By Ivy Maloy
Mother-to-child HIV transmission has substantially declined since the scale-up of prevention programs in Kenya.
The global community has committed itself to eliminating mother-to-child transmission (EMTCT) of HIV and Syphilis as a public priority. The EMTCT initiative focuses on a harmonized approach to improving health outcomes for mothers and children. In 2007 World Health Organization(WHO) launched an initiative for the global elimination of congenital syphilis, and progress is being made in increasing access to syphilis testing and treatment for pregnant women. Kenya adopted the additional WHO modifications in 2016.
This transmission can happen during pregnancy, labour, delivery or breastfeeding. In the absence of any intervention, transmission rates range from 15% to 45%. This rate can be reduced to below 5% with effective interventions during the periods of pregnancy, labour, delivery and breastfeeding. Kenya has an estimated 13,000 new infant HIV infections that occur annually. The simple and effective interventions available include the prevention of new infections among women of reproductive age, prevention of unintended pregnancies, antenatal screening, and Antiretroviral treatment for HIV positive pregnant women.
In March 2021, the First Lady Margaret Kenyata called for renewed commitment to the elimination of mother-to-child transmission of HIV and Syphilis in the country. The First Lady emphasized the need for concerted efforts to accelerate the progress made towards achieving EMTCT through promotion of stronger partnerships.
Available records show that Kenya has made progress on the elimination of mother-to-child transmission of HIV and curbing maternal mortality with new HIV infections reducing by 47 percent from 12,826 in 2013 to 6,806 in 2020. First Lady Margaret Kenyatta in 2017 during a Beyond Zero Summit launched the Kenya Framework for the Elimination of Mother-to-Child Transmission of HIV and Syphilis 2016-2021 that contributed to the achievement. The First Lady commended the innovative implementation of the Kenya EMTCT Framework adopted by counties through the county business plan model.
“So far, we have successfully launched 11 county business plans. It is my hope that we, as partners, will commit to resourcing and supporting the remaining county governments on their respective journeys.” First lady, Margaret Kenyatta.
Kenya is now aiming to ensure there is zero mother-to-child HIV transmission in Kenya. This is after the country missed its 2021 targets of ensuring the rates of transmission are below 5%. Kenya had set targets to get validated on the elimination of mother-to-child transmission of HIV and ensuring 95% coverage of maternal interventions. Though these targets were slightly missed, Kenya has managed to reduce the number of new infections among children by more than 50 percent.
It is evident that Kenyan hospitals and the Ministry of Health(MOH) are moving in the right direction with regard to the EMTCT coverage, provision of the recommended methods and earlier timing of the Antiretroviral Therapy(ART) initiation. Compared to earlier analyses, a higher proportion of infants received HIV prophylaxis, as well as HIV testing. Most importantly, the proportion of infants infected with HIV has decreased. This is a promising step toward the actualization of elimination of pediatric HIV.