Background According to Kenya’s Demographic Health Survey (KDHS) 2009, 6.2% of 39 million residents are HIV-infected. Of 1.5 million annual pregnancies, 93,000 are HIV-infected. Without interventions, 35–40% of their infants would be infected. We describe Kenya’s progress towards eMTCT.
Methods Kenya has Prevention of MTCT Technical Working Group with members from Ministry of Health, PEPFAR agencies, UN family, implementing partners focusing on guideline and policy development. From single dose nevirapine in 2005 to Option A in 2010, Kenya is rolling out new guidelines with Option B+, elimination framework, mentor mother programmes, health systems strengthening activities, community strategies, private partnerships, and maternal/child health integration of anti-retroviral (ARV) therapy. Appointment diaries, mobile telephones, home visits are retention strategies. Longitudinal antenatal registers, mother-baby booklet, HIV-Exposed Infant (HEI) registers for easy identification and tracking of mothers and infants used. HEI are identified and tested at 6–8 weeks through PCR. Capacity building, infrastructure, supportive supervision, commodity security, safe infant feeding are monitored. EID dashboard (website) shows EID results from all PCR labs in real-time.
Results Kenya demonstrates tremendous progress from 2005 to 2012: PMTCT sites from 926 to 4,500; pregnant women counselled and tested for HIV from 318,000 to 1.2 million (80% coverage); ARV prophylaxis from 52% to 90% of HIV-positives identified; CD4 access from < 50% to > 72%; over 57% attending 4+ antenatal visits. Exclusive breastfeeding for 6 months increased from 3.2% to 32% (KDHS). The number of infants tested by PCR increased from 4,500 in 2006 to 64,000 in 2011. PCR positivity has dropped from 11.2% (2010) to 7.6% (2011) and 5.2% (2012) at 6-week testing of infants.
Conclusion Use of more efficacious regimen including Option B+, integration of services, implementation of new guidelines and eMTCT framework should enable Kenya to attain a transmission rate less than 5% by 2015.
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