The Federal Ministry of Health in Ethiopia has announced how it plans to end the transmission of HIV from mothers to their children by 2020. The government is finalising a five year strategic plan for 2016 to 2020 which aims to reduce new HIV infections passed from mothers to their children to between two per cent and zero.
The Ministry of Health is expecting HIV prevalence among children born from HIV positive mothers to fall from 11 per cent in 2015 to five per cent in 2016.
Ethiopia has had services in place to prevent mother to child transmission of the virus since 2001. It is currently providing these services in more than 2,600 of the country’s 3,000 maternal and child health facilities. However there are still major gaps, which means many people still struggle to access services. To address this, the government has endorsed an integrated approach to services to cover prevention of mother to child transmission, reproductive health and maternal, newborn and child health.
Pregnant women on antiretrovirals
In 2012, the government adopted Option B+ as part of this plan. This means HIV positive pregnant women get lifelong treatment, regardless of their CD4 levels (the level of infection-fighting white blood cells in a patient’s blood).
Sister YetimworkTekle, case team leader at the Ministry of Health, says a lot has been done – especially over the past three years.
“The percentage of HIV positive pregnant women who received antiretroviral treatment has significantly increased in 2015. We have managed to reach 70 per cent of the estimated 28,000 HIV positive mothers who needed the service,” she says. This is a dramatic change from 2013, where prevention of mother to child transmission coverage was at 42.9 per cent.
A mother from Addis Ababa, who has used prevention of mother to child transmission services, says she managed to have two children free of HIV, five years after she found out that she was living with HIV.
“My husband wanted to have a baby and I got pregnant. I attended a year and a half programme at Tikur Ambasa Hospital and confirmed that my son was born free of the virus,” says the mother. She went through the same process while having her daughter, and the daughter is also HIV negative.
Mother baby cohort
Despite all the achievements so far, Yetimwork says there are some challenges remaining. “As much as we are getting the HIV positive mothers, we couldn’t get all the children who are exposed to the virus. So one focus in the next five years is to diagnose children born before the mother knew her HIV status.”
Yetimwork says she hopes a new monitoring and evaluation tool, ‘mother baby cohort’, will help in this regard. This will enable health service providers to follow up both mothers and children for two consecutive years.
Forty per cent of service providers are already implementing mother baby cohort. The rest are expected to start using it in the months to come.
Community outreach
According to UNAIDS, new HIV infections among children in 21 priority countries, which include Ethiopia, have declined by 48 per cent since 2009.
Sister Yetimwork says: “So far, prevention efforts [in Ethiopia] have been focused mainly at health institutions, but this year we will be piloting an increase in community involvement in 50 selected districts. Around 34 thousand health extension workers dispatched throughout the country are also expected to contribute to creating awareness at the grass roots level and bringing mothers and their families to the service.”
These activities will be focused on areas with relatively high HIV prevalence, including at major infrastructure projects that the nation is undertaking, such as the Great Ethiopian Renaissance Dam.
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