Operationalizing the WHO 2010 Guidelines on the Prevention of Mother-to-Child Transmission (PMTCT) of HIV and Infant Feeding in Three Health Care Facilities in Tanzania

In July 2010, the World Health Organization (WHO) released new guidelines on the prevention of mother-to-child transmission (PMTCT) of HIV and infant feeding practices.  These guidelines sought to enhance the effectiveness of PMTCT by optimizing anti-retroviral (ARV) usage and infant feeding practices based on the latest scientific evidence on maximizing HIV-free survival.  In August 2011, to align with the new guidance, the Ministry of Health and Social Welfare (MOHSW) in Tanzania adopted and revised their national PMTCT and infant feeding guidelines to reflect the 2010 WHO guidelines. 

But successful large-scale implementation of the 2010 guidelines requires adaptation of existing services delivery systems to the updated guidelines.  Between July 2011 and March 2012, the USAID Health Care Improvement Project (HCI) supported three health care facilities and the Njombe Town Council Health Management Team in Tanzania to transition to the 2010 guidelines and develop a prototype of how the 2010 guidelines could be successfully operationalized in one district of Tanzania.  The goal of the activity was to generate lessons and recommendations that could be used to guide successful scale-up of the updated PMTCT and infant feeding guidelines in other settings. 

This prototype demonstrated that implementation of Option A of the WHO 2010 PMTCT and infant feeding guidelines is feasible, but requires support from all levels of the health system for successful implementation. Facility staff demonstrated that they can monitor their monthly data to identify operational challenges and come up with local solutions to improve care.  While this intervention examined operational challenges and solutions to implementing Option A of the 2010 WHO PMTCT and infant feeding guidelines, its findings are also applicable to Option B and B+.  The report’s recommendations are aimed at countries beginning Option B+ implementation.

Report Author(s): 
Elizabeth Hizza, Monica Ngonyani, Rhea Bright, Delphina Ntangeki, and Alipa Lupembe
USAID Health Care Improvement Project/URC
ASSIST publication: 
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