Call to Action (USAID/PEPFAR)
With funding from the United States Agency for International Development (USAID) and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), EGPAF implemented the eight-year Call to Action (CTA) project in 12 countries, including Swaziland (from 2004 through 2010). This service-based program aimed at scaling up prevention of mother-to-child transmission of HIV (PMTCT) services, and preventing pediatric HIV infection through research, advocacy, and prevention and treatment programs.
CTA’s work was conducted in accordance with national health policies and within national AIDS response frameworks. EGPAF-supported programs integrate HIV counseling and testing and antiretroviral (ARV) prophylaxis regimens into existing maternal and child health (MCH) services. Patient flow, HIV counseling techniques, testing algorithms, drug distribution, and other aspects of program delivery differ among countries. CTA funds have supported basic clinic improvements, essential commodities, community mobilization, training of health care workers, education to mothers on infant feeding, technical assistance for program implementation, evaluation and monitoring, and psychosocial support.
Since its inception in 2004, EGPAF’s strategy in Swaziland has been to support the PMTCT program of the Swaziland Ministry of Health (MOH) through design, development, management, monitoring, and technical support activities. Under CTA, EGPAF supported the Swaziland national PMTCT program to prevent HIV infection among infants and utilized the PMTCT program as a point of identification of HIV-positive individuals to provide care and support and access to HIV treatment services. EGPAF directly supported facilities to provide HIV testing and counseling (HTC), ARV prophylaxis for PMTCT, early infant diagnosis and treatment, psychosocial support, training of service providers, adequate counselor and laboratory technician staff, confidential counseling spaces, monitoring and evaluation systems, and strengthened MCH/family planning services. Swaziland-specific highlights include:
Increased coverage of comprehensive PMTCT, HIV care and treatment services: By the end of project, EGPAF support reached over 80% of pregnant women who gave birth in all facilities, and reached 100% coverage in MOH facilities;
Improved Early Infant Diagnosis: Early infant diagnosis in Swaziland has resulted in 83% of HIV-exposed infants receiving CTX prophylaxis at six weeks at the 47 EGPAF-supported sites;
HIV testing of pregnant women increased from 15% to 67%, and maternal and infant uptake of prophylaxis increased from 87% to 90%.