UNAIDS’s new campaign aims to eliminate mother to child transmission (MTCT) of HIV by the 2012 World Cup in Brazil. It is fantastic to see that UNAIDS is using the enthusiasm and media coverage of World Cup to draw attention to one of Africa’s most pressing health issues, perinatal transmission of HIV.
My colleague Jude Nwokikie, program manager of the Strengthening Pharmaceutical Systems (SPS) project in South Africa and Namibia declared, “The world is no longer in the mood to tolerate MTCT.”
It is indeed a shame that despite the technology at hand, we still have so many perinatal infections. Yet, according to UNAIDS approximately 430,000 babies are born each year with HIV. This means that over the course of a 90-minute football match, nearly 80 babies will become newly infected with HIV (UNAIDS). This is truly unconscionable and no one working in HIV prevention should be satisfied until we eliminate perinatal transmission.
In the past decade, the global health community has succeeded in having approximately 69% of pregnant women in low income countries attend at least one antenatal care visit and yet skilled delivery among these same women has leveled off at 43% (WHO). For HIV positive pregnant women, we are missing a huge opportunity to provide antiretrovirals during pregnancy to the mother and immediately postpartum to the newborn.
The reasons that women provide for not delivering with a skilled provider are complex. My colleague Samuel Kinyanju, based in Kenya with the SPS project, says “Most mothers, at least from Kenya, cite the negative attitude of health care workers towards mothers in labor and the poorly designed delivery process in most public health facilities. In particular, mothers are harassed and insulted when they ask questions anxious to know how they are progressing or generally what to expect.”
He continues, “The traditional birth attendants on the other hand offer ‘TLC’ and are quick to reassure the mothers with information on the progress of labor, explaining clearly and patiently to clients on what to expect. Midwives offer care and support to the family and ensure food and other needs of the client are met promptly. According to one woman, ‘they make the experience of giving birth dignified and noble; one is treated like a true queen’.”
So the big question, according to Samuel is “What can be done to improve our health facilities and encourage mothers to deliver under our skilled health workers?”
Clearly one answer is in providing integrated HIV and maternal and newborn health services. One of MSH’s technical expertises is to assist governments and nongovernmental partners to design and implement integrated HIV & AIDS policies, strategies, and interventions. This is our way of giving the red card to mother to child transmission of HIV.
Daraus Bukenya is MSH’s Global Lead on HIV/TB.
Photo Credit: UNAIDS