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Country Profiles |
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Beyond PMTCT in Kenya |
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MAY 2009 — In Port Reitz District Hospital in Kenya's Kilindini District, pregnant women attending antenatal care (ANC) services are offered HIV testing with same-day results as a routine part of the service. Those who are HIV-positive are offered PMTC interventions and counseled on the benefits of chronic care for their health, and referred to the comprehensive care center (CCC) by a dedicated volunteer community health worker (or CHW). The counselors encourage the women, and assist them in disclosing their status to their spouses. The families are invited for testing and, as appropriate, enrolled into care and treatment. The CHW then provides follow-up to the community and encourages the women to deliver at the hospital.
Since the CHW program began, there has been a marked improvement in follow-up visits from the mothers and babies for the first 18 months after delivery. In addition, uptake by mothers of antiretroviral drugs that prevent transmission of the virus to infants during birth has increased from the usual 4 percent to an almost unheard-of approximately 86 percent, well above the national average of approximately 56 percent. According to FHI Senior Technical Advisor Dr Gloria Sangiwa, "hospital staff are following the national guidelines to a T—and making the Millennium Development Goal of an HIV-free generation by 2015 look like a reality, not just a dream." Related Story: Creating Opportunities for Male Involvement in PMTCT PHOTO: Women attend an antenatal clinic at a Comprehensive Care Center in Nakuru. (Jim Daniels) |
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The comprehensive care, treatment and support offered includes cotrimoxazole to prevent opportunistic infections and fortified nutritional supplements to malnourished HIV-infected pregnant women, continuing for up to six months after they give birth. The hospital and CHW have formed a peer support group for women who have undergone prevention of mother-to-child transmission (PMTCT) services to provide ongoing support. Groups meet twice monthly for psychotherapy. The CHWs are part of the home and community-based care (HCBC) program around the facility and provide that critical link between the health facility and community.