Community participation: Involving men in PMTCT

Reinforcing the capacity of civil society organizations to implement the national plan to eliminate HIV transmission from mother to child

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CD Congo, The Democratic Republic of the

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Web http://www.linkedin.com/pub/fatim-kaba/48/309/4a8/
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About the project Edit

In the DRC, HIV seroprevalence is high and all of the country’s provinces are affected. Men, women and children in particular pay a very high price to this pandemic. According to the 2009 epidemiological report, the number of people living with HIV in 2010 was estimated at 1,082,040, 575, 375 of whom are children under the age of 15. 337,240 adults over the age of 15 and 40,225 children under the age of 15 living with HIV need ARV treatment.

PMTCT (Prevention of Mother-to-Child Transmission) is a term generally used for programs and interventions that aim to reduce the risk of mother-child transmission of HIV. Long underestimated and ignored, it’s actually renown as one of the main strategies in the fight against the spread of HIV/AIDS. In fact, PMTCT does not only save the lives of many children born to HIV-positive mothers which reduces maternal and infant morbidity and mortality, but is also the foundation in the fight against HIV/AIDS.

The national programme to combat HIV/AIDS and sexually transmitted diseases (NAP/STD) estimates that there are 42,000 children infected by HIV following vertical transmission where breastfeeding is customary. As well, the proportion of Acquired Immune Deficiency Syndrome (AIDS) cases in children under five on the total reported cases increased from 8% in 1997 to 23% in 2003. The prevalence of HIV in women increased from 3.5% infections among 2,576,800 planned pregnancies in 2010. 83,557 seropositive pregnant women need PMTCT services. The prevalence of HIV in women under 15 is estimated at .33%.

The goal is to reinforce the capacity of civil society organizations to advocate, plan and implement a national plan to eliminate mother-child transmission of HIV, in partnership with the healthcare system, men and families.

ACRONYMS:

1. EMTCT: Elimination of Mother-to-Child Transmission of HIV
2. PMTCT: Prevention of Mother-to-Child Transmission of HIV
3. HIV: Human Immunodeficiency Virus)
4. ARV: Antiretroviral Treatment
5. PNC: Prenatal Consultation

Themes

In what ways is this project unique and creative? Edit

Its goal is to move away from the classic medical approach that is focused on mother-child and towards reinforcing the healthcare system (services) without increasing the number of women’s visits to maternal services (request for services) to an approach based on the family. For this, increased community participation for a greater involvement by men (the woman’s husband or partner).

What is the social value of this project? Edit

Community participation towards a family approach as a national PMTCT strategy will:

• Encourage men to take responsibility of PMTCT as a parental commitment of the mother and husband/partner and be tested.
• Make men responsible who will now accompany pregnant women to their doctor’s appointments.
• Improve men’s understanding of family planning, another pillar of PMTCT .
• Encourage men to pay greater attention to the health of mother and child.

All these factors contribute to using services and reducing the transmission of HIV from mother to child.

What is the potential of this project to expand and develop? Edit

The combination of strategies on a national level that focuses on reducing stigma and promote family stability, as well as the importance of continuity of care through:

• Making health authorities aware
• Mobilizing national and local authorities, community leaders, as well as religious faiths for the cause
• Reinforcing the community system
• Partnering between health and the civil society
• Creating awareness for communities and families
• Promoting male leaders (champions) who believe in the strategy

What was the triggering factor of this project? Edit

Due to the population’s large size and low availability and use of PMTCT services, the DRC is an African country that significantly contributes to some of the needs that are not covered. Of the 2,576,800 expected planned pregnancies in 2010, 2,249,944 did not have access to HIV testing – the door to PMTCT services. Among the 82,557 seropositive pregnant women estimated in 2010, 79,186 did not receive ARV to reduce mother-child transmission.

PMTCT results in the DRC are equally mediocre if we compare the progress in neighbouring countries: Congo Brazza 60%, RCA 56 %, Burundi 29.96 % and in Rwanda from July 2012 to June 2011, the PMTCT national program tested 84% of seropositive pregnant women’s partners.

According to health authorities, the main reasons for this delay is:

• the weakness of the healthcare system
• insufficient financial resources

To that, we must add the weak mobilization of pregnant women for implications of health services delivery. According to the 2010 MICS survey, 87% of pregnant women had at least one PNC during their pregnancy, 44% at least 4 times. This is due in large part to the too much attention given to the medical aspects to the detriment of civil society organization (NGOs and associations). We also note the weak attention given to men (woman’s spouse or partner) as a target for the program.

What is the business model of this project? Edit

This project has no business model, but it is possible to consider studies to evaluate the economic impact on the elimination of mother-child HIV transmission plan by estimating the benefits of:

• Decreasing maternal and infant mortality
• Breaking the transmission of new infections
• Reducing the number of orphans and children vulnerable to AIDS
• The demographic impact on family planning


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