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Background:  National surveillance in 2001 showed an overall HIV prevalence of 29.5% in pregnant women attending government antenatal clinics (ANC). An estimated 40 000 infants acquire HIV annually in Zimbabwe. The implementation of a national program for prevention of mother-to-child transmission is therefore a national public health priority. 

Methods: National expansion of prevention of mother-to-child transmission was undertaken in 2001 through development of working partnerships between the Zimbabwe Ministry of Health and technical, financial, and implementing partners. Development of necessary tools, training, and provision of direct resources at health facility level were essential partner contributions. Data are collected by health workers and submitted manually to Ministry of Health registry of prevention of mother-to-child transmission sites. Coordination, leadership, data entry and analysis have come from the Ministry of Health.

Results : In 2002, 69 health facilities, 5% of national total, were offering prevention of mother-to-child transmission services to women attending antenatal clinics. This includes 32 district or central hospitals, 54% of national total. During 2002, 45,690 women booked at an antenatal clinic providing prevention of mother-to-child transmission services. Of these bookings, 33,724 (74%) were pre-test counseled; 22,257 (49%) of these bookings or 66% of those pre-test counseled, were tested;  22% (4861) of those tested were HIV positive. Approximately 35% of the HIV⁺ women received NVP or AZT and 29% of their infants received NVP. Of those women tested 1.5% (338) of their male partners were also tested. 

Conclusions:  Implementation of prevention of mother-to-child transmission programs have recently become a realistic possibility in resource poor countries. The Zimbabwe experience has shown that a collaborative partnership with ongoing evaluation and monitoring can develop a National program and continue to improve its function. Leadership, ownership and coordination for these programs should remain with Ministry of Health in order to maximize integration and future sustainability. The current approach of targeted short course NVP is likely to empower women, improve antenatal care, provide HIV diagnostic capacity, identify a cohort of infected persons and benefit health worker mobilization with reduction of community stigma, and pave the way for enhanced future strategies.

Keywords: PMTCT; Developing Country; Implementation