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PREVENTING PARENT TO CHILD TRANSMISSION (PPTCT)
 
 
Prevention of Parent-To-Child Transmission (PPTCT) is a specific programme that provides a comprehensive, family-cantered spectrum of support and clinical services along with other public health initiatives, to prevent the transmission of HIV from parents to their baby.  
Every year around 6 lakh new-born children get infected with the HIV virus worldwide. The most important source of infection in infants is the transmission of HIV virus from the mother to the child, during pregnancy or childbirth, or at the time of breast feeding. A pregnant woman with HIV infection has an approximately 30% chance of passing the virus on to her newborn baby.

TANSACS provides a comprehensive, low cost PPTCT programme of short-term preventive medicine and treatment for the mother as well as the baby. It offers a safe delivery practice, safe infant feeding practice, counselling and support services that is expected to significantly reduce the number of HIV infected infants in Tamil Nadu.

PPTCT pilot project was started in Tamil Nadu in 2000, at a few centres in Chennai, which eventually expanded into a programme offered in all medical colleges. By 2005, the service was made available in 260 centres in medical college hospitals, taluk hospitals and upgraded PHCs.

 Tamil Nadu’s PPTCT programme is recognised by NACO as the model program for the entire country, with 10.3 lakh (in 2009) pregnant women covered under the programme and 91% ( in 2009) of the Mother-Baby pair were administered Nevirapine. Among the states, this is quantitatively the highest and qualitatively the best HIV service coverage in the country.
The PPTCT programme comprises:
Ante-Natal Check-up registration at health centres using Mother-Child Health card
HIV Counselling, Group Counselling on – Nutrition, Health & Hygiene, importance of regular antenatal check-up, motivation for institutional delivery, immunization, Safe Sex Methods
Redribbon HIV testing of ante-natal mothers
Redribbon Partner counselling and Testing
Redribbon If positive, compulsory ART registration at the ART centre and Pre-ART preparation, CD4 count
Redribbon Relevant referrals - TB, STI
Redribbon Enrolment and Line listing positive mothers for offering follow up services.
Redribbon Choices offered to the positive mothers – Termination of pregnancy, Continuation of pregnancy
Redribbon Planning the delivery with the mother and her family – Place of delivery, mode of delivery (vaginal/caesarean - If the mother decides to deliver in another district, linkages with the respective district PPTCT and NGO is ensured by introduction to the block-in-charge, and Out-Reach Worker (ORW) for further follow-up
Redribbon ART prophylaxis – Single dose Nevarapine to the Mother at the onset of labour pain and Baby on birth
Redribbon Follow-up every month by ORW, using the ‘ORW Blue book’ - Regular home-visits by the ORW with consent of the mother/family. The Out-Reach Workers accompany the mother during labour to hospital
 
Redribbon Ensuring Nevirapine administration to mother and baby
Redribbon Counselling for family planning services
Redribbon Supply of Disposable Delivery Kits during delivery
Redribbon Referrals to Community Care Centers & Drop-in-centres, if necessary
Redribbon Counselling on infant feeding practices to mother and family
Redribbon Linkages to welfare schemes in the area
Redribbon Early Infant Diagnosis (baby tested from 6 weeks onwards up to 18 months)
Redribbon Supplementary feeding related financial assistance
 
Ensure the Co-trimoxazole Therapy for baby
Arrows Follow up for the baby up to 18 months of age
Arrows Ensure ART services to infected children
 
The Centres:
At present PPTCT services are being offered in 786 centres in government facilities in the state and in 77 private hospitals as part of a Public Private Partnership (PPP) initiative.
 
PPP:
The private hospitals identified for PPTCT services should be in areas that house at least 75,000 people. It should have at least 10 beds and conduct at least 10 deliveries per month.
 
The private hospital should make available 24x7 an Operation theatre, dispensary, laboratory and consultant services. TANSACS’ HIV/AIDS-PPTCT services in private hospitals will match its facility-integrated government PHC services.
 
 
As many as 10.38 lakh pregnant women were covered by the PPTCT programme in the year 2009.