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Project Svetana: Private Sector Expansion for Prevention of Parent To Child Transmission

India has the third-highest burden of HIV infection in the world. It is estimated that there are 2.1 million people are living with HIV in India. Mother to Child transmission (MTCT) of HIV in the primary route of HIV transmission among children. In India it is estimated that around 35,255 pregnant women will need Prevention of Parent to Child Transmission (PPTCT) services annually.

The transmission of HIV from a HIV-positive mother to her child during pregnancy, labour, delivery or breastfeeding is called mother-to-child transmission. In the absence of any intervention, transmission rates range from 20% to 45%. This rate can be reduced to below 5% with effective interventions during the periods of pregnancy, labour, delivery and breastfeeding. To achieve the goal of elimination of new HIV infections among children, India has adopted WHO guidelines for preventing Parent to Child Transmission (PPTCT).

The new Sustainable Development Goals place heightened emphasis on prevention of mother-to-child transmission (PMTCT) in the context of better health for mothers and their children. Countries like Cuba, Thailand, Armenia and Belarus have eliminated mother-to-child transmission of both HIV and syphilis. Project Śvetana is a Public-Private Partnership (PPP) initiative to scale-up Prevention of Parent to Child Transmission of HIV (PPTCT) services in private health sector supported by The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM). The initiative builds on SAATHII’s prior experience engaging the private sector in Tamil Nadu, Andhra Pradesh, Telangana, Maharashtra and Karnataka with support of EGPAF and MAC/AIDS.

According to National Family Health Survey-3, the private medical sector remains the primary source of health care for 70% of households in urban areas and 63% of households in rural areas. Several reasons are cited for relying on private rather than public sector; the main reason is high quality of care provided in the public sector. Out of an estimated 27 million pregnancies in a year, 4.26 million delivered in private sector and 12.17 million women delivered in public sector. As the majority of PPTCT services are in the public health sector and a significant proportion of institutional deliveries takes place in the country's private health sector, Project Śvetana fills the critical gap of reaching pregnant women availing maternity services in the private sector.

Śvetana is implemented in 12 States and 2 Union Territories and these states are selected considering two major factors
➢ High prevalence of HIV
➢ High proportion of private sector deliveries.

The programme strengthens capacity of private sector in providing complete cascade of PPTCT services, leverage resources and facilitate shared responsibility in reaching HIV positive women with critical services.

SAATHII provides technical support and interfaces with government and private hospitals towards the implementation of project Śvetana in private health sector. Private hospitals can participate in this PPTCT project in the following ways:

PPP Model Sites: private hospitals providing mother and child health services that are willing to provide PPTCT services to HIV-positive pregnant women as per the national guidelines and to report to the government.

Model A - Market Led Model: Sites will use their own testing kits and will maintain and report in the registers issued by respective SACS / NACO. Sites will be provided with technical assistance

Model B - Market Sharing Model: Sites will use NACO test kits and will maintain and report in the registers issued by respective SACS / NACO. Sites will be provided with technical assistance.

Model C - Data Sharing Model: Sites will use their own testing kits and will maintain their own registers as per NACO formats and report as per NACO guidelines

Referral Sites are those facilities which are currently testing antenatal women as part of their existing practices and hat are willing to refer identified HIV-positive women to the government or PPP sites but not to provide PPTCT services themselves.

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  • Aug 31 2012