Partners Join Forces To Ensure That Children In Lesotho Are Born Free Of HIV
These were but a few of the points highlighted during a recent multisectoral review of PMTCT and Pediatric AIDS supported by UNICEF and WHO in Lesotho. Led by the working group of the Ministry of Health and Social Welfare (MOHSW) - comprising national stakeholders in PMTCT and Pediatric AIDS - with the technical support of members from the Interagency Task Team [UNICEF, WHO, Clinton Foundation, Baylor and US Government], the review witnessed dynamic sharing of experiences and lessons learned with the objective of making strategic recommendations to pave the way forward for a scaled up PMTCT and Pediatric AIDS plan.
Supporting HIV-positive mothers and their children goes far beyond providing them with anti-retroviral (ARV) drugs. It embraces prevention across the board; engaging men; promoting reproductive health; encouraging safe delivery practices; promoting appropriate infant and child feeding and reaching the entire family with a continuum of treatment, care and support for sustained longer lives. "Comprehensive PMTCT, which ensures that HIV infected women receive care and treatment for themselves and their families, can save the lives of children, prolong the lives of parents, delay orphaning and break the cycle of infection" said Mrs. Aichatou-Diawara-Flambert, UNICEF Representative in Lesotho.
Despite the introduction of PMTCT in Lesotho in 2003 and progress in rolling it out to 17 hospitals and 20 health centres, access remains critically low, "only about 5% of pregnant women with HIV infection are accessing PMTCT services" said Dr. Angela Benson, WHO Representative in Lesotho.
While PMTCT and Pediatric AIDS treatment are now available, partners in Lesotho are grappling with effective strategies to increase access and uptake of services and reach all those in need.
"PMTCT is the optimal entry point to reach mothers, fathers and children, but it requires a strong engagement of men, whose support is critical throughout the process" emphasized Dr. Ramatlapeng, Minister of Health and Social Welfare. She stressed the need to bring the services closer to the people and to provide fast and quality service delivery. Treatment delayed is treatment denied.
Over 50,000 women become pregnant every year in Lesotho. According to the MOHSW HIV prevalence in pregnant women increases from about 12% in women aged 15-19 to 25% in women 20-24 and peaks at 38% in women 25-29. According to recent UNAIDS local estimates about 29,000 people will be newly infected in 2007 bringing the number to 270,000 of which over 16,000 will be children. Of the currently estimated 4,000 children in need of ARVs, about 1,160 are receiving Pediatric medication. If left untreated, half of HIV positive infants would die before they reach the age of two.
Pediatric AIDS treatment was introduced in Lesotho in 2005, yet clinics are not optimally equipped to cater for all the specific needs of children infected with HIV, for example DNA PCR machines (to test newborns for HIV) are not available in country. UNICEF is currently supporting transportation of blood samples to South Africa for testing. Through UNICEF's support, all eligible children below 18 months receive the antibiotic cotrimoxazole to protect them against life threatening pneumonia and other common childhood infections and reduce the frequency of hospitalization and HIV related deaths.
The Health sector is gradually moving towards a provider-initiated, or opt-out, strategy in Antenatal Care (ANC) clinics to test all pregnant women for HIV, unless they refuse. Dr. Chewe Luo, UNICEF Senior HIV and Health Advisor, emphasized that many women access ANC services at least once (90%), but few women deliver in health facilities (36%). Some access ANC services at their local health clinics but not all clinics offer rapid testing, let alone PMTCT. "We need to optimize the service on that one visit and ensure a rapid test is provided and that women return for their treatment" she said.
The national target by 2011 is to achieve universal access to treatment care and support. This means "scaling up activities from hospitals to health centers to communities and families, where women and children must receive support. Effective PMTCT and care and treatment for women, their children and families are no longer an option but an imperative" said Ms. Flambert, UNICEF Representative. She emphasized the importance to link with ongoing interventions (i.e. Infant and Young Child Feeding, Child Survival â€" Expanded Programme of Immunization and Integrated Management of Childhood Illnesses -, and the National Action Plan for Orphans and Vulnerable Children (OVC)).
The review culminated with the Director General of Primary Health Care, Dr. M. Moteete, echoing a collective call to work together to reach all Basotho in need with a person centered quality PMTCT and Pediatric AIDS service "we need to boost up our human resource capacity and most importantly strengthen the key role of community health workers" she said.
The next steps will be for the technical working group to finalize the scale up and follow-up plan (2007-2011) with recommendations and action points presented at the review and clear delineated tasks and roles for each partner and service provider at all levels - central, district and community.
Background
UNICEF has been involved in shaping and expanding the PMTCT programme, since its inception. More women are coming forward to be tested for HIV and out of these almost all HIV positive women go on to receive Nevirapine to prevent passing the virus to their unborn children. Nevirapine is given to all women enrolled in the PMTCT programme during their last counseling session with instructions on how to use it.
UNICEF and UNAIDS launched the Global campaign on Children and AIDS in 2005 to encourage collective efforts to reduce the impact of AIDS on children, who remain the missing faces in national responses. The failure to step up prevention will bring dire consequences evidenced by a generation of children orphaned by AIDS. The failure to arrest the growing numbers of OVC, and step up measures to protect children from neglect, abuse and exploitation and support their care, including treatment for those infected will signify the failure to fulfill our obligations to children. UNICEF recognizes that children and women are the emerging faces of HIV and AIDS, 13% of new global HIV infections are children, and 14% of AIDS deaths are children. Overall in Africa a mere 10% of women are accessing PMTCT. Optimal prevention and care and successful linkages between elements of the HIV care continuum are key to reverse the tide of the HIV epidemic.
www.unicef.org
Parteneri reunesc forþele pentru a se asigura cã copiii în Lesotho se nasc libere de HIV - Partners Join Forces To Ensure That Children In Lesotho Are Born Free Of HIV - articole medicale engleza - startsanatate