Strategy

In partnership with the Global Fund for AIDS, Tuberculosis and Malaria, UNICEF has supported the governments of Botswana and Lesotho to implement targeted programmes for adolescent girls and young women. In Lesotho, a national multi-sectoral referral framework is strengthening community-facility linkages and is catalyzing increased access to HIV/SRH services by guiding adolescent and young people to appropriate services and care. In Botswana, a radio drama series together with peer education components is tackling tough issues adolescents are facing in love, life and relationships. Documentation of both experiences are available for download.

Adolescent and young mothers are a priority population for UNICEF in Eastern and Southern Africa, including those who are affected by HIV. In this region, one in four women aged 20-24 years gives birth before the age of 18 years and 30 per cent of all new HIV infections occur among adolescent girls and young women aged 15-24 years. Studies increasingly show poorer maternal, child and HIV outcomes for this age group as compared to older women. Together with governments and partners, UNICEF has been working to promote differentiated, evidence-based approaches to meet the complex needs of adolescent and young mothers in several countries across the region.

This newly released report describes these efforts in nine countries, highlighting the results achieved and the learning. Key insights include the importance of responsive service delivery and social support as well as working across sectors. Also offered are ways in which policy makers, researchers, programme managers and implementers can strengthen HIV and health services for adolescent and young mothers and their children.

The 'Last Mile' road map draws on the latest scientific research and programmatic evidence to describe and recommend strategies to achieve the elimination of mother-to-child transmission of HIV (EMTCT). It includes a synthesis of evidence and country experiences for reaching EMTCT and recommends clear strategies that can improve the coverage, effectiveness and quality of national programmes for the prevention of mother-to-child transmission (PMTCT). The goal of this document is to provide guidelines for coordinated action so that national programmes address local priority areas to achieve EMTCT in an effective, people-centred, efficient and directed manner.

This document was conceptualized by the United Nations Children’s Fund (UNICEF) and partners including the Start Free working group, the Joint United Nations Programme for HIV/AIDS (UNAIDS) and the World Health Organization (WHO), and it was validated by ministries of health of Botswana, Malawi, Seychelles, Uganda, Zambia and Zimbabwe.

Approximately half of HIV infections among children take place during breastfeeding. While there has been success in retaining pregnant women on antiretroviral therapy (ART) during pregnancy, there has been inadequate focus on retention support to
mother-baby pairs (MBPs) during the breastfeeding period.

Literature shows that the majority of MBPs not retained in prevention of mother-to-child transmission (PMTCT) programs are due to loss to follow-up (LTFU) rather than death. These children are at higher risk of vertical acquisition of HIV compared to breastfeeding infants who remain in care. Current postpartum LTFU rates limit successful implementation of PMTCT programs in sub-Saharan Africa. Cumulative sub-Saharan Africa PMTCT LTFU rates in 2011 were estimated to range from 20-28% during antenatal care, then sharply increase to 70% at four months postpartum and reach approximately 81% six months after birth.

Given these staggering statistics, the quality and effectiveness of PMTCT services should include an assessment of the proportion of MBPs retained in care and early infant diagnosis (EID) rates.

This is part of a series of 12 policy briefs by the Child Survival Working Group on scaling up key interventions for children and adolescents living with HIV. Learn more.

The Kingdom of Eswatini (formerly Swaziland) released its National Strategic Plan for Ending AIDS and Syphilis in Children (2018 – 2022). This strategy aligns with the ‘Three Frees’ Framework and aims to make a final push towards the elimination of mother-to-child transmission of HIV and syphilis as well as an end to paediatric AIDS.

This Plan has been designed to ensure that every child is born and remains HIV and syphillis free, and that every pregnant woman or mother living with HIV have access to lifelong HIV treatment. In addition, every child and adolescent living with HIV should be linked to quality HIV treatment, care and support to realize their full potential without stigma and discrimination.

Many millions of people around the world are affected by emergencies, the majority of whom are women and children. Among them are many who are known to be living with HIV and others who may not know their HIV status.

The purpose of this document is to provide operational guidance on HIV and infant feeding in emergencies. It is intended to be used to complement emergency and sectoral guidelines on health, nutrition and HIV, including specifically infant feeding, prevention of mother-to-child transmission of HIV and paediatric antiretroviral treatment.

The envisaged target audience consists of decision makers, policymakers, national and subnational government managers and planners, managers of refugee camps and similar settlements for displaced persons, and managers and planners in United Nations agencies, nongovernmental organizations and other groups responding to humanitarian situations.

This operational guidance is based on a consultation convened by the WHO, UNICEF and the Emergency Nutrition Network in Geneva in September 2016, which brought together a cross-section of senior-level participants from United Nations agencies, government, nongovernmental organizations, academia, and other agencies working in nutrition and HIV in emergencies. This document sets out basic principles related to HIV and infant feeding in emergency settings, and the actions that government and other stakeholders can take to prepare for emergencies.