Using the MCH Platform to Address Pediatric HIV
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BASICS Pediatric HIV Advisor, Dr. Gloria Ekpo, will present Using the MCH Platform to Address Pediatric HIV at this year's Global Health Council international conference. The conference is being held from May 26 to 30 at the Omni Shoreham Hotel in Washington, DC.
Leaning Objectives By the end of the presentation, participants will be able to identify key ways to use the MCH platform for pediatric HIV care and treatment interventions.
Background
Currently, there are about 2.1 million children under 15 with HIV. Only about 4% access cotrimoxazole prophylaxis and in most of sub Saharan Africa, the most heavily affected region, under 10% who need ART are accessing it. Globally, gains in pediatric HIV care lags behind other HIV and child health interventions. While much effort is focused on testing and treatment sites, mothers and babies should also be reached using existing MCH entry points, e.g., postpartum visit, immunization, sick child visits. Two examples from the USAID/BASICS project illustrate success with this approach.
Methodology
With support from United States Agency for International Development (USAID), the Elizabeth Glaser Paediatric AIDS Foundation (EGPAF), Horizons/Population Council, and USAID/BASICS project conducted operations research. Postpartum visits were scheduled in the week (rather than a more usual six week time frame) following delivery and integrated essential newborn care (ENC) into PMTCT through the training of 132 trainers and supervisors and health care providers (nurses, midwives, PMTCT coordinators).
In 2007 in Rwanda, USAID/BASICS supported a district action planning exercise as part of the national effort to scale up pediatric HIV care. The provision of cotrimoxazole prophylaxis to HIV-exposed and infected children was integrated into the national IMNCI-HIV-Birth Spacing training module in 25 districts and was included in district action plans in five districts. Training and supportive supervision reached these districts, respectively and an indicator on CPT was included in the monitoring tool.
Results/Outcome and Challenges/Solutions
In Swaziland, the proportion of HIV-positive postpartum women and their infants starting CPT increased from 47 percent to 65 percent and from 13 percent to 37 percent, respectively. More providers confirmed that HIV-positive postpartum women received the relevant or appropriate follow-up care and treatment.
Six months after relevant training In Rwanda, pediatric HIV activities in 16 health facilities showed a 42% increase in the number of children identified at multiple entry points to care; a 16% increase in the number of women enrolled in PMCTCT; a 37% increase in the number of children receiving CPT; and a 61% increase in the eligible number of children receiving ART.