Better paediatric HIV services reduce infections
IRIN PlusNews | January 20, 2011
IRIN Plus News reports on a Foundation project in Malawi that trains additional healthcare workers in three districts: Lilongwe, Dedza, and Ntcheu. The program, active since 2006, has trained an estimated 1,200 HIV service providers and has helped put Malawi on track to reach the Millenium Development Goal of reduced infant mortality by 2015.
More mothers and pregnant women in Malawi are attending antenatal clinics since the increased training of health workers in paediatric HIV care improved services to prevent mother-to-child transmission (PMTCT) of HIV, and pediatric HIV testing and treatment.
"I was reluctant [about] going for the voluntary HIV [test] when I got my first pregnancy in 2007,” said Fanny Yolamu, whose previous child had been delivered by traditional birth attendants.
“We [pregnant women] had to walk about five kilometers to the nearest clinic [in Dedza, central Malawi]. I opted for home delivery but the result was fatal, as my child died a year later from an HIV-related disease,” she told IRIN/PlusNews.
Yolamu is now one of the thousands of HIV-positive women who have given birth to HIV-negative babies. In 2005 – when only three percent of HIV-positive mothers were using PMTCT services – mother-to-child transmission accounted for 30 percent of all new HIV infections.
Today, 45 percent of HIV-positive pregnant women use PMTCT services, putting Malawi on track to meet the Millennium Development Goal of reduced infant mortality by 2015.
Providing antiretroviral (ARV) drugs like nevirapine as part of PMTCT services can lower the baby's chances of being infected by more than 40 percent, according to UNAIDS.
A project by the Elizabeth Glaser Pediatric AIDS Foundation to improve PMTCT services by training more healthcare workers is being rolled out in three districts in central Malawi: Lilongwe, Dedza and Ntcheu.
Patricia Mbetu, the foundation's country director, said the programme had trained an estimated 1,200 service providers in PMTCT since it began in 2006, and now supported 17 percent of all sites providing PMTCT services nationwide.
"Our entry point has been the ministry of health's antenatal clinics … so we mainly support the programmes belonging to the ministry of health," she said.
Yolamu said, "The beauty about the project is that when the babies are born, health-care providers follow them up and keep on educating the mothers to make sure they continue exclusively breast-feeding them for at least six months before they start introducing other foods.”
The Mothers2Mothers support group, where HIV-positive mothers could share information on how to take care of their children and families, was an important component of the health-worker training programme.
“There are some mothers who fear to stop breast-feeding their children and introduce them to other food, fearing they would contract HIV. During the gatherings we tell such women not to worry, and we encourage them to start feeding the child other foods," said Esnart Msekeni, advisor to the mothers' groups at Bwaila hospital in the capital, Lilongwe.
There are still many challenges. The country's report to the 2009/10 UN General Assembly's Special Session on HIV/AIDS (UNGASS) noted that drug stock-outs were a major hurdle in scaling up PMTCT services.
Staff shortages and inadequate infrastructure were other barriers, while the reluctance of men to go for HIV testing and support their partners worsened the already difficult situation of women struggling with stigma and discrimination.
Yet Mbetu was optimistic about winning the battle to eliminate pediatric AIDS. “Nothing will stop us. We are also looking at supporting the ministry of health at national level through technical working groups, where we share our technical expertise and experiences from other 16 countries we operate in.”
Dr Mary Shawa, Permanent Secretary for Nutrition and HIV and AIDS in the Office of President and Cabinet, said the project complemented the government’s four-year Paediatric HIV Care Scale-up Plan, set up to curtail new infection rates.
She told IRIN/PlusNews: "Our target is to reduce the transmission-from-mother-to-child rates to zero, and new infection rates between those who are sexually active to almost two percent by 2015."