Abstract:
Background: Eswatini has one of the highest HIV prevalence rates in the world, with significant implications for maternal and child health. Pregnant women are particularly vulnerable to HIV, and without proper intervention, the virus can be transmitted from mother to child during pregnancy, childbirth, or breastfeeding. The HIV program was introduced to prevent new HIV infections and reduce the transmission of HIV. The HIV program seeks to reduce new HIV infections among pregnant women by incorporating HIV testing and counselling, prevention strategies, and treatment into antenatal care (ANC) services at health facilities. HIV prevention services in Eswatini includes Pre-exposure prophylaxis (PrEP), Post Exposure Prophylaxis (PEP), condoms commodities, as well as health education.
In 2010, Eswatini had a high HIV prevalence among pregnant women, estimated at around 41%. Despite challenges, Eswatini has made notable strides in HIV program implementation with a reduction in HIV new infections amongst pregnant women.
Objective of the study: To evaluate the effectiveness of the HIV program in Eswatini, specifically assessing its impact on reducing new HIV infections among pregnant women attending ANC.
Methodology: The researcher used national Antenatal care (ANC) data from 2020 to 2024 from the ministry of health’s Client Management Information System (CMIS). HIV new infection rates were calculated based on the total number of newly tested HIV positive pregnant women over the total number tested for HIV at ANC. Additionally, sero-conversion rates (the rate at which women converted from HIV-negative to HIV-positive between their first ANC visit and subsequent visits) were assessed.
Results: Data for 122,884 pregnant women attending ANC between 2020 and 2024 was analysed in STATA. Results show a significant reduction in positivity rates for women tested at ANC from 8% in 2020 to 3% in 2024. Pregnant women Sero-converting decreased by 34% from 2020 to 2024. 63% of pregnant women who sero-converted were young women aged 20-29 years.
Conclusion and recommendations: The HIV program has been effective in reducing the rate of new HIV infections among pregnant women. However, the ministry of health needs to target young women aged between 20-29 years on strengthening HIV prevention messaging, and interventions aimed at reducing the risk of contracting HIV. PrEP during the first ANC visit must be made widely available and accessible to pregnant women at high risk.
Biography:
Mr. Mbuso Siwela is a seasoned Monitoring and Evaluation expert with over 14 years of dedicated experience in the public health sector. His distinguished career spans both pivotal roles within the Ministry of Health and impactful positions at leading international NGOs. Mbuso has developed a robust expertise in designing and implementing M&E frameworks that enhance program effectiveness and drive data-informed decision-making. He is a passionate advocate for utilizing evidence to improve health outcomes and strengthen health systems. Mbuso is now seeking to apply his strategic insight and evaluative acumen to new, complex challenges in global health.
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