Dr. Jim Shelton's Pearls "Pearl" for the week of February 13, 2004

Effect of ART on Ongoing MCH Efforts

Q:I’ve heard WHO sees maternal child clinics as "key entry points" for antiretroviral therapy. Doesn’t that risk overburdening fragile delivery systems so common in developing countries, and potentially weakening important MCH efforts including family planning?

A:It could. Or it could be an opportunity to strengthen those activities. Here are three good reasons why ARV efforts as they are deployed, should specifically undertake to strengthen these MCH services.

1. The value such services may have for the ARV treatment directly (e.g. contraception to potentially avoid teratogenicity of the ARV, good counseling in antenatal care so that ARVs are taken appropriately to prevent maternal-to-child transmission.)

2. Stronger MCH programs to provide a better "draw" to find appropriate candidates for ART.

3. Ethical and programmatic concern about potentially jeopardizing these other important public health services

Reference: WHO. Entry points to antiretroviral treatment. WHO/HIV/2003.16. Geneva, 2003.



The "Pearls" offer answers to commonly asked questions about family planning. These "Pearls" are prepared by Dr. James D. Shelton, Senior Medical Scientist, Office of Population, United States Agency for International Development (USAID)