According to UNAIDS, there are currently 930,000 adults living with HIV. 62% of the population live below the poverty line.
The Malawi Government has played a major role in implementing prevention programmes for mother to child HIV virus transmission. It was one of the first countries in the developing world to apply WHO protocol (Option B+).
Although this service is now present in the majority of maternity units, the correct implementation of the protocols and effective management of care centres is yet to be established.
So whilst an estimated 73% of HIV+ women enrol on the programme there is little evidence of continued retention rates and only 30% of children exposed to HIV are tested within two months of birth. This lack of expertise in monitoring and follow up is one of the main obstacles preventing Malawi from developing and improving its Public Health System for EMTCT. There is also a significant lack of investment in a specialised health workforce.
In this project, ABC is partnering with Sant’Egidio DREAM to Sponsor a public maternity ward – to support & train local health staff and to raise performance outcomes.
ABC is funding a specialist trained health team, transport and certain equipment for one year.
The DREAM health team comprises a doctor, nurse and two expert clients (local mothers who have successfully been through the programme) who will work in the public maternity facility to implement best practice EMTCT protocol. The doctor and nurse will visit the health centre every week in order to monitor the implementation of the programme and work with problematic clinical cases. The expert clients (mother mentors) will work five days a week in the maternity ward in order to track patients’ treatment, verify the medical attendance, actively search for missing patients, promote voluntary testing and counselling, and implement awareness sessions. Pregnant women going to the public maternity ward will be encouraged to take the voluntary testing for HIV and, if positive, will be enrolled in the PMTCT programme that includes anti-retroviral drugs throughout pregnancy, childbirth and breastfeeding and regular diagnostic monitoring.
This clinical path ensures the highest quality intervention, very high retention rates and hence the elimination in 98% of HIV+ pregnant women. This intervention has been proved to be successful in other maternity units.