Luwero Forum of People Living with HIV, with support from the ViiV prevention of mother to child transmission (PMTCT) project, has carried out spot checks on health facilities, network support agents and health workers implementing the PMTCT project in Luwero.
Luwero Forum of People Living with HIV, with support from the ViiV prevention of mother to child transmission (PMTCT) project, has carried out spot checks on health facilities, network support agents and health workers implementing the PMTCT project in Luwero. The evaluation involved visiting a number of health centres and groups of people living with HIV, and participants included the office of the District Health officer (DHO), the Luwero District HIV/AIDS focal person and the community development officer for the district.
This was an opportunity for district leaders to communicate with the groups’ members and to note issues raised by people living with HIV as a basis for subsequent support.
According to Rose Mary Atim, a nursing officer: “At Bishop Asili health centre, we have been working well with Yvonne Ssenvuma, a network support agent who refers all mothers that are pregnant. We have already started using Option B+. Fortunately for us here, most mothers who attend antenatal services come back to deliver at this facility.”
She noted that the turn up of men is not good and out of ten women, only two attend with their husbands. She observed that in most cases men are tested for HIV when women come to deliver.
Nyanzi Ismail Kigozi, an HIV/AIDS counsellor and community focal person at the same health centre, was happy that most staff at this facility were trained in the new option B+ but the hospital was worried about staff turnover and the extra effort involved in retraining staff. He indicated that another challenge is that some mothers only report at the health facility at the point of delivery.
“On the whole, mothers recruited to the programme are complying by adhering to treatment,” he said. “They direct us to their proper homes and have good nutrition. Even when mothers have been lost to follow up, we have the capacity to know where they went. Our greatest joy is when results come out and the newly born child is negative, that is a time for celebration. The cases where a child is born HIV positive are still there but these are few.”
The health centre’s early infant diagnosis report book indicated that out of the 223 mothers who had been diagnosed HIV positive in the recent past, only 12 cases of children were born positive, the other 211 were born HIV negative.
At Bombo health centre the nursing officer in charge, Janet Ahebwa, said that they were happy with the rate at which counsellors mobilized the mothers for antenatal and post natal services. “For us at Bombo, we have an average out of 35 – 40 mothers who attend antenatal services here. We have had three children who tested HIV positive in the last two months.”
Network support agents
According to Yvonne, a network support agent (NSA) for PMTCT: “The challenge is that mothers who test HIV positive do not want to receive follow up. When I ask them whether I should come and visit them in their homes, they are very reluctant to comply. They say ‘do not come’. They do not want their husbands and neighbours to know their status.“
Another NSA, Proscovia Kagoya based at Kyaligondo health centre, said that, it is not easy to engage the men. “I travel with my condoms to male joints like drinking places and gambling spots where they know that I distribute condoms. Some men have an official wife at home and so many women on the side. So they cannot come to a health centre with one of their other women because news will get back to the official wife at home. The men do not want to break up their families by visiting the health centres with unofficial wives. Overall the PMTCT project is progressing well at the health centre where I am based, where you find that in 10 deliveries only one child may be born HIV positive.”
Salongo Kagumba, a network support agent with Kasana Hospital, observed that: “The number of women delivering in rural areas at the hands of traditional birth attendants have greatly reduced but the challenge is that sometimes testing kits run out of stock and we also need Maama kits which include items to aid clean delivery such as soap, gloves and plastic sheeting.”
Luwero district leaders
According to Godfrey Kalyesubula, the HIV/AIDS focal person in Luwero: “With option B+, PMTCT cannot be achieved without community involvement. The community helps the health facilities to reach more people.”
He proposed that Network Support Agents be integrated into the monthly health facility meetings to improve the outcomes of the elimination of mother to child transmission project. He invited all people living with HIV to the 2013 AIDS candlelight memorial for Uganda which will be held in Luwero later this year.
Mrs. Kizito, who represented the District Health Office, and also used the opportunity to check the health facilities’ stores of vaccines noted that disclosure of HIV status is an area that not only presents a major challenge for women but also for men.
The ViiV PMTCT project is funded by the Positive Action for Children Fund through the International HIV/AIDS Alliance.