Indicator 4.5: "Knowledge of prevention of mother to child transmission of HIV"
The percent of respondents who report that maternal to child transmission of HIV can be prevented through anti-retroviral therapy during pregnancy and avoiding breastfeeding.
UNAIDS general population survey; DHS AIDS module; FHI BSS; MICS (UNICEF).
What It Measures
This indicator looks at whether women and men know of methods to prevent the transmission of HIV from mother to child. In this field as in the field of prevention of sexual transmission, knowledge is a prerequisite for decision-making and intervention, although by no means sufficient to ensure it.
This indicator measures people's knowledge of methods to prevent transmission from mother to child through anti-retroviral therapy and by avoiding breastfeeding. Men's knowledge in this area is also important, not least because in many societies men dominate decisions about family formation and childbearing, so the indicator is constructed for both sexes. Since most IEC campaigns in this area are aimed at women, programme managers will want to monitor their effectiveness by disaggregating the indicator by gender.
How to Measure It
Respondents in a population survey are asked a series of questions about the transmission and prevention of HIV (see Knowledge Indicators 1 and 2). Among these are questions about whether HIV can be transmitted from mother to child, and about means of preventing mother to child transmission.
The indicator is the number of respondents who say that HIV transmission from women who have tested HIV positive can be prevented by the mother taking drugs during pregnancy, and by the mother avoiding breastfeeding, divided by the total number of respondents to the survey.
Strengths and Limitations
This indicator presupposes that efforts are being made to educate women about maternal to child transmission of HIV, and that information about prevention forms part of that education.
The indicator does not distinguish in its denominator between those who know about maternal to child transmission and those who do not, since people who do not know that it can be prevented are definitely among those who have not been reached with information about prevention methods. The questioning sequence does, however, allow countries to construct an indicator of knowledge about HIV transmission from mother to child should they wish.
It is the knowledge that transmission from mother to child can be prevented that is likely to shape women's care-seeking and breastfeeding behaviour. A pregnant woman who simply knows that HIV can be passed on to her child is less likely to seek to know her HIV status than a pregnant woman who knows that transmission of HIV to her child can be avoided.
In many countries in Latin America and elsewhere, the demand for prevention has driven a radical improvement in service provision for pregnant women with HIV. Such a demand cannot arise unless people know that therapy exists and can be effective in reducing transmission of HIV to infants.