Prevention of vertical transmission of HIV in India through service integration: lessons from Mysore District, Karnataka

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World Health Organization. Regional Office for South-East Asia

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Meeting the needs of HIV‑positive pregnant women and their offspring is criticalto India’s political and financial commitment to achieving universal access to HIVprevention, treatment, care and support. This review of the strategy to preventvertical transmission of HIV in Mysore district, Karnataka, highlights the need tointegrate prevention of parent‑to‑child transmission (PPTCT) and reproductive andchild health (RCH) services. All key officials who were involved in the integration ofservices at the state and district levels were interviewed by use of semistructuredprotocols. Policy documents and guidelines issued by the Department of Healthand Family Welfare and Karnataka State AIDS Prevention Society were reviewed,as were records and official orders issued by the office of District Health andFamily Welfare Officer and District HIV/AIDS Programme Office, Mysore. Routinedata were also collected from all health facilities. This review found that 4.5 yearsof PPTCT‑RCH integration resulted not only in a rise in antenatal registrations butalso in almost all pregnant women counselled during antenatal care undergoingHIV tests. Based on the findings, we propose recommendations for successfulreplication of this strategy. Integration of PPTCT services with RCH should takeplace at all levels − policy, administration, facility and community. The increaseddemand for HIV counselling and testing resulting from service integration mustbe met by skilled human resources, sufficient facilities and adequate funds at thefacility level
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