Scaling up with other HIV interventions and services
Q.33 How can national and district health authorities manage these recommendations while ART for mothers with CD4 counts less than 350 is being scaled up?
Ideally, updated protocols on lifelong ART and ARVs as prophylaxis for pregnant women should be implemented simultaneously with revised policy and support for infant feeding and HIV. If these interventions are not consistently available at all facilities in a coordinated manner, then district health managers should prioritize actions to ensure availability of all ARV interventions and information to pregnant women and mothers to reduce HIV transmission and improve the survival of mothers and infants.
If despite these efforts, ARVs for lifelong treatment are not available, health authorities should permit health workers to provide the ARVs that are available as a temporary measure. For example, infant NVP could be used to reduce the risk of HIV transmission during pregnancy or while a mother breastfeeds. Health workers in facilities should communicate difficulties with availability of ARVs to district health teams and follow up to accelerate access to the full range of interventions.