Integrating HIV Counselling and Testing into Maternal, Newborn and Child Health (MNCH) weeks, Benue, Nigeria Olusoji Akinleye, HIV Specialist UNICEF Nigeria

Background Nigeria accounts for 9% of the global population of people living with HIV. She harbors 10% of new HIV infections and 30% of children living with HIV. One of the reasons for this is low coverage of PMTCT service. One of the key reasons cited for low PMTCT coverage is limited access to ANC. This approach integrated HCT into services offered to pregnant women during MNCH weeks and linkage provided into PMTCT for those positive. It also examined the acceptability of HIV testing during MNCH weeks in Benue State, a State with the highest seroprevalence.

Methodology HTC was provided as part of the services offered to during the MNCH week. 13 LGAs contributing 70% of MTCT burden selected for intervention in All 23 LGAs were covered in Preparatory activities included generating estimates of expected attendance resource requirements and development of follow up plan Intensive community mobilisation HCT services offered in accordance with national protocols, in designated MNCHW facilities – also PMTCT sites. PMM data was analysed using STRATA v. IC 11 Positive pregnant women were registered into PMTCT immediately. Appointment defaulters were tracked and supported to attend clinics.

Key findings Uptake of HTC increased significantly as a result of the integration into MNCHW compared with uptake during routine ANC in a whole year

Key findings HTC as a result of the integration yielded between 54 and 77% pregnant women who had never known their status and may have missed PMTCT entirely

Key findings Only about a third of women served has had previous HTC exposure In areas where uptake of HTC during routine ANC is low, integration into MNCHW led to appreciable increase in uptake Integration complimented routine service delivery to increase service uptake

Lessons learned Integration of HTC for pregnant women feasible as a strategy to increase access to PMTCT MNCHW gives the best results where routine ANC service uptake is low Targeting at least 70% of the estimated population of pregnant women with HTC during every round of MNCHW has potential to rapidly increase coverage 74 – 82% of positives successfully linked to PMTCT

Plans for country scale-up Integration now part of the national strategy for eMTCT Advocacy to States to replicate process National implementation guidance document disseminated Technical assistance to implementing States Sourcing and coordination of commodities Monitoring and quality assurance Coordination of reports Targeted testing for higher yield in focus

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