PMTCT - Preventing Mother to Child Transmission

In Africa, despite the availability of drugs to prevent HIV transmission to an unborn child, up to 30% of babies are born infected with the virus. These children often remain undiagnosed until much later in their lives, with devastating effects.

Zoë-Life envisions both parents devoting themselves to caring and taking responsibility for their unborn child, and working with our communities, NGOs and government to ensure that no more babies are born with HIV.

Our work to strengthen Health Facilities

In partnership with McCord Hospital in Durban (KwaZulu-Natal province), Zoë-Life has been providing a strengthened and integrated prevention of mother-to-child transmission (PMTCT) service, linked with tuberculosis (TB) and HIV care and treatment. This project has entailed building capacity at five municipal clinics - one in the area south of Durban, and four in the Outer West area - to serve the needs of pregnant women, including those who are HIV-infected, and their infants.

Over the years, services to pregnant women have improved, so that now:

  • More than 90% of women are accessing HIV testing by counsellors and nurses (Provider-initiated Counselling and Testing or PCT);
  • 90 % of the women now receive the drugs they need to prevent HIV transmission to their unborn babies;
  • Clinics are providing structured education, using creative and engaging tools, to encourage families to take loving responsibility for their own health and the health of their baby;
  • More and more babies are being tested for HIV at six weeks (PCR TEST), ensuring that infected babies are put onto treatment as early as possible. The turn-around time of PCR test results has decreased from between three and six months to only a few weeks;
  • Partners are encouraged to test for HIV, so that infected partners or family members can be integrated into HIV palliative care and antiretroviral treatment (ART) programmes;
  • Access to couple counselling has been increased, addressing issues such as family planning, risk reduction and infant feeding choices.

Challenges that remain are to:

  • increase the role of fathers in championing their family's health;
  • address the psychosocial issues that arise from discordant couples (one partner infected, the other partner not);
  • reduce unprotected sex during the pregnancy and breastfeeding;
  • improve good follow-up and tracking of mother-child pairs, especially during the infant feeding period;
  • assist HIV-positive parents who want more children to do so safely without transmitting HIV.

Working to strengthen community prevention of HIV transmission to children

Into the next financial year, Zoë-life will be extending support to families by linking facility-based services to community-based services. In the community, we will be developing the capacity of local organisations to support pregnant women and their families in the following activities that help to reduce HIV transmission:

  • Supporting women to book at clinics early (by 14 weeks) rather than late in their pregnancy. Ensuring their access to prevention treatment very early in the pregnancy offers considerably greater protection to the baby.
  • Supporting partners to practise safe sex during pregnancy, to take an HIV test as early as possible, and to have a healthy pregnancy through good support and nutrition.
  • Providing technical mentorship to support group facilitators, giving accurate information to families around prevention, supporting adherence to drugs that prevent transmission, raising awareness of the importance of ongoing follow-up at clinics for infants, and correct support for breastfeeding or replacement feeding.
  • Mentoring community members to provide home-based support to families.

Infant and Young Child Feeding is a key component in the fight to prevent mother-to-child transmission. Fathers, family members and their community play a vital role in supporting a mother to make the most appropriate feeding choice.


Working to strengthen government's response to PMTCT

Zoë-Life has assisted KwaZulu-Natal's provincial, district and local government Departments in maintaining the required systems for ensuring that all families have access to quality health services.

Zoe-Life has worked to:

  • strengthen referral networks between PMTCT and other vertical programmes, including paediatric services;
  • provide human resource development through training, mentorship and supervision of PMTCT staff;
  • implement Quality Assurance and Quality Improvement through supportive supervision, technical assistance and mentoring activities;
  • strengthen strategic information through development of simple, integrated Monitoring and Evaluation (M&E) systems.
  • Zoë-Life has worked with national and provincial steering committees to improve the Monitoring and Evaluation of PMTCT in KwaZulu-Natal province. The M&E system integrates data from ART, TB, palliative care and PMTCT services, optimises the provincial PMTCT data protocols, ensures smooth referrals into other vertical programmes, and uses M&E tools to enhance follow-up of infants' health.





Support through training and materials development

  • Zoë-Life has developed practical and integrated training programmes that have trained teams across KwaZulu-Natal province.
  • Working with the KZN MCWH Unit in 2008/2009, we trained over 2 000 healthcare workers to implement new guidelines that would radically reduce the numbers of HIV-infected children.
  • Zoe-Life is currently training the Province's Lay Counsellors and District Trainers to implement the new, groundbreaking WHO guidelines on Infant and Young child feeding. These guidelines will see women who breastfeed being able to reduce risk of HIV transmission through access to ARVs during the breastfeeding period - a substantial achievement in our country.


 
Zoë-Life co-ordinated a clinical hand-over of our on-site activities to the municipal clinic staff. Over the years, we have seen that ongoing mentoring for teams and individuals is a key intervention for sustaining quality of service.

From 2011, once our programmes are re-based at community sites, our team will be offering mentorship as part of a roving technical support service to the municipal clinic staff and other organisations helping them. We want them to feel excited and confident about their independent management of the systems we've put in place.

Beyond this phase, we hold a vision of Zoë-Life leading a thoroughly integrated Prevention of Parent-to-Child Transmission (PPTCT) service project, falling under PARENTAL AND CHILD CARE, rather than a mother-only focus. We believes it is crucial to draw fathers and all male family members into HIV treatment, care and support, and that this inclusive approach will help enormously in strengthening families and communities.

We need a "PPTCT Community" to inspire and uplift moms, dads, aunties and uncles, gogos and granddads in helping one another for all their needs - not only around HIV, but to share cheap, nutritious meals, ideas for household income, willing shoulders to cry on, grown-ups making sure that babies and kids are never left unattended or vulnerable to harm ... whole neighbourhoods of families getting stronger and healthier, and joining together to guard their children's wellbeing. Just as all Zoë-Life's programme work is linked, this is how we as a caring society should understand health and development.

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