Saving babies one mother at a time:A policy analysis for preventing mother-to-child transmission of HIV in Angola

INTRODUCTION: With an HIV/AIDS treatment recommendation soon to be updated by the WHO and rates of HIV increasing in its international border regions, Angola has sufficient reason to reevaluate its approach to preventing mother-to-child transmission of HIV (PMTCT). This study analyzes different policy options for preventing mother-to-child transmission of HIV (MTCT), assesses their feasibility in the context of developing nations, and evaluates the short- and long-term implications of each. METHODS: This study used a policy analysis methodology of three approaches to PMTCT in Angola: integrating PMTCT services with existing antenatal care, shifting to the simplified treatment regimen of Option B+, and incorporating community health workers into PMTCT programs. The seven variables used in this analysis, which were repeatedly found in the literature, include the following: decrease partner-to-partner transmission of HIV, decrease MTCT, plausible implementation of policy option, sustained adherence to treatment, outreach to non-clinical populations, cost-effectiveness, and increased testing in mothers. The three policy options were evaluated using a decision matrix that scored policy outcomes on each of these variables. RESULTS: Variables in the decision matrix were weighted according to relative importance, yielding a combined total of 57. The antenatal integration policy scored 36, followed by Option B+ (31), and the community health worker policy (23). CONCLUSION: According to the analysis of the policy options, integration of PMTCT with antenatal care is the option with the greatest likelihood of success in decreasing MTCT rates in Angola.