Review of Field Experiences: Integration of Family Planning and PMTCT Services

Introduction

This report reviews field experiences with the integration of family planning and prevention of mother-to-child HIV transmission (PMTCT) services. It is hoped that this review will provide evidence and information for developing effective strategies for appropriately promoting family planning within PMTCT programmes.

Preventing unintended pregnancy among HIV-positive women through family planning services is one of the four cornerstones of a comprehensive programme for PMTCT (WHO 2002). Reducing unintended pregnancies among HIV-positive women through family planning reduces the number of children potentially orphaned when parents die of AIDS-related illnesses. It also reduces HIV-positive women's vulnerability to morbidity and mortality related to pregnancy and lactation. In addition, family planning for both HIV-positive and -negative women safeguards their health by enabling them to space births.

The global public health community - NGOs, governments, and international donors - has mobilised to design and provide essential PMTCT services: voluntary counseling and testing (VCT), infant feeding counseling, outreach to communities and families, and a short course of antiretroviral therapy. In most cases, the implementation approach has been to incorporate PMTCT into services that already reach pregnant women and women of childbearing age: antenatal care, obstetrical care, and maternal/child health.

Yet the complexity of introducing PMTCT into the real world—that is, existing health services in resource-poor settings—soon became clear. Population Council and its research partners have been addressing several key questions about PMTCT services and how well they function in field settings.