Hareg PMTCT Project

Category 2

The Hareg Project followed the approach that PMTCT programs succeed when they are well-integrated into antenatal care (ANC) and maternal and child health (MCH) services, and utilize existing resources from the national level to the community level. This holistic approach mobilized community-based organizations, community leaders, traditional birth attendants and local NGOs in the fight against HIV/AIDS. IntraHealth focused on establishing comprehensive PMTCT services at the health center level, mobilized communities to decrease stigma and discrimination, and encouraged women to utilize health services in an effort to reduce transmission of HIV.

Goal of the Practice
  • Target antenatal care as the entry point
  • Strengthen connections between communities and health facilities to increase use of preventive measures and services
  • Strengthen regional and community teams, and a national PMTCT health management information system
Core Components
  • On-the-job training for service providers at the facility level
  • Training Regional Health Bureau staff members in how to manage PMTCT programs
  • Supportive supervision at Health Centers
  • Quarterly review meetings with providers, facility managers, woreda health officials, HAPCO heads and community promoters
Noteworthy Results
  • The number of new ANC clients increased
  • The number of new ANC clients who were HIV tested and received their results increased
  • Nevirapine was accepted by approximately 46% of mothers who delivered during the course of the project
  • The number of referrals of HIV-positive children for ART initiation achieved surpassed the projected target by 132%
  • The MoH has declared PMTCT a regular health center service to be provided in all health facilities within two years
Lessons Learned
  • Low continued use of Cotrimoxazole in infants due to the difficulty women face in returning monthly to the health centers and inconsistent provision of the drug - implications for community outreach and supply aspects of the program
  • Involvement of regional and district (woreda) staff crucial to ensuring management of the program
  • Innovative strategies such as health extension worker training and mother's support groups which contributed to the promotion of PMTCT in communities, countering stigma and discrimination
Focus Areas
Care and Support
Implemented By
Participating Organization
  • Ethiopia Ministry of Health (MoH)
  • Ethiopia National HIV/AIDS Prevention and Control Office (HAPCO)
  • Columbia University
  • Johns Hopkins University's Center for Communication Programs (JHU/CCP)
  • University of Washington/The International Training and Education Center on HIV/AIDS (I-TECH)
  • Johns Hopkins Program for International Education in Gynecology and Obstetrics (JHPIEGO)
  • Family Health International (FHI)
  • Management Sciences for Health/Rationale Pharmaceutical Management Plus (MSH/PRM+)
Clinic/Health facility
Target Population
  • Children (ages 2-12)
  • Infants (newborn to 24 months)
  • Males
  • Females
  • General Public
  • Workforce
> 50000
Implementation Years
09/2004 - 12/2007