According to UNAIDS, Mozambique ranks third in the world after Nigeria and South Africa for new paediatric infections, among the 22 countries that contribute to the global burden of new HIV infections. In 2011, Mozambique endorsed the Global Initiative for the Elimination of Mother-to-Child transmission (EMTCT). The country revised previous targets that had been set in 2010, reducing them to less than 5% Mother-to-Child Transmission by 2015 and 90% coverage with more effective antiretroviral (ARV) regimens. As of December 2014, population ARV coverage for the prevention of mother-to-child transmission (PMTCT) was 96%.
In 2013, the Ministry of Health commenced universal access to all HIV-infected children under 5 years. Despite the positive increase in access to anti-retroviral treatment (ART) for children under 15 years, in the last two years, paediatric ART still lags behind. Only 8.5% of all patients treated in the country are children, far below the WHO recommendation that 10 – 15% of patients should consist of paediatric treatment.
By December of 2013, a total of 41,400 child patients had been reached, corresponding to a coverage of 36% of eligible children compared to 25% (25,891) and 22% (23,053) in 2012 and 2011 respectively. In 2014, this figure increased again to 60,768 (49%), showing a positive trend over the past two years.
The main challenges faced in Mozambique are related to the retention and adherence to treatment for both PMTCT and Paediatric ART. Paediatric ART is among the key priorities for the Ministry of Health. According to data from Spectrum, in 2014 the number of children aged 0 to 14 years living with HIV was estimated at about 183, 631, and of these, 121,983 children were eligible for ART.
What we are doing
Technical assistance and support for coordination, particularly in policy development/update through active participation in the above groups and leading the PMTCT UNTAM group, CNCS PPF.
- Liaison with global/regional TA structures, e.g. IATT, GTT, dissemination of most updated strategic information and support development of reports.
- Partnerships: strengthen the existing and stimulate new strategic ones e.g. with the civil society, private sector, academic institutions, and the First Lady for more inclusiveness in community interventions and at operational level.
Knowledge management and Innovation
- Innovation/Point of Care Testing (POCT) introduction and scale-up of point of care PCR and CD4.
- Expansion of Early Infant Diagnosis, and the introduction and scale-up of new technologies in equity targeted provinces.
- Knowledge Management: information generation or complementarity through studies.
- Support knowledge generation with government and implementing partners
- Capacity building, mentoring and supportive supervision for implementation of revised guidelines
Community mobilisation and linkages for improved identification and retention in care of pregnant women, children and adolescents (example of Kuplumussana, CUAMM PCA Beira city).
The way forward
UNICEF is working on three key priorities in Mozambique: PMTCT, paediatric treatment and health care for adolescents with HIV.
- Implementation of the Elimination of Mother To Child Transmission (EMTCT) Plan and reporting: support national and subnational level to more effectively monitor the implementation of EMTCT plan, including the initiation of option B+, data collection, analysis and use.
- Support the development of a communication strategy for increasing adherence and retention on PMTCT and pediatric ART services.
- HIV accelerated plan implementation: Support point of care technologies and expansion of access to early infant diagnosis with a focus on innovative approaches to increase early initiation of ART in children, and the expansion of alternative entry points for massive testing.
- Support to documentation and dissemination of best practices in pediatric treatment and specific study, e.g., the analysis of task shifting pediatric ART treatment for Children in CCR.
- Technical support to MOH to address transitioning care of adolescents living with HIV in the national adolescent strategy through participation/consultation in the process, particularly supporting the study of the social norms dynamic for HIV prevention among adolescents.
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