By Michael Gwarisa
Zimbabwe’s goal to eliminate mother-to-child transmission (MTCT) of HIV, syphilis, and hepatitis B virus by 2026 could be in jeopardy as a significant number of pregnant women are still not registering for antenatal care (ANC).
Recent data reveals that the country recorded 522,786 pregnancies last year. However, 16% of these women, approximately 83,000, did not register for ANC services, which include HIV testing, antiretroviral therapy (ART) initiation, and counseling.
The country adopted the Triple Elimination Roadmap for the prevention of MTCT of HIV, syphilis, and hepatitis B in December 2023, with the goal of reducing mother-to-child transmission of HIV to less than 5% by 2026.
Out of the 522,786 pregnancies recorded last year, only 441,303 women booked their pregnancies, translating to 84% coverage. Our target is 95-95-95, meaning we missed our goal last year as 16% of pregnant women did not attend ANC,” said Justice Nyakura, the National Early Infant Diagnosis Officer in the Ministry of Health.
He added that they are concerned about the health status of women who did not book for ANC, as they could have unknowingly transmitted any of the three diseases to their children.
“This is a major challenge in terms of PMTCT. While we strongly recommend that every pregnant woman books at ANC, we also respect their rights and do not force anyone to undergo HIV testing,” he said.
Nyakura further emphasized that the risk of HIV transmission increases during childbirth, making it essential to monitor mothers closely.
“PMTCT interventions should start from pregnancy and continue through breastfeeding and post-breastfeeding. At six weeks, our MTCT rate stands at 5.4%, and by the end of breastfeeding, it rises to 7.35%. This means that of the children born to HIV-positive mothers, 5.49% test positive at six weeks, and by the end of breastfeeding, the number increases to 7.35%,” he explained.
Zimbabwe has 64 districts, but disaggregated ANC data shows that more than half of them still have ANC coverage below 90%. However, the country has made significant progress in HIV testing, achieving 99% coverage, with most women who book for ANC successfully initiated on treatment.
“We are currently at 92% treatment coverage, which is commendable. Our focus is on ensuring that every woman who tests positive at ANC is promptly initiated on ART,” Nyakura said.
Meanwhile, Zimbabwe is working towards World Health Organization (WHO) Gold Tier Certification for Triple Elimination. However, the gold category has stringent requirements, including 95% ANC coverage, 95% HIV and syphilis testing in ANC and 95% hepatitis B testing
For Gold Tier certification, a country must sustain elimination targets for at least three consecutive years, maintain a strong health system that ensures high service coverage and equity, implement a robust monitoring system to track EMTCT progress, and uphold low MTCT rates with high vaccination coverage.
“About 7,496 women were diagnosed with syphilis at ANC, and we managed to put 6,963 on treatment,” Nyakura noted.
