BAYELSA STATE Operational Plan for Elimination of Mother-to-Child Transmission of HIV 2013 – 2015 BAYELSA STATE Operational Plan for Elimination of Mother-to-Child Transmission of HIV 2013 – 2015 This publication may be freely reviewed, quoted, reproduced, or translated, in full or in part, provided the source is acknowledged. The mention of specific organizations does not imply endorsement nor suggest that they are recommended by the Bayelsa State Ministry of Health over others of a similar nature not mentioned. First edition copyright © 2013 Bayelsa State Ministry of Health, Nigeria Citation: Bayelsa State Ministry of Health, FHI 360 and UNAIDS. 2013. Operational Plan for the Elimination of Mother-to-Child Transmission of HIV, Nigeria: Bayelsa State Ministry of Health FHI 360and UNAIDS. The Bayelsa State Operational Plan for the Elimination of Mother-to-Child Transmission of HIV was supported in part by the U.S. Agency for International Development (USAID) and United Nations Joint Programme on AIDS (UNAIDS). FHI 360 and UNAIDS provided technical assistance to the Bayelsa State Government during development of the plan. Financial assistance was provided by USAID under the terms of the Cooperative Agreement AID-620-A-00002, of the Strengthening Integrated Delivery of HIV/AIDS Services Project. This report does not necessarily reflect the views of UNAIDS, FHI 360, USAID or the United States Government. Table of Contents Foreword............................................................................................................................................................................. iii Acknowledgements ......................................................................................................................................................... iv List of Contributors .......................................................................................................................................................... v Acronyms ............................................................................................................................................................................ vi EXECUTIVE SUMMARY ....................................................................................................................................................1 1 INTRODUCTION ..........................................................................................................................................................2 1.1 Nigeria HIV Situational Analysis ....................................................................................................................................2 1.2 Nigeria PMTCT Situation Analysis ................................................................................................................................2 1.3 Accelerating Scale-up of PMTCT in 12+1 States ...................................................................................................3 1.4 Funding Opportunities ......................................................................................................................................................4 2 BAYELSA STATE ..........................................................................................................................................................5 2.1 State Profile ............................................................................................................................................................................5 2.2 HIV/AIDS in Bayelsa State ...............................................................................................................................................5 2.3 PMTCT in Bayelsa State ....................................................................................................................................................5 3 PROCESS ................................................................................................................................................................. 7 4 STATE-WIDE RAPID HEALTH FACILITY ASSESSMENT ..................................................................................8 4.1 Methodology ..........................................................................................................................................................................8 4.2 Findings ....................................................................................................................................................................................9 5 BAYELSA STATE EMTCT OPERATIONAL PLAN ............................................................................................... 11 5.1 Rationale .................................................................................................................................................................................11 5.2 Goal and objectives ............................................................................................................................................................11 5.3 Scale up Targets .................................................................................................................................................................12 5.4 Implementation Approaches ........................................................................................................................................13 6 BENEFITS & IMPACT OF EX-PANDED ACCESS TO PMTCT SERVICES IN BAYELSA STATE ............... 16 7 IMPLEMENTATION PLAN ....................................................................................................................................... 19 8 MONITORING AND EVALUATION PLAN ...........................................................................................................38 8.1 Bayelsa State PMTCT M&E Framework .................................................................................................................39 9 SUMMARY BUDGET ................................................................................................................................................40 10 APPENDIX - DETAILED BUDGET ......................................................................................................................... 42 OPERATIONAL PLAN FOR ELIMINATION OF MOTHER-TO-CHILD TRANSMISSION OF HIV I List of Tables Table 1: 12+1 States arranged in order of 2010 HSS prevalence** ..................................................................................3 Table 2: Uptake of PMTCT Services in Bayelsa State ...........................................................................................................6 Table 3: Characteristics of facilities providing ANC with no PMTCT ARV support .................................................8 Table 4: LGA HIV burden and PMTCT Service Coverage Gap ........................................................................................ 10 Table 5: State Level Targets for the Operational Plan ........................................................................................................12 Table 6: Potential Impact of Meeting PMTCT Targets in Bayelsa State by 2015 ...................................................16 Table 7: Targets of the Indicators for Bayelsa State ...........................................................................................................38 Table 8: Bayelsa State Summary Budget by Focus Area.................................................................................................. 40 List of Figures Figure 1: Trend of State HIV Prevalence among Pregnant Women Compared to the National (Source: Federal MOH Technical Report 2010) .................................................................................................................................6 II BAYELSA STATE Foreword As the world marches towards an HIV/AIDS free generation, it is imperative that every government, na- tion, community and person is engaged towards achieving zero new infections, zero AIDS related deaths and zero stigma and discrimination of people living with HIV (PLHIV) and those affected by HIV/AIDS. Bayelsa State is one of the 12+1 states that contribute 70% of Nigeria’s burden of mother-to-child transmission of HIV (MTCT). With an HIV prevalence rate of 9.1%, approximately every one in 10 pregnant persons in Bayelsa State is HIV positive, yet coverage of prevention of mother-to-child transmission of HIV (PMTCT) services had been low. Only 38 of the 226 health facilities in the state provide PMTCT related services. Consequently, state performance relative to key PMTCT indicators shows only 1-6% achievements. This plan was developed using inputs from assessments conducted in 2013. Supported by FHI 360 and with funding from USAID, we embarked on a state-wide rapid health facility assessment. The Saving One Million Lives team from the Federal Ministry of Health also supported us to conduct a PMTCT diagnostics - the PMTCT Deep Dive. These assessments helped us to identify key areas to focus our resources on towards eMTCT. We are buoyed by the fact that if we achieve the targets set in this operational plan by 2015, we would have averted 3,813 pregnancies among HIV-positive women; averted 6,139 new HIV infections among HIV-exposed infants averted 2,310 infant deaths among HIV-exposed infants. All these will contribute to 372,888 DALYs saved. This is a good reason to invest and we believe that this return on investment is well worth our efforts. The State Government has therefore