The county has the highest HIV prevalence rate in the country, but efforts to prevent Mother-to-Child Transmission are providing hope that the tide will one day turn around
Evelyn Makena @evemake_g
When Achieng Odingo found out that she was pregnant in 2014, she was elated. The prospect of building a family with her husband brought immense joy to the first-time mother.
But her joy was overshadowed during her first antenatal clinic at ACK Hope Compassionate Clinic, Homa Bay, which she attended at eight months of her pregnancy. A routine blood test revealed that Achieng was HIV-positive.
As she struggled to take in the news, her immediate thoughts revolved around the safety of her baby. “I asked the nurse what I would do to prevent my unborn child from contracting the virus,” says Achieng.
After counselling, she was immediately initiated into antiretroviral treatment. She was also advised to go to a health facility to deliver where she would be assisted by skilled medical personnel.
It was such a great relief to know there was a chance to save her child from getting infected and so she followed every instruction to the letter and took her medication without fail.
It was also important for her to have a strong support system to help in the journey. Immediately she found out her HIV status, she informed her husband and encouraged him to get tested.
He also turned out positive. “My husband was very supportive of me. He ensured I never missed my medication and also started taking his medication to ensure that he would not increase my viral load,” she says.
Her child was born healthy and HIV- free. For the first six months, the nurse advised her to administer Nevirapine syrup to her child in order to prevent post natal HIV infection as she exclusively breastfed.
When her child was tested for HIV at six weeks, six months, nine months and one year and two years, all tests showed that the baby was HIV negative.
During her second pregnancy in 2014, Achieng ensured that she went for her first antenatal clinic on time, followed the advice given at the hospital and had a second HIV-free child. “I intend to have more children. I am happy that they will not have to contract the virus from me,” she reveals.
The 24-year-old woman, who now works as a HIV/Aids peer educator with a non-governmental organisation in Homa Bay, is among the many HIV-positive mothers that have benefited from Prevention of Mother-to-Child Transmission interventions (PMTCT) by the county government in partnership with several non- governmental organisations including Elizabeth Glaser Pediatric Aids Foundation (EGPAF), PATH and Medicins Sans Frontieres (MSF).
With a 26 per cent HIV prevalence, Homa Bay county has the highest HIV infections in the country. Since the PMTCT programme was introduced in Homa Bay District Hospital in 1999 by an NGO, Naresa, the county has seen a significant reduction of infections from HIV-positive mothers to infants.
Out of the 260 Health facilities in Homa Bay, 220 provide PMTCT services. In 2017 alone, about 6,000 pregnant mothers benefited from the PMTCT services across the county.
“We have availed PMTCT care in almost all of our facilities. Expectant women visit these facilities for HIV testing. In case they turn positive, they are advised to have hospital deliveries, and put on medication.
This has helped us make strides towards a HIV-free generation; Children born without the virus from mothers with HIV,” says Professor Richard Otieno Muga, CEC Health Services Homa Bay county.
According to Penina Awour Kasera, Nurse in Charge, ACK Hope Compassionate clinic, one of the health facilities implementing PMTCT, care given to pregnant HIV-positive mothers to avoid transmission to infants involves initiating mothers to ARV treatment during pregnancy, skilled delivery, and safe infant feeding practices. “We care for these mothers during pregnancy and after giving birth.
The virus is mostly transmitted to infants during delivery, breastfeeding and incase a mother opts for early mixed feeding,” she says.
After birth, Nevirapin syrup is administered to the child for the first six months to boost their immunity and avoid infection from the mother through breast milk.
Mothers are advised to exclusively breastfeed their children for six months. In cases where a mother can afford formula milk as an alternative for breast milk, they are advised not to breastfeed their babies at all.
There is a high success rate of these interventions for mothers who adhere to the advice given to them. “Out of 10 HIV-positive pregnant women who come to our facility eight deliver HIV-negative babies. The success of PMTCT is based on how keenly the expectant follow instructions,” says Penina.
Even with the high degree of success of the programme, there are mothers who have not fully benefited from the interventions. Patients in remote villages in the vast county have to travel long distances to access the services.
Reliance on traditional birth attendants who mainly use outdated techniques and equipment has also been an impediment to ensuring that all HIV-positive mothers do not infect their children during delivery.