1. To review global and regional trends and perspectives of PMTCT as well as approaches of linking MCH (maternal child health), STI, HIV interventions
2. To provide an update on the Philippine HIV data and current response
3. To disseminate and discuss the Davao Medical Center PMTCT review findings
4. To consult with stakeholders on key issues of national PMTCT guidelines and scale up
5. To look at PMTCT as part of the Philippine’s national response
   

Rationale
The Philippine AIDS Registry reported that in 2006, a total of 37 HIV infections were caused by mother-to-child transmission (1.5%), the second largest reported mode of transmission. Based on the data, perinatal transmission was also to leading cause of HIV infection among infants and children below 14 years of age in the Philippines.

In an effort to prevent new HIV infections in women and children, the Department of Heath (DOH) in collaboration with the Davao Medical Center (DMC), with support from UNICEF, initiated a pilot PMTCT program implemented from July 16, 2007 to March 2008. The target for the PMTCT pilot implementation was to reach all pregnant women attending antenatal care (ANC) in DMC with comprehensive PMTCT services.

The Review Team was composed of Dr. Jose Gerard Belimac, Program Manager, NASPCP, Dr. Renee Faldas, STI and HIV Coordinator, DOH Region 11, Ms. Gudrun Nadoll, HIV and AIDS Specialist, UNICEF Philippines, Mr. Philip Castro, HIV and AIDS Officer, UNICEF Philippines and Dr. Madeline Salva, Programme Officer, WHO Philippines.

Dr. Belimac presented the findings of the Review Team.

Review findings and highlights

• 4,019 women attending ANC were reached by HIV education and counseling
• 1,736 (43%) of which had voluntary HIV testing
• 546 (32%) of those who were tested received their results
• None among the pregnant women tested was HIV positive
• 224 male partners of women attending ANC volunteered for HIV testing
• 30 (13%) received their results and all were negative
  

Achievements and additional findings

1. The Review Team conducted a PMTCT training package among a team of doctors, nurses, midwives, social workers and laboratory personnel
2. HIV education was part of the routine services for pregnant women accessing ANC at the Out-Patient Department
3. A protocol to implement PMTCT was developed
4. The current epidemiological context, DMC would need to test about 5000 women of the antenatal population in order to identify one HIV infection
5. Generally, ANC services were perceived to be readily accessible and affordable by clients including women of the general population, women living with HIV and women in sex work
6. The PMTCT program was recognized to be a good initiative by hospital officials and clients. It gained appreciation and acceptance from other stakeholders including the HIV positive community

1. Continuing education for DMC staff was requested to improve information delivery and skills such as pre- and post-test counseling, data delivery
2. Integration of HIV education into a broader health education package for women such as benefits of breastfeeding, STI education, maternal and child health, etc.
3. Provision of laboratory supplies such as gloves used during blood extraction
4. Strengthen procurement system of ARVs to ensure ready supply
5. Inclusion of men and women who are already living with HIV in the PMTCT interventions
6. Current discussion platforms (Local AIDS Councils, meetings) should be maximized for PMTCT interventions
   

The full report “Review of the Pilot Phase of Prevention of Mother-to-Child Transmission of HIV (PMTCT) was published in April 2008 and is available from UNICEF at 901-0170, manila@unicef.org or contact NASPCP at naspcp@yahoo.com.