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Chasing a mother’s dream

 Street News Service 02 December 2019

In Malawi a USAID-funded project has proven effective in helped reduce HIV infection among babies born to HIV positive mothers, as Lameck Masina reports. (1113 Words) - By Lameck Masina

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SNS(EU)_Chasing a mother’s dream

 Estnart Msekeni, Mothers2Mothers adviser. Photo: Elizabeth Glaser/ Pediatric AIDS Foundation

TWO years ago, 32-year old Elizabeth Chidwala was given the news many expectant mothers in Malawi dread - she tested HIV positive, and feared that her newborn would face the same fate.

But a combination of medical methods and treatments, combined with training and education in the country, is offering hope to many like Elizabeth, who is among 20 HIV positive women who have so far given birth to HIV negative babies.

The USAID funded Call to Action (CTA) project - spearheaded by the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) - has been operating for five years now, and trains health workers and mothers to do everything they can to prevent unborn babies from getting infected, instilling hope in women, despite their status.

EGPAF country director in Malawi Patricia Mbetu reveals that although encouraging, those 20 cases are only among 413 HIV positive pregnant women in three districts of Lilongwe, Dedza and Ntcheu.

The successes have only been achieved by training health workers, who offer Prevention from Mother to Child Transmission (PMTCT) services to women.

"Our entry point has been the ministry of health's antenatal clinics at facility level. So we mainly support the programs belonging to the ministry of health," she says.

Mbetu adds once tested positive, mothers are now advised to take ARV combination therapy that helps reduce mother-to-child transmission. This includes Zidovudine also known as AZT and lamivudine (3TC).

During labour mothers take a single dose of Nevirapine to reduce the chances of the baby becoming infected. Sometimes mothers are put on an intravenous drip of AZT.

Unborn babies are also saved from HIV when they are born through caesarian section known as c-section in medical terms.

"The issue is that HIV is transmitted by the blood getting in the eyes, nose and ears during birth. But during c-section the sac housing the baby has own blood supply. What it gets from its mother is food, and the HIV is killed by the stomach acid so it doesn't reach the baby," says Mbetu.

After the baby is born, HIV test are performed to check the status of the baby. Whether tested negative or positive to the tests, the infant is put on drug treatment for the period of one week and repeat the tests thereafter.

Health workers advise mothers that mixed feeding before six weeks may damage the lining of the baby's stomach and intestines making it easier for HIV in breast milk to infect the baby. Whereas breast milk alone, poses no risks of infection because it can't cause any damage in baby's body.

Mbetu says the foundation, has so far trained an estimated 1,200 service providers in PMTCT from 60 at the onset of the project in 2006.

She also says the number of sites providing PMTCT services has also increased from 140 to 518 by January 2010.

"These health workers counsel and encourage expectant women to go for HIV tests in the first place so that if they were infected they may prevent their unborn babies from getting infected."  

The health workers keep track of the babies, right from their time of birth until they start receiving supplementary foods.

At the time of finding out her status, Elizabeth says she was "full of bitterness".

I still remember how I cried," she adds. But the biggest implication for her was how she and her husband Edwin would cope with the financial implications of having an HIV-positive baby."I was worried over the care I would give to the child because we understand HIV positive children fall ill frequently and need special care and good diet", explains Edwin, who would also later test HIV positive.

Elizabeth says that she has since turned that bitterness into hope for a future for her and her baby.

"The beauty about the project is that when the babies are born, healthcare providers follow them up and keep on educating mothers to make sure we continue exclusively breast-feed them for at least six months before they are introduced to other foods", she says.

She reveals that with the PMTCT services at her fingertips, she has agreed with her husband to conceive another baby once her new baby reaches four years.

"I will definitely have another baby because I am still strong and I need to fulfil my plan of having two children," she says.

Another component of the program is the formation of women's grouping known as Mothers2Mothers in heath centres - a platform where HIV positive mothers discuss wide range of issues and share information on how to take care of their children and families.

The group's advisor at Bwaila hospital in the capital Lilongwe Esnart Msekeni says the members act as role models for other women and has led to an increase in number of women who volunteer for HIV testing.

"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", she says.

The Project's Assessment Report released in September has shown the initiative is currently supporting 99 percent (91 of 92) of antenatal facilities providing PMTCT services in the three districts.

This represents 17 percent of all sites providing PMTCT services nationwide, funds permitting Mbetu says, plans are underway to reach out to other areas.

Despite the success story, the Assessment Report has spelled out, shortage of medical personnel, lack of infrastructure and reluctance of men to go for HIV testing as major huddles in the fight.

But Mbetu, albeit conceding to the challenges says she is optimistic that the battle will be won.

"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 from", she says.

She says other countries like Botswana and Rwanda have had similar challenges but are considerably making headway in eliminating the paediatric HIV infection rate.

Permanent Secretary for Nutrition and HIV and Aids in the Office of President and Cabinet Dr Mary Shawa has hailed the project. She says it has highly complimented to the government four-year Paediatric HIV Care Scale-up Plan which seeks to curtail new infection rates.

"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 2 percent by 2015", Shawa says.

Statistics show that over 26 000 children in Malawi are infected annually through mother to child transmission. About 83 percent of them are living with HIV/AIDS while one in every five children dies of AIDS.

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