Communities in Malawi are hailing a successful initiative that has proven successful in ensuring children of parents living with HIV are born free from infection.
Communities in Malawi are hailing a successful initiative that has proven successful in ensuring children of parents living with HIV are born free from infection.
Wiseman Ngwira, chair of Kanyerele community-based organisation in Rumphi district, northern Malawi, said: “There are many couples living with HIV who have benefited from the prevention of mother to child services (PMTCT). HIV positive couples are bearing children who are free from HIV. We have been encouraging expectant mothers to go for PMTCT services.”
In 2011, Malawi pioneered the development of a simplified public health approach for preventing transmission of HIV from mothers to their babies and treatment that offers all pregnant women living with HIV lifelong antiretroviral therapy (ART).
Option B+
Initiating an HIV-positive pregnant woman on ART as early as possible both significantly reduces the risk of passing HIV to her child and protects the mother’s own health. The national rollout of this treatment, referred to as Option B+, has achieved impressive results in Malawi with 87 per cent of known HIV-positive pregnant women commencing lifelong ART according to the National AIDS Commission.
The scale up and expansion of the programme, as narrated by the communities, has contributed to the rapid decline in infant infections and maternal deaths.
“We have managed to reduce HIV and AIDS from a killer disease to a condition we can live with,” said Mara Kumbweza-Banda, National AIDS Commission chairperson and a representative of people living with HIV on the national response board of trustees. “This, to me, is a cause for hope that we can indeed view the prospect of achieving zero AIDS-related deaths and an AIDS-free generation.”
Right to bear children
One young couple who sought unanimity from Mdabwi community-based organisation (CBO) in Kasungu district in the central region of Malawi says that they tested HIV positive immediately after their wedding.
“We challenged the fact that we could not bear children just because of our HIV positive status. As members of a CBO offering home-based care to those living and affected by the virus, we were encouraged by our chairperson Chibisa Munga to go for PMTCT.
“We agreed, and now we have two children who tested HIV negative,” said the husband. “The secret is that my wife underwent PMTCT when she was pregnant. She got information about having a healthy pregnancy and motherhood. And as a family we followed the instructions from the health experts”.
Chibisa Munga concurred with the young couple saying that PMTCT has registered significant success in the area as many women were going for treatment.
Disclosure
Maiden Mahowe, a nurse and PMTCT coordinator for Zomba General Hospital in southern Malawi, told how in situations where a pregnant woman has just tested positive for HIV and is failing to disclose the news to her husband, an “expert patient” is assigned to counsel the couple before the woman breaks the news to him.
Expert patients, according to Mahowe, are people who are living with HIV themselves and are voluntarily providing full time counselling services to pregnant women in the hospital wards.
Zomba General Hospital is the first in Malawi to adopt the use of expert patients as key members of the HIV treatment team, bringing new knowledge, insights, and skills together with a deeper understanding of the community and what it means to live with HIV.
“Pregnant women who have just tested positive usually find themselves challenged as to how they can break the news to their husbands and this is where the expert patients come in,” said Mahowe. “Many people’s lives have been saved through this programme and I am proud to be a driver of change.”
Image: a woman receives contraceptives from Dr Andreas Tembo of the Family Planning Association of Malawi Dowa clinic on an outreach day to a rural area © 2007 Nell Freeman for Alliance
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