The most effective way to prevent mother-to-child transmission of HIV involves antiretroviral drugs and avoidance of breastfeeding, When women who are already on ART become pregnant, the benefits and risks of ART in the first trimester need to be considered. The benefits are a reduction in the risk of developing resistance and a decrease in the risk to the mother. The risk consists of the potential for ARV fetal toxicity. Good clinical management of HIV in pregnant women requires the support of a multidisciplinary team, including antenatal specialists, paediatricians, counsellors and community-based organisations.
Cygnus Medicare, a newly emerging healthcare organisation dedicated to providing world class healthcare in resource-limited settings, has been working in the slums of Delhi for last several years with a strong public health approach. It runs seven fully equipped hospitals where poor people are treated at subsidised rates and special programmes are held which focus on education of high risk groups, including commercial sex workers and migrant workers on HIV. Daily ante-natal clinics are held, benefitting over 5000 women in last 3 years. Ante natal clinics and delivering rooms have a dedicated team of health workers trained in education on PMTCT. A large number of awareness camps and activities are organised. The entire medical team periodically goes through trainings and orientations focusing on education and prevention of HIV/AIDS with an emphasis on PMTCT.
The organisation also has an outreach component of service delivery, through which remote slum areas are regularly visited by mobile medical vans to provide curative, diagnostic and educational services to the pregnant women.
The response and acceptance to the programme so far has been very positive. Over the last three years, there has been a large increase in the number of women attending the ante-natal clinics and camps.
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