GHARP Successes in PMTCT

OCTOBER 2008 — Preventing mother-to-child transmission of HIV (PMTCT) is a major public health challenge in Guyana. The GHARP Project supported activities including counseling and testing for pregnant women, PMTCT training, and facilities upgrades.

PMTCT services supported under the GHARP Project included counseling, testing, and providing the antiretroviral drug nevirapine to HIV-positive women before delivery and to their infants after birth to cut transmission rates. As PMTCT services were expanded into the labor and delivery wards of Guyana's five major hospitals, GHARP and the Ministry of Health (MOH) determined that additional staff would be needed, including social workers, counselors, laboratory aides, clerks, and a counselor/tester. Because of the shortage of human resources in Guyana, GHARP employed a creative strategy to fill these critical positions: recruiting retired nurses. Many nurses had retired only because of Guyana's mandatory retirement age for all workers, age 55. So although many were skeptical that the strategy would work, more than half of the hundreds of applicants for the positions were retired health workers. The success of this innovative hiring effort was a result of GHARP's emphasis on building rapport with the MOH and with members of Guyana's healthcare community—relationships solidified during numerous meetings, workshops, and training sessions.

One of many hiring successes was Doreen Peters, a practical nurse/midwife with 31 years of experience working at the Dorothy Bailey Health Center in Georgetown. Peters had been on the verge of emigrating when she saw the PMTCT positions advertised in the newspaper; she's now back in a job she says has "enhanced her life." Many of the retired health workers hired reported satisfaction with their work—sharing their knowledge with clients, helping them accept their test results, and teaching them how to keep themselves healthy and deliver healthy babies even if they are HIV-positive.

Men also benefited from PMTCT services, receiving information on the use of condoms and the importance of testing, and advice on how to support their partners. In Agricola, GHARP supported the Guyana Responsible Parenthood Association (GRPA) to conduct a series of men's meetings in four communities to discuss PMTCT and HIV/AIDS and encourage men and their partners to get tested. One 23-year-old participant who had never had an HIV test came to counseling and participated in outreach sessions. His involvement with the sessions convinced him to seek counseling and testing for himself and his partner; after learning more about HIV testing and the risks of HIV, the couple decided to have a confirmatory test three months later, and to delay starting a family.

The GHARP Project also helped with the upgrading of clinic facilities by reinforcing existing structures, adding walls to ensure client privacy, and buying new equipment. Forty-five sites throughout Guyana were scaled up and supported by GHARP, benefiting hundreds of clients; 38,917 pregnant women were provided with HIV counseling and testing

PHOTOS: (Top) A pregnant client receives counseling at the David Rose Health Centre. (Bottom) A father and his child visit the Dorothy Bailey Health Centre. (FHI/Guyana, Andrea Rohlehr-McAdam )