NEPWHAN’s PMTCT Implementation Model under the N-THRIP GC7 Project

The Prevention of Mother-to-Child Transmission (PMTCT) programme at NEPWHAN combines evidence-based interventions with community-led support to ensure that pregnant and breastfeeding women living with HIV—and their infants—receive comprehensive care from diagnosis to early childhood. Through the Global Fund N-THRIP GC7 Project, NEPWHAN strengthens PMTCT services across health facilities and communities nationwide using a mentor mother–led model that improves treatment adherence, reduces infant HIV infections, and enhances positive health outcomes for families.

pmtct program impact

NEPWHAN has strengthened PMTCT outcomes nationwide by deploying trained Mentor Mothers, improving linkage to care, increasing retention of pregnant and breastfeeding women living with HIV, and ensuring timely early infant diagnosis across facility and community settings. Through community-led support, strong partnerships with health facilities, and rigorous follow-up systems, NEPWHAN has significantly reduced treatment interruption, expanded access to lifesaving services, and advanced Nigeria’s progress toward eliminating mother-to-child transmission of HIV.

25,350

Out of 30,992 people living with HIV have been newly enrolled (or restarted) on treatment after default across the intervention states.

1,912

HIV-positive pregnant women in unconventional setting have been linked to care

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The Network of People Living with HIV/AIDS in Nigeria (NEPWHAN) is implementing an impactful Prevention of Mother-to-Child Transmission (PMTCT) model under the Global Fund (GC7) N-THRIP Project, designed to strengthen treatment, care, and support for pregnant and breastfeeding women living with HIV (PBFW) and their infants.

Although Nigeria has made progress in HIV treatment coverage, children, adolescents, and pregnant women remain underserved. NEPWHAN’s PMTCT model responds to these gaps by deploying a community-driven, mentor mother–led approach to ensure that HIV-positive pregnant women initiate treatment early, remain engaged in care, and that HIV-exposed infants (HEI) receive timely prophylaxis and early infant diagnosis (EID).

The PMTCT component is implemented at facility level in Anambra, Ebonyi, Gombe, and Kwara States, and at the community level across all 36 States and the FCT, using structured coordination with TB Sub-Recipients (SRs), Traditional Birth Attendants (TBAs), Community Birth Centers (CBCs), and national HIV program stakeholders.

NEPWHAN’s Mentor Mother–Led PMTCT Model

Mentor Mothers (MMs) are HIV-positive women who successfully prevented HIV transmission to their children and are trained to serve as peer counselors and community mentors. The national HIV guidelines endorse their role as a key strategy for improving retention, adherence, and continuum of care for PBFW.

Through the N-THRIP project, NEPWHAN identifies, trains, deploys, and supervises Mentor Mothers to support PMTCT activities at both facility and community levels.

Objectives of the Mentor Mother–Led PMTCT Model

NEPWHAN’s PMTCT model aims to:

Improve retention in care for all pregnant and breastfeeding women living with HIV.

Increase uptake of PMTCT services for women and their infants across all service-delivery points.

Strengthen EID services so all HIV-exposed infants receive appropriate testing and prophylaxis.

Provide holistic psychosocial, adherence, and treatment support to PBFW and their infants.

Strategic Approaches

To achieve these objectives, NEPWHAN works with state treatment teams, facilities, TB SRs, and community structures to implement the following:

Optimization of PMTCT services: Ensuring women are diagnosed early, initiated on ART immediately, and remain engaged in care throughout pregnancy, delivery, and breastfeeding

Minimizing Interruption in Treatment (IIT): Mentor Mothers use structured follow-up—including the 90-day adherence calendar—to monitor adherence and reduce treatment interruption.

Maximizing Enhanced Adherence Counselling (EAC): Providing targeted counseling for women with high viral loads and supporting viral suppression.

Strengthening Infant Follow-Up and Testing: Improving community and facility tracking of HEIs, including those delivered outside health facilities.

Enhancing Community–Facility Linkages: Through TBAs, CBCs, faith-based birth centers, and community structures, NEPWHAN ensures seamless referrals to PMTCT services.

Services Provided Through Mentor Mother Support

For Pregnant and Breastfeeding Women Living with HIV

Routine adherence counseling and medication support

Psychosocial support and linkage to social services

Follow-up using adherence calendars and appointment tracking tools

Referral for viral load testing at 32–36 weeks gestation

Guidance on breastfeeding, nutrition, personal hygiene, family planning, and SRH

Coordination of service uptake from pregnancy through postpartum

For HIV Exposed Infants (HEI)

Initiation of ARV prophylaxis within 72 hours of birth

Coordination of DBS/EID sample collection at:

0–3 days,

6 weeks,

9 months, and

6 weeks post-breastfeeding cessation

Support for Rapid Testing at 18–24 months for final HIV status

Appointment alignment and mother–baby pair tracking

Immediate linkage to ART if diagnosed HIV-positive

Roles and Responsibilities of Mentor Mothers

Mentor Mothers serve as:

Peer counselors, offering practical guidance based on lived experience.

Adherence coaches, helping women stay on treatment.

Community mobilizers, improving PMTCT awareness and service uptake.

Youth mentors, supporting adolescent girls and young women through youth clubs.

Facilitators of parenting and psychosocial sessions, linking families to essential services.

Liaisons, ensuring pregnant women in TBAs, CBCs, and congregational birth settings are referred to PMTCT services.

Implementation Framework Under N-THRIP

NEPWHAN’s PMTCT implementation involves:

Engagement of Mentor Mothers and Escorts: MMs and escorts are trained and deployed to both facility and community service points to support PMTCT interventions.

Integration with Facility-Based Staff: NEPWHAN collaborates with clinicians, nurses, case managers, and TB SRs to strengthen HTS, ANC, labor and delivery, and postpartum PMTCT services.

Strengthening Linkages Across 36 States + FCT: A nationwide structure enables community-level outreach, HEI tracking, and EAC optimization across all implementing states.

Monitoring, Documentation, and Reporting: Data is captured using national tools such as -

HTS Registers

ANC and Labor/Delivery Registers

PMTCT Maternal Cohort Register

PMTCT Appointment Diary

Monthly Summary Forms

Tracking and Discontinuation tools

ICT/Index and genealogy forms

These tools support accurate monitoring of targets and timely reporting.

Justification for the PMTCT Model

To achieve the UNAIDS 95–95–95 targets, a community-grounded model is essential. The Mentor Mother approach ensures:

Early detection and enrolment into care

Strengthened adherence and viral suppression

Reduction in mother-to-child transmission

Timely diagnosis and treatment for HEIs

Collaboration across health facilities, TB SRs, community birth attendants, and local structures

Conclusion

Through the N-THRIP GC7 Project, NEPWHAN is delivering a robust, community-driven PMTCT model that empowers women, supports infants, and strengthens the entire PMTCT cascade from pregnancy to early childhood.

By leveraging the lived experience of Mentor Mothers, NEPWHAN ensures that no woman or child is left behind, and that Nigeria continues to make measurable progress toward eliminating mother-to-child transmission of HIV.