By Tracy Lee
5 JUNE 2009 [MEDIAGLOBAL]: The Joint United Nations Programme on HIV/AIDS (UNAIDS) has called for a “virtual elimination” of mother to child transmission (MTCT) of HIV by 2015 in the midst of latest estimates which showed that in 2007 only 33 percent of HIV-positive pregnant women received necessary treatment.
Included in the estimates was that 21 percent of women in low- and middle-income countries were tested for HIV.
MTCT of HIV can occur during pregnancy, labor and delivery, or breastfeeding, particularly impacting sub-Saharan Africa, where a high percentage of people do not know their HIV status.
Transmission can be prevented, and death rates be curbed with the proper intervention and access to health care services.
In a 2008 report published by the UN Children’s Fund (UNICEF), UNAIDS, and the World Health Organization (WHO), it was found that only 8 percent of children born to HIV-positive mothers were tested before they were two months old.
Organizations, such as Pathfinder International, have been working to increase access for preventative measures, as well as treatment options for women in developing regions.
For HIV-positive pregnant women, Pathfinder International offers a comprehensive package for preventing mother-to-child transmission (PMTCT)—guaranteeing that women have access to basic antiretroviral medication as well as the necessary support and tools for optimal breastfeeding.
By creating a supportive environment for local communities, Pathfinder International can engage in “community mobilization” towards HIV prevention, family planning, HIV counseling, and testing.
MediaGlobal spoke to several members of the Pathfinder Organization, including Alden Nouga, Senior HIV/AIDS Advisor, Sinah Chaba, Project Manager in Botswana, and Ellen Israel, Senior Advisor for Reproductive Health who detailed the MTCT projects in Nigeria, Kenya, Botswana, and South Africa.
The team highlighted several types of support and care that Pathfinder is currently addressing, including pre-pregnancy care, which revolves around increased community awareness about HIV/AIDS. In addition, community mobilization efforts for preventative measures include: condom distribution, referrals for HIV counseling, routine testing, and family planning.
During antenatal care (ANC), Pathfinder provides information on PMTCT to highlight the importance of HIV counseling and testing for pregnant women.
“We encourage mother[s] to deliver in health facilities, especially those who are HIV positive. However, the majority of women continue to deliver at home under unskilled attendance. A major factor that contributes to this, including economic, is poor access to delivery units due to distance and poor means of transport,” Dr. Karanja Dominic who is leading the PMTCT project in Kenya, told MediaGlobal.
For labor and delivery care, Pathfinder gives referrals for facility deliveries, and offers sensitization and support of traditional birthing attendants specific to PMTCT. At the onset of labor, mothers are then given the antiretroviral drug of Nevirapine, while babies are administrated the drug within 72 hours of delivery.
In addition, Pathfinder offers infant feeding and support, such as replacement feeding through home visits, in order to prevent any infection being passed on from mother to baby.
Madam Sinah Chaba, Project Manager, Pathfinder International in Botswana told MediaGlobal that, “Since 2005, Pathfinder-Botswana has improved the health and psychosocial well-being of HIV-positive pregnant women, mothers, and their families through peer education and group psychosocial support. Through local organizations, Pathfinder offers peer counseling services that address myths and common challenges, promote safe infant feeding and testing, and engage men. To date, peer educators have made over 34,000 visits to pregnant women and male peers.”
“In the last six months—October ’08 to March ’09—we were able to test 26 percent of all exposed babies at six weeks. Though yet to achieve our target, we are making progress. We have also rolled out the services to over 50 percent of supported facilities and more are being added,” Dominic told MediaGlobal.
“We have come from far, but the journey is still a long way off. We need to improve now on quality of care, our focus previously was mainly on quantity with small focus on quality, mainly due to donor demands where number[s] were important. We need to shift gears and now focus more on quality while maintaining the same momentum on quantity. We need to improve supplies logistics to avoid unavailability of kits and essential drugs,” he added.