Monitoring and costs
Q.35 What would be the most feasible indicators of infant feeding and ARV usage?
An indicator on HIV and infant feeding comprised of three parts is currently being field-tested.
- Percentage of HIV-exposed infants who are exclusively breastfeeding at 3 months of age.
- Percentage of HIV-exposed infants who are replacement feeding at 3 months of age.
- Percentage of HIV-exposed infants who are mixed feeding at 3 months of age.
Feeding practices should be routinely recorded on clinic records and the child’s health card. HIV-exposed children should be weighed and their weight recorded as per national charts ideally based on WHO growth standards. The mothers of children whose growth is faltering should be counselled in infant feeding and any other health matter and referred for further assessment or treatment as necessary.
Measuring infant feeding practices at 3 months should not be mis-interpreted as recommending exclusive breastfeeding only to 3 months. The indicator is regarded as a snapshot of how mothers are feeding at that single time point. In countries that support breastfeeding with ARVs, HIV-infected women are strongly recommended to exclusively breastfeed to 6 months, continuing to at least 12 months while introducing complementary feeds.
Other relevant indicators that will help national authorities monitor services include:
- ARVs to reduce post-natal transmission: percentage of infants born to HIV-infected women (HIV-exposed infants) who are breastfeeding and covered by an ARV prophylaxis intervention to reduce the risk of HIV transmission during the breastfeeding period;
- infant ARV prophylaxis to reduce perinatal transmission: percentage of infants born to HIV-infected women (HIV-exposed infants) receiving ARV prophylaxis to reduce the risk for mother-to-child transmission during labour and delivery; and
- maternal ARV regimens to reduce peripartum transmission: percentage of HIV-infected pregnant women who received ARVs to reduce the risk for mother-to-child transmission during labour and delivery.