Coordinating in the clinic
Q.46 For mothers on lifelong ART, how would dispensing of maternal ARVs link with counselling and support for infant feeding?
The manner in which health services organize the dispensing of ARVs and support for infant feeding will vary according to local circumstances (e.g. high and low HIV prevalence settings and prevalence of breastfeeding); services available (such as integrated family treatment sites or decentralized approaches to integrate dispensing of ARV interventions into MCH services, and using existing routine health opportunities such as immunization attendance). Whatever the structure, health managers should consider technical issues such as:
- the shelf life of ARVs for both the mother and infant and local dispensing routines;
- the intensity of support needed by mothers to improve infant feeding practices at different ages of the infant (e.g. additional support may be anticipated when the infant is reaching 6 months of age when complementary feeds should be introduced, or at 12 months when breastfeeding might stop);
- the needs of mothers, such as regular CD4 testing every 6 months and family planning counselling;
- other routine child visits, e.g. for immunizations.