What Works for Women and Girls

Chapter 9.Safe Motherhood and Preventionof Vertical TransmissionA. Preventing Unintended PregnanciesB. Pre-ConceptionC. Antenatal Care:1. Testing and Counseling2. TreatmentD. DeliveryE. PostpartumTwo vital components of AIDS programming for women living with HIV are ensuring safemotherhood through access to health care during pregnancy and childbirth and ensuring accessto services to prevent vertical HIV transmission. In 2008, an estimated 1.4 million pregnantwomen living with HIV in low- and middle-income countries gave birth. Sub-Saharan Africaaccounted for 91% of all pregnant women living with HIV(UNAIDS, 2009d). Globally, of the 136 million women whogave birth each year between 2005–2010, an estimated 60million women delivered at home each year without accessto skilled attendants (Berer, 2004) and may not have accessto prevention of mother-to-child transmission (PMTCT)services. “….Significant increases in PMTCT coverageamong those at risk can only be achieved by substantiallyincreasing uptake of general ANC and delivery services….“PMTCT is too much about thebaby and not enough about themother.”—Woman in a PMTCT program,Malawi (Bwirire et al., 2008: 1997)PMTCT programmes need to be strengthened by investing more generally in maternal healthservices…” (Kasenga et al., 2009: 1). For example, less than 70% of women in the MiddleEast and North Africa region have at least one antenatal checkup, hindering PMTCT efforts205