Center for Health Market Innovations (CHMI)

Programs

MTCT Plus Initiative

last updated Oct 4, 2011

Overview

Implementing organization: 
International Centre for AIDS Care and Treatment Programs
Implementation Partner(s): 
Mailman School of Public Health at Colombia University
Legal Status: 
Private (not-for-profit)
Year Launched: 
2002
Stage: 
Existing/expansion stage
Income Level of Target Population: 
All income levels

Funding

Primary Source of Funding: 
Donor
Funders: 
Bill & Melinda Gates Foundation, U.S. Agency for International Development (USAID), U.S. Centers for Disease Control and Prevention (CDC) under The President’s Emergency Plan for AIDS Relief (PEPFAR), William and Flora Hewlett Foundation

Scale

Number of Clients Served: 
16,000
Number of Facilities Operated/Networked: 
14
Summary: 

All HIV services, including antiretroviral therapy, are extended to all mothers' HIV-infected children, partners, and other family members. The initiative is known internationally as a model program for family-based care and the early diagnosis and care of infants exposed and infected with HIV.

Program goals/rationale: 

In low resource, high prevalence settings, programs to prevent mother-to-child transmission (PMTCT) of HIV were limited to prevention interventions and did not provide care nor antiretroviral treatment to HIV-infected pregnant women and children. The MTCT-Plus Initiative, recognizing the important roles that women and mothers play in their families and communities, built on PMTCT programs to include comprehensive treatment services for women identified as HIV-infected during pregnancy and to their families. The Initiative was conceptualized to meet the needs of each family member infected or affected by HIV/AIDS.

The services offered by the Initiative are designed to be comprehensive, with a focus on keeping each member of the family healthy and engaged in long-term care.

Key program components: 

The MTCT-Plus Model of Care has been implemented through 14 clinical programs based in nine countries throughout sub-Saharan Africa and Asia. In addition to antiretroviral therapy for those who are eligible, a variety of HIV-related and primary health care services are provided, including opportunistic infection prophylaxis, screening and treatment for other diseases, particularly tuberculosis, nutritional evaluation and support, access to family planning, and clinical and immunologic monitoring. Psychological support and adherence counseling by counselors or peers are considered critical components of the MTCT-Plus Initiative.

Pediatric care is an essential component of family-focused services. All HIV-exposed infants are monitored until HIV infection can be definitively diagnosed or excluded. Each site has access to early virologic tests to provide timely diagnosis of HIV infection during the first months of life. All children have regular assessments of growth, developmental status and CD4 counts while receiving opportunistic infection prophylaxis and ART, if eligible.

Program history: 

In 2000, the MTCT-Plus Initiative was conceptualized in response to a call to action at the Durban International HIV Conference. At that conference, Dr. Allan Rosenfield, former Dean of Columbia University’s Mailman School of Public Health (MSPH), asked a simple question – where did treatment of mothers fit into HIV perinatal prevention efforts?

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