Optimizing Prevention: A Comprehensive PMTCT Program in Mombasa, Kenya

The primary goal of any prevention of mother to child transmission (PMTCT) program is to reduce and avoid HIV-related morbidity and mortality in both mother and child. Since its inception in 2004, the PMTCT program at Bomu Medical Centre, in Mombasa Kenya, has strived to provide the best possible care and counseling to HIV+ pregnant women enrolled in treatment at its comprehensive care center (CCC). As of July 12th, 2006, 158 women have benefited from Bomu's PMTCT program. While the majority of enrolled women received care according to Kenyan Guidelines, gaps in monitoring pregnancies and following up with treatment of exposed infants has left many infants unaccounted for and/or without proper care. In June 2006, a working group was convened to discuss viable methods for implementation of a standardized, effective, and comprehensive PMTCT program. The goal of the working group was to identify programmatic inconsistencies in the treatment of HIV positive pregnant women and their children, integrate PMTCT and HIV treatment and care services, and formalize workable solutions. Guidelines were created that ensured constant continuity of care between Bomu's CCC, the antenatal clinic, and the maternity ward. Also, a counseling regimen was developed for women who entered the program. Such counseling included discussions of modes of mother-to-child transmission, antiretroviral therapy adherence, nutritional recommendations including infant feeding, and options for delivery (ie. Cesarean section). Finally clinical and administrative guidelines were developed to insure consistent and continuous care.