Government-funded programmes and services for vulnerable - Unicef
Government-funded programmes and services for vulnerable - Unicef Government-funded programmes and services for vulnerable - Unicef
Department of Health ➔ Family planning must be discussed with her and she should be encouraged to have her infant tested. If she is not on lifelong ART, then at the sixweek post-partum visit her CD4 count must be measured, she must be clinically staged and screened for TB. If her CD4 cell count is higher than 200, she must be referred for wellness services xxviii and family planning. If her CD cell count is less than 200 or she is at stages 3 or 4 of disease progression, she must urgently be referred for lifelong ART; unknown HIV status should be offered testing and counselling before discharge (and at post-natal care visits) to ensure that their infants get ARV prophylaxis if the mother’s test is positive; judged to be in the first 72 hours of life should be given infant NVP as soon as possible and then daily for six weeks or until testing of the mother/infant confirms the absence of HIV exposure. ➔ 115
Government-funded programmes and services for vulnerable children in SA ➔ Treatment of HIV infection in children and adults xxix Every infant and child that is exposed to and/or infected with HIV has a right to comprehensive therapy which includes PEP, counselling and support, nutritional support, supplementation and an extended immunisation schedule. Counselling and support and nutritional support for HIV-infected children are dealt with under the preceding sections on nutritional programmes, PMTCT and testing and counselling. The extended immunisation schedule for HIVinfected children is dealt with below under the IMCI programme and immunisations. Prevention and treatment for HIVexposed and/or -infected infants under the age of one year includes: to all HIV-exposed infants (infant NVP) from birth up until the age of six weeks; as a prophylaxis against opportunistic infections for all HIVexposed and HIV+ children. CTX is given to all HIV-exposed infants from six weeks Targeted beneficiaries All HIV-exposed infants younger than one year of age All HIV+ infants and children younger than one year HIV+ children older than one, but younger than 15 at stages 3 or 4 of the disease or who have a CD4 count below 750 if the child is younger than five, or below 350 cells/mm³ if the child is older than five HIV+ children between the ages of 15 and 18 (adolescents) and HIV+ adults with a CD4 count of less than 200 or at clinical stage 4 HIV+ pregnant adolescents and women and all HIV+ adolescents and adults with TB with a CD4 count less than 350 All HIV+ people older than 15 Primary, secondary and tertiary health facilities Primary healthcare facilities (clinics) are now expected to be able to initiate and provide ART for both adults and children. xxx Up until 2010, ART could only be initiated by doctors at accredited sites. It can now be initiated and provided by nurses at primary healthcare facilities, with the objective of caring for an increasing number of children and pregnant women at primary healthcare level. ➔ 116
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Department of Health<br />
➔<br />
Family planning must<br />
be discussed with her<br />
<strong>and</strong> she should be<br />
encouraged to have her<br />
infant tested.<br />
If she is not on lifelong<br />
ART, then at the sixweek<br />
post-partum visit<br />
her CD4 count must be<br />
measured, she must be<br />
clinically staged <strong>and</strong><br />
screened <strong>for</strong> TB.<br />
If her CD4 cell count<br />
is higher than 200, she<br />
must be referred <strong>for</strong><br />
wellness <strong>services</strong> xxviii <strong>and</strong><br />
family planning.<br />
If her CD cell count is<br />
less than 200 or she is at<br />
stages 3 or 4 of disease<br />
progression, she must<br />
urgently be referred <strong>for</strong><br />
lifelong ART;<br />
<br />
unknown HIV status<br />
should be offered<br />
testing <strong>and</strong> counselling<br />
be<strong>for</strong>e discharge<br />
(<strong>and</strong> at post-natal<br />
care visits) to ensure<br />
that their infants get<br />
ARV prophylaxis if<br />
the mother’s test is<br />
positive;<br />
<br />
judged to be in the<br />
first 72 hours of life<br />
should be given<br />
infant NVP as soon<br />
as possible <strong>and</strong> then<br />
daily <strong>for</strong> six weeks<br />
or until testing of the<br />
mother/infant confirms<br />
the absence of HIV<br />
exposure.<br />
➔<br />
115
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