ACCELERATING CHILD SURVIVAL AND DEVELOPMENT 2009

Uganda’s Battle Against the Top Childhood Threats

.© UNICEF Uganda/Chulho Hyun
PREVENTING MOTHER
TO CHILD TRANSMISSION
OF HIV
SITUATION SUMMARY
According to the recent 2007 Uganda Child Verbal
Autopsy Study carried out by the Uganda Bureau of
Statistics, HIV/AIDS accounts for close to 6% of deaths
for children under-five. Approximately 110,000 children
are living with HIV, of which 50,000 are in immediate
need of life-saving treatment. Tragically, however, only
10,000 (<20%) of these children are receiving treat-
ment, which is less than 10% of all the people on Anti- A UNICEF-supported Voluntary Counseling and Testing Site in
Retroviral Therapy (ART). northern Uganda.

Paediatric AIDS is a result of failure of the Preventing

Mother-to-Child Transmission (PMTCT) programme as
95% of children with HIV acquire the virus from their
mothers. However, having a healthy baby is possible.
Developed countries have reduced HIV transmission
from mothers to children to less than 2% - yet in
Uganda, transmission rates remain between 25-30%.
To arrest transmission, pregnant mothers should be
tested during their ante-natal care (ANC) visits, and be
given ARVs, if positive for the virus. According to ac-
cording to the UDHS 2006, approximately 94% of
women made at least one ANC visit, showing the enor-
mous potential of this intervention to reach women with
life-saving information and care.
However, at the end of 2008, the PMTCT intervention
was available in only 66% of all health facilities provid-
ing ANC in UNICEF-supported districts (up from 43%
in 2007). Positively, 70% of women were tested for HIV
in ANC in 2008, up from 48% in 2007. However, only
55% of HIV+ pregnant women received ARVs to re-
duce MTCT in 2008 (up from 29% in 2007). In the ab-
sence of the PMTCT intervention close to 30,000 chil-
dren are infected with HIV per year.
REGIONAL PERSPECTIVE
There are regional variations in coverage levels but all
have increased over the last year. For example, only
3% of HIV+ pregnant women in Karamoja received
ARVs for PMTCT in 2007 but in 2008 this rose to 41%.
Performance by Region on PMTCT - 2008
A NC sites with P M TCT
Expected pregnant wo men tested HIV at A NC
HIV+ wo men given A RVs fo r P M TCT
100
80 90
83
81
60
61 64
59
40
57
49
42
20
0 Chief, Children and AIDS
Acholi Lango Karamoja
UNICEF’S CATALYTIC RESPONSE
UNICEF works at both the national level, and in 23
districts to remove bottlenecks in systems and
structures, enhancing the Government of Uganda’s
capacity to deliver essential services in pursuit of
MDG6 (to arrest and reverse the spread of HIV) Our
“catalytic” support aims to ensure that:
• Children represent at least 15% of all patients bene-
fiting HIV care and treatment programmes (through
advocacy and leveraging of resources from HIV
partners/donors in Uganda);
• Children and mothers access early diagnosis and
referral by scaling up availability of PMTCT services
to 80% of all ANC clinics (through technical assis-
tance and support to Districts/Ministry of Health);
• 80% of expectant mother are tested for HIV and
70% access ARVs (by ensuring districts have ade-
quate stocks of drugs and supplies for the ANC/
PMTCT intervention through supply, cash and tech-
nical assistance);
• Medical Workers and focal-points have adequate
qualifications, training and authority to implement
the full ANC and PMTCT package;
• Community members are aware of HIV-related risks
and the services available for treatment, leading to
an increase in utilisation of services (through social
mobilization activities).
UNICEF CHILDREN AND AIDS PROGRAMME
INDICATIVE BUDGET FOR 2009
Budgetary Requirements: 6 million USD
• 5 million USD for interventions in 23 focus districts;
• 1 million USD to expand advocacy, leveraging and
partnerships at the national level.
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50 FOR MORE INFORMATION
Dr. Dirk Stefan Buyse Karen Allen
Deputy Representative
West dbuyse@unicef.org kallen@unicef.org