In Sub-Saharan Africa, the Human Immunodeficiency Virus (HIV) has caused a severe and generalized epidemic. In at least 16 countries the HIV sero-prevalence in pregnant women exceeds 10%, and in at least 6, it is over 20%. Without treatment, when a mother has HIV infection, the risk of transmitting the infection to her child is reported to be 20-42%. This has, over the last two decades, resulted in reversals of previous gains in child survival. Prevention of mother-to-child transmission is not only important to reduce childhood illness and death, but through counseling and testing, it can also help prevent mothers from becoming HIV infected and improve the health and well being of mothers and children. Short courses of antiretroviral drugs such as Nevirapine and AZT have been shown to lower transmission rates by nearly half. Longer course of ARVs and routine HIV testing of pregnant women has dramatically lowered the rate of MTCT to 2 - 5% in some developed countries and has made pediatric HIV infection a rare occurrence.

Breastfeeding also exposes infants to HIV, and with breastfeeding for 18 to 24 months; another 10 - 15% of infants become infected. Thus, in non-breastfeeding populations without antiretroviral treatment, approximately 15-30% will become infected; with prolonged breastfeeding, 25 - 45% of infants will become infected.

Situation in Kenya

The number of people infected with HIV in Kenya is currently 2.2 million. Recent national surveillance data showed a prevalence of 6.1% among adults, which indicated a decline from the previous figure of 13.5 %.

In the general population, women are slightly more likely to be infected than men, with teenage girls being at high risk of HIV infection. Pregnant women form 5% of the total population (KDHS, 2002). This translates to 1.2 million. The program is targeting 80% that is 1 million to access PMTCT services. According to NASCOP Sentinel surveillance of HIV and STDs in Kenya, 2005, HIV prevalence among pregnant women attending Ante Natal Clinic is estimated to be 7.8%. This translates to 78,000 women HIV positive annually and infection among infants is estimated 50,000 - 60,000 annually as a result of mother-to-child transmission. The status requires availability of effective and more accessible HIV prevention, care and treatment services in the country.

Program Goal

The Kenya PMTCT program has adopted the UNGASS goal, which aims to reduce the proportion of infants infected with HIV by 50% by 2010. In line with this, the program aims to increase access to PMTCT of HIV services to reach at least 80 % of health facilities in 2007.

Specific Objectives

• To strengthen the existing policy & structures to support PMCT
• To strengthen management system and planning to support PMTCT
• To strengthen monitoring, evaluation, data collection and quality service provision.
• To educate the community through IEC materials.