerk,Christine; Debpuur,Cornelius; Phillips,James F.; Hodgson,Abraham
Ghana Medical Journal 39(1): 8-13
Publication date: 2005
Integrating family planning and PMTCT services (HTML)
Rutenberg,Naomi; Baek,Carolyn
Global AIDSLink 87(1)
Publication date: 2004
Review of field experiences: Integration of family planning and PMTCT services (PDF)
Rutenberg,Naomi; Baek,Carolyn
Horizons Final Report
Publication date: 2004
Education improves breastfeeding practices in Zambia (PDF)
Population Briefs 9(2)
Publication date: 2003
Empowering communities to respond to HIV/AIDS: Ndola Demonstration Project on Maternal and Child Health: Operations research final report (PDF)
Hope Humana; LINKAGES; National Food and Nutrition Commission; Ndola District Health Management Team; Horizons Program; Zambia Integrated Health Project
Horizons Final Report
Publication date: 2003
Evaluation of United Nations-supported pilot projects for the prevention of mother-to-child transmission of HIV: Overview of findings (PDF)
Rutenberg,Naomi; Baek,Carolyn; Kalibala,Sam; Rosen,James
HIV/AIDS Working Paper
Publication date: 2003
Family planning and PMTCT services: Examining interrelationships, strengthening linkages (PDF)
Rutenberg,Naomi; Baek,Carolyn; Kankasa,Chipepo; Nduati,Ruth; Mbori-Ngacha,Dorothy; Siwale,Margaret; Geibel,Scott; Apicella,Louis
Horizons Research Summary
Publication date: 2003
HIV voluntary counseling and testing: An essential component in preventing mother-to-child transmission of HIV (PDF)
Rutenberg,Naomi; Kankasa,Chipepo; Nduati,Ruth; Mbori-Ngacha,Dorothy; Siwale,Margaret; Geibel,Scott; Apicella,Louis
Horizons Research Summary
Publication date: 2003
Infant feeding counseling within Kenyan and Zambian PMTCT services: How well does it promote good feeding practices? (PDF)
Rutenberg,Naomi; Kankasa,Chipepo; Nduati,Ruth; Mbori-Ngacha,Dorothy; Siwale,Margaret; Geibel,Scott
Horizons Research Summary
Publication date: 2003
Programme recommendations for the prevention of mother-to-child transmission of HIV: A practical guide for managers (PDF)
Rutenberg,Naomi; Kalibala,Sam; Baek,Carolyn; Rosen,James
HIV/AIDS Working Paper
Publication date: 2003
Integrating HIV prevention and care into maternal and child health care settings: Lessons learned from Horizons studies (PDF)
Rutenberg,Naomi; Kalibala,Sam; Mwai,Charles; Rosen,James
Horizons Report
Publication date: 2002
Ndola Demonstration Project: A midterm analysis of lessons learned (PDF)
Horizons Program
Horizons Report
Publication date: 2002
Community involvement in initiatives to prevent mother-to-child transmission of HIV
Leonard,Ann; Mane,Purnima; Rutenberg,Naomi; Nyblade,Laura; Field-Nguer,Mary Lyn
Community Involvement in Initiatives to Prevent Mother-to-Child Transmission of HIV: A Collaborative Project
Publication date: 2001
Community involvement in the prevention of mother-to-child transmission of HIV: Insights and recommendations (PDF)
Rutenberg,Naomi; Field-Nguer,Mary Lyn; Nyblade,Laura
Community Involvement in Initiatives to Prevent Mother-to-Child Transmission of HIV: A Collaborative Project
Publication date: 2001
Evidence for the importance of community involvement: Implications for initiatives to prevent mother-to-child transmission of HIV (PDF)
Leonard,Ann; Mane,Purnima; Rutenberg,Naomi
Community Involvement in Initiatives to Prevent Mother-to-Child Transmission of HIV: A Collaborative Project
Publication date: 2001
Women, communities, and the prevention of mother-to-child transmission of HIV: Issues and findings from community research in Botswana and Zambia (PDF)
Nyblade,Laura; Field-Nguer,Mary Lyn
Community Involvement in Initiatives to Prevent Mother-to-Child Transmission of HIV: A Collaborative Project
Publication date: 2001
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