Uganda: People living with HIV make progress in implementing PMTCT

Groups of people living with HIV in the districts of Luwero and Nakaseke in Uganda have made significant progress in implementing preventing mother to child transmission (PMTCT) activities.

Groups of people living with HIV in the districts of Luwero and Nakaseke in Uganda have made significant progress in implementing preventing mother to child transmission (PMTCT) activities.

Their efforts stem from a community based PMTCT programme supported by the International HIV/AIDS Alliance with funds from ViiV HealthCare’s Positive Action for Children Fund. The ambitious programme is designed to increase rates of enrolment and retention in PMTCT care in limited resource settings to reduce the number of  babies who become HIV positive through birth.

Groups of persons living with HIV are celebrating the improvements made in community-based PMTCT. In Semuto, Luwero a HIV network group known as Asiika Obulamu has succeeded in reaching out to ten villages including Kikandwa, Kikondo, Kijaguzo, Mijinga, Nakasandagira, Kabere, Kitoto, Namirembe, Kawonya and Kapeeka.

Theopista Basemera from Asiika Obulamu and Namusaale group said: “Our PMTCT intervention also involves education on family planning, HIV testing, advice on antenatal care, nutrition and male circumcision and generally a good health style. We also work with our partners at the district and local government through the network support agents in designated health facilities to give guidance to the community on PMTCT and other HIV related involvement.”

In just four months another group of people living with HIV from Nyimbwa, Luwero carried out a number of PMTCT activities including:

  • Following up with women from PMTCT programmes to offer home based care, on-going counselling and health referrals
  • Using volunteers to distribute Mama kits and to follow up with mothers to ensure safe delivery in health facilities
  • Conducting community leaders’ dialogue on PMTCT to advocate for male involvement and to increase demand for PMTCT services
  • Facilitating Network Support Agents [peer outreach workers] to be located in various health facilities

Benefits of community based PMTCT

The community-based PMTCT project has led to formalised links being created between clinics and the community as a way to increase the perceived ‘friendliness’ of services. It has also helped clinics maintain regular contact with clients.

Mr. Zziwa of Nyimbwa PHA group said: “In one case, our NSA managed to refer 27 pregnant women to health facilities and visited 31 homes, where they found that all [were] in need of more help. But we have generally also noted that there has been increased knowledge about PMTCT among women and even men who previously did not take note of it.

“In line with this is the increase of male involvement in PMTCT activities, especially men accompanying their spouses to health centres. We are also happy that our collaboration with health centres has been progressing very well, especially where the Network Support Agents are located.”

Such an assertion can be confirmed by research carried out by Chang, L, et al (2010) published by PloS ONE, which found that involving peer health workers – as the case is with NSAs – provides a ‘pragmatic and effective strategy’ for addressing the human resource crisis in HIV programming, and promotes the long term sustainability of antiretroviral therapy in low resource settings.

Challenges

As in any activity the groups have faced some challenges while implementing the project. In addition to some operational challenges, Theopista Basemera notes that: “Some of the women we have approached do not want to attend ANC [antenatal care] in health facilities and we cannot drag them to go there.

“They have a bias against hospitals and worse of all is that they do not want their blood samples taken to be tested for HIV. Even in cases where they are tested and found to be HIV positive, they do not want to be followed up for fear that they will be identified as an ‘HIV/AIDS patient’ and could lose their husbands.”

Such challenges have been noted in a study by Busza. J, et al (2012), published in the Journal of The International AIDS Society, which found the fear of receiving positive results to be a great disincentive to HIV testing during pregnancy.

Other studies such as one by Rujumba, et al (2012) from BMC Health Services Research finds key lessons for programme improvement are: ensuring constant availability of critical PMTCT supplies such as HIV testing kits; antiretroviral drugs (ARVs) for mothers and their babies; regular in-service training of health workers to keep them abreast with the rapidly changing knowledge and guidelines for PMTCT; ensuring that lower level health centres provide maternity services and ARVs for women in the PMTCT programme, and provision of adequate facilities for effective follow-up and support for mothers.

On the whole, the PLHIV groups in Luwero and Nakaseke have made tremendous efforts among the women and infants adhering to PMTCT programmes, and with time mortality is bound to be brought down. This is despite the fact that many women still present for PMTCT  too late. This highlights the need for targeted interventions that enable mothers and infants access to prevention and care services for HIV.

 

 

COMMENTS

WORDPRESS: 1
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    the story is good.
    thanks for fighting HIV and i hoe you are fine too.