Number/percent of health providers trained in PMTCT
Number or percentage of health care workers who successfully completed a training program in preventing mother-to-child transmission (PMTCT) of HIV within the reporting period. Types of training can include: in-service; continuing education; on-the-job training; computer based training; and distance learning (PEPFAR, 2009). Individuals will not count as having successfully completed their training unless they meet the minimum requirements as defined by international or national standards. For a comprehensive manual on PMTCT training developed by WHO, CDC, U.S. Department of Health and Human Services and the Global AIDS Program, see WHO et al. (2008).
As a percentage, this indicator is calculated as:
(Number of health care workers trained in PMTCT within reporting period / Total number of health care workers in facilities that provide health care for women and infants) x 100
An individual should only be counted after they have completed the training. Individuals that are mid-way through a training course should be counted in the next reporting period. Individuals attending more than one training during a reporting period should be counted only once.
Types of health care provided to women and infants include reproductive health and family planning, antenatal care, labor and delivery care, and postpartum care for mothers and infants. Public, private, and non-governmental facilities should be included. PEPFAR (2009) includes an indicator under the health system strengthening subarea for HIV/AIDS training specific to male circumcision and pediatrics that also provides a good overview of training indicator measurement, uses and issues.
PMTCT training data should be collected continuously from training facilities and programs, and aggregated periodically for the purposes of program management, review, and district and country-level reporting. The denominator can be an estimate of the total number of healthcare workers in facilities providing services to women and infants; or both the numerator and denominator can be based on counts of those trained and the total counts from a subset of facilities selected for evaluation. Data can be disaggregated by type of facilities, districts, and urban/rural location.
Health care facility and program reports; human resource information systems; educational institutions; professional associations; ministry of education; labor or health departments.
This indicator tells us the number and percent of trained health care workers who are available to support the mitigation of the HIV/AIDS epidemic through PMTCT in a given reporting period and allows comparison of trends over time. Ideally, all or a very high proportion of health care workers providing services for mothers and their infants should be trained in PMTCT. Based on these data, countries can determine how to prioritize investments in the education and on-going training of health care workers to maximize workforce expansion and capacity building for PMTCT.
Presently, women account for nearly half of all people living with HIV and 76 percent of young people (15-24 years) living with HIV are female (UNFPA 2011). Infants of women with HIV can become infected during pregnancy, labor and delivery, and through breastfeeding. Children account for more than ten percent of all new HIV infections and most of these are through mother-to-child transmission (IATT, 2007). Many countries have programs for PMTCT and are scaling up efforts to provide comprehensive prevention, care and support for women, children and their families. Current WHO recommendations for a multifaceted approach to PMTCT include: (1) primary prevention of new infections; (2) prevention of unintended pregnancies among women living with HIV; (3) prevention of transmission of HIV from mothers to their children; and (4) care, treatment, and support for mothers living with HIV and their children and families. Specific guidelines for use of antiretrovirals (ARV) for PMTCT call for earlier ARV therapy, longer provision of ARV prophylaxis, and provision of ARVs to the mother or child to reduce the risk of HIV transmission during breastfeeding. For more details on the WHO PMTCT recommendations, see WHO (2009). USAID (2010) is training patients (expert clients) at PMTCT service sites to help other pregnant women better understand and access HIV/AIDS services. Given the scaling up and expanding recommendations, the availability of sufficient numbers of health care workers trained in PMTCT is vital. For further technical guidance on interventions and indicators for PMTCT, see UNAIDS (2010).
This indicator does not measure the quality of the training, nor does it measure the outcomes of the training in terms of the competencies of individuals trained or their job performance. Evaluators may wish to complement this indicator with Number/percent of trainees who have mastered relevant knowledge, found in the Training section of this database.
This indicator does not measure the placement or retention in the health workforce of trained individuals. While PMTCT training is an essential component of human resources for health, programs should plan it in the context of effective human resources management and an overall human resources for health strategy.
training, newborn (NB), HIV/AIDS, safe motherhood (SM)
Interagency Task Team (IATT) on Prevention of HIV Infection in Pregnant Women, Mothers and their Children, 2007, Guidance on the Global Scale-up of the Prevention of Mother-to-Child Transmission of HIV, Geneva, WHO. http://whqlibdoc.who.int/publications/2007/9789241596015_eng.pdf
PEPFAR, 2009, The President’s Emergency Plan for AIDS Relief: Next Generation Indicators Reference Guide, Washington, DC: USAID/PEPFAR. http://pdf.usaid.gov/pdf_docs/Pcaac330.pdf
UNAIDS, 2010, Prevention of Mother-To-Child Transmission of HIV (PMTCT): Technical Guidance Note for Global Fund HIV Proposals, Geneva: UNAIDS.
UNFPA, 2011, Preventing HIV/AIDS: Protecting the Health of Women and Girls, New York: UNFPA. http://www.unfpa.org/hiv/women.htm
USAID, 2009, An Early Intervention: Prevention of Mother-to-child Transmission of HIV, Technical Issue Brief, Washington D.C.: USIAD. http://www.who.int/hiv/pub/mtct/mtct_key_mess.pdf
WHO/CDC/USHHS/GAP, 2008, Prevention of Mother-to-Child Transmission of HIV: Generic training package draft participant manual, Washington, DC: USHHS.
WHO, 2009, New WHO recommendations: Preventing Mother-to-Child Transmission, Geneva: WHO. http://www.who.int/hiv/pub/mtct/mtct_key_mess.pdf