1. eMTCT Tanzania Experience 6 th Joint Biennial HIV & AIDS Sector Review Dr MD Kajoka PMTCT Coordinator

2. Content 1.Introduction 2.Country Policies and Guidelines 3.Current programmatic performance 4.Challenges and Opportunities

3. Introduction Population 45 Million people 1.6m persons living with HIV (THMIS, 2012) 101,226 pregnant women living with HIV 5.6% HIV prevalence among pregnant women Proportion of making at least one ANC visit 97% Proportion of making at least four ANC visits 43% Percentage of women with unmet need for family planning 25% Maternal Mortality Ratio 432/ 100,000 6% HIV contributed death to Under five

4. Prong1; Prevention of New HIV infection Prong2; Prevention of unintended pregnancies among PLHIV 2000; Pilot 2002 – 2006 Sd NVP (ANC/Maternity) 2006 – 2010 AZT starting 28 th week of GA 2010 – 2013 AZT starting 14 th week of GA 2013 -> Long Life triple therapy ARV for pregnant and lactating mothers Milestones; changes on prongs 3&4

5. Country Goals and Targets (eMTCT plan 2012 - 2015) Goal; To eliminate new HIV pediatric infections and keep mothers alive through improved maternal, newborn and child health and survival programmes by 2015 in Tanzania Impact Results; 1.Reduction of mother to child transmission of HIV from an estimated 26% in 2011 to 4% by 2015 2.Reduction of new HIV infections among child-bearing women by 50% by 2015 3.Reduction of unmet need for family planning among women of child bearing age living with HIV by 100% by 2015 4.Increase the percentage of HIV positive pregnant women who receive ARVs treatment for PMTCT and for their health from 55% in 2010 to 98% by 2015 5.Increase the proportion of HIV exposed children tested for HIV by age of two months from 21% to 90% by 2015 6.Increase the proportion of HIV-infected infants and children initiated on ART before the age of 2 years to 90% by 2015

6. Country Policies and Guidelines 1.Test and Treat; for pregnant and lactating women living with HIV (LLAPLA, a.k.a Option B+) a.Testing  Opt-out; Part and parcel of ANC care unless a client declines I.Elevating couple counseling and testing b.Treatment initiated at point and time of diagnosis (RCH clinics) I.Lab evaluation remains necessary and important, but does not preclude treatment initiation (All women should at some point receive CD4, blood chemistry and other hematological evaluations) c.Retained in RCH for at-least 2 years

7. PROGRAMME PERFORMANCE

8. Site coverage

9. HIV testing;

10. Effective Utilization; Cascade

11. Infant Indicators

12. Estimated HIV transmission; MTCT

13. Pediatric ART Against Estimated Needs GAP

14. Challenges and opportunities 1.Low HEID utilization, and low Pediatric ART 2.Low family centered approach for families with HIV (Couple counseling V/S ART for women only in RCH clinics, HEID V/S referral for pediatric ART) 3.Retention into care 4.Quality assurance for HIV tests 5.Consistent supply of HIV commodities

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