FHI - Namibia President's Initiative

Program background

DECEMBER 2003 — The national weighted HIV prevalence among pregnant women is 23.3%. Of the estimated 75,000 births annually, approximately 17,500 (23.3%) are to a HIV-positive woman. Based on a transmission rate of 30-40% in this breastfeeding population, approximately 5,250 to 7,000 newborns become infected with HIV each year. According to the DHS, antenatal care was received from a doctor or nurse for over 90% of most recent births and more than 3 in 4 women who gave birth in the five years before the survey were assisted by trained personnel.

The majority (94%) of mothers breast feed their children during the first three months of life, but the proportion declines with the age of the child. Ninety-two percent of children 4-6 months were still being breast fed, compared to 80% in the aged group 7-9 months and 75% of children in age group 10-12 months. Of the 0-3 months old 26% receive exclusive breast-feeding and 3% of the 4-6 months old. Infant formula is available in hospitals on a prescription basis for children with feeding, digestion or other indicative problems and mothers with serious illness.

At present the Government is in the process of expanding PMTCT and universal access to Highly Active Antiretroviral Treatment (HAART) to six public hospitals, and this support will increase to all public hospitals under the Global Fund. National HAART guidelines have been approved (including chapters on PMTCT and post-exposure prophylaxis) and training of medical staff on HAART is ongoing.

Under the President's PMTCT Initiative, USAID/Namibia led the formation of a consortium of international and local partners to work in a holistic approach to provide the necessary infrastructure, baseline research, training and delivery of quality services in eight regions of Namibia, primarily in the North, which is most affected by the epidemic. In addition, the Centers for Disease Control and Prevention (CDC) will be supporting the public hospitals.

Under the USAID Initiative, FHI together with Johns Hopkins University/Health Communication Partnership (JHU-HCP), Population Services International/Social Marketing Association (PSI/SMA) and Rational Pharmaceutical Management (RMP) will be implementing a comprehensive community mobilization program for the prevention of mother to child transmission through support to faith-based hospitals and their faith- and community-based affiliates (FBO) to provide access to prevention programs as well as voluntary counseling and testing, prevention of mother to child transmission, treatment, maternal and child health services in predominantly rural areas for women and their families.

Specifically, FHI will improve the infrastructure, and build human capacity and provide support to implement quality PMTCT services at five ministry-supported faith-based hospitals, located in Rehoboth in the South, and in Oshikuku, Nyangana, Andara and Onandjokwe in the North, respectively managed by Catholic Health Services and the Lutheran Medical Services.

Community mobilization and support will be provided through three faith-based organizations (FBOs): Catholic AIDS Action (CAA) and the Evangelical Lutheran Church in the Republic of Namibia (ELCRN) through its church and community based Evangelical Lutheran Church AIDS Program (ELCAP) and the Evangelical Lutheran Church in Namibia (ELCIN) AIDS Action (ELCIN-EASA). This support will enable the FBOs to build and expand on their current community-based activities, to include community-mobilization activities promoting VCT and PMTCT, capacity-building, advocacy and establishment of effective referral systems between health facilities and the community using their over 2,000 trained volunteers to ensure that women and their children infected and affected by HIV will receive care and support they deserve. To ensure quality training in counseling and supervision, LifeLine/Childline has been selected to develop standard training curricula to ensure that a pool of well-trained and qualified counselors will be available both at the community and health facility level.

For more information on these and other USAID/Namibia funded projects, please go to the USAID/Namibia home page at http://www.usaid.org.na.