The seroprevalence rate of HIV among pregnant women in Africa exceeds 20% in many areas. In Kenya HIV prevalence in urban sentinel sites in 1998 among pregnant women was reported to range between 4 - 10% in low seroprevalence sites to 20 - 35% in high seroprevalence sites. With the observed trends, the percentage of pregnant women who are HIV infected is increasing at an alarming rate. Upto 90% of HIV infection in pregnant women is due to heterosexual contact.

In 1 999, 1 0% of reported AIDS cases in children were under 5 years of age, out of which 90% of the HIV infection was due to MTCT With our population estimated at 28.2 million, a birth rate of 1.2 million per annum, a seroprevalence rate of 20% in mothers, and an MTCT rate of 40%, the expected number of HIV infected infants per annum in Kenya will be approximately 100,000. This is a big number that the country will find difficult to cope with.

Transmission of HIV from infected mothers to their babies can occur during the antenatal period (10 -20%), labour and delivery (35 - 50%), and breastfeeding (40 - 50%). In order to reduce MTCT these areas must be targeted. There are measures which can be put in place in the management of expectant mothers so as to reduce the rate of transmission of HIV from an infected mother to the baby. These measures include voluntary counseling and testing (VCT), antiretroviral therapy and modification of obstetric practices and replacement feeding for the baby.

With reduction of MTCT, the following benefits will be derived:

Increase in child health and survival;
Decrease in the number of HIV infected orphans;
Opportunity to improve, expand health services and strengthen health infrastructure.

In order to achieve these set goals collaboration between health care providers and other significant stake holders must be put in place.