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Tuesday, July 12, 2011

HIV-free babies: Antenatal attendance is the way to go

Both men and women should work together and share the responsibility of saving their unborn children from contracting HIV. Experts say that prior preparations to receive the unborn baby, HIV counseling as well as attendance of antenatal clinics in hospitals with skilled medical workers by expectant mothers ensure healthy mothers and HIV-free babies, reports Sade Oguntola.
Helen Adams (not real name), a mother of three and living with HIV. She is ever pleased to express her gratitude for her three sons and husband that are free of HIV, thanks to good antenatal care and provision of HIV medicines.
Mrs Adams, the coordinator of Mother and Child club at the Braithwaite Memorial Specialist Hospital, Port Harcourt, River State, is always apt to encourage mothers to be positive about their HIV status and to ensure that they confirm to the instructions they are given once they start attending antenatal care.
No wonder, Christiania Amaka, a mother of one, accepted easily to register for antenatal care to ensure she delivers HIV-free healthy baby. “I assessed antenatal care at the Nnamdi Azikwe Teaching hospital during my first pregnancy. We received HIV counseling, were talked to about what to do to maintain our health and our preferred mode of having child delivery. I chose Nnamdi Azikwe Teaching hospital to be able to stay with my mother so that she can take care of me.
“But, now with my second pregnancy, I registered for antenatal care with Braithwaite Memorial Specialist Hospital, Port Harcourt because I could not afford to be paying N5,000 on transportation every clinic day to Nnamdi Azikwe Teaching Hospital, Anambra State. For instance, if there is any problem, I will talk to them about it so that they can give me drugs alongside the other HIV medicines,” she reiterated.
Equally, Mrs Borida Monday, who was diagnosed with HIV after her first pregnancy, is looking forward to having an HIV-free baby. “I was referred to the Nnamdi Azikwe Teaching Hospital after being diagnosed with HIV for antenatal care because the nursing sister that initially attended to me at a nearby hospital wanted me to have my baby and in good health,” declared Mrs Monday.
Nigeria plans to reduce maternal deaths and HIV new cases by 2015 – goals five and six of the Millennium Development Goals, MDGs, a United nation’s initiative agreed to by governments around the world. Despite the Federal government midwifery scheme and other initiatives to promote safe mothers and healthy children that are HIV-free, one in three infants of 210,000 HIV positive pregnant mothers in Nigeria will become HIV infected annually and one in three of 67,000 HIV infected infants will die before the first birthday; while one in two before their second birthday if there are no interventions to curtail it.
Reasons for these are diverse, regardless of advancement in medical science and provision of services to ensure babies and mothers are healthy and transmission of HIV is curtailed in the course of giving birth or breastfeeding. Even in Rivers State where there is subsidised health care for pregnant women and free caesarian section, Dr Dango Kalio, a consultant obstetrician and gynecologist, Braithwaite Memorial Specialist Hospital, Port Harcourt, stated that a good number of pregnant women still seek antenatal care from churches and traditional birth attendants because of poverty, religious beliefs and illiteracy, rather than from hospitals with facilities to support healthy mothers and HIV-free babies.
According to him, “Rivers State government built health facilities in various areas with a view to decentralising services, encouraging pregnant women to access the facilities, give them access to good medical care and ensuring that those requiring specialty care are attended to. But many still do not want to attend antenatal care in these government hospitals.”
Although Braithwaite Memorial Specialist Hospital attends to new 26 pregnant mothers with HIV per month on the average and at least 18 end up having HIV-free babies, the number of women that had benefited from such initiatives like this is in Nigeria is innumerable. No doubt, antenatal services that include modes of preventing mother to child transmission of HIV is good news to couples with HIV.
However, as stated by Dr Kalio, a former President, Nigerian Medical Association (NMA), Rivers State, “pregnant mothers should try as much as possible to patronise hospitals where they are sure of getting the best antenatal services that medical science can offer. Those patronising traditional birth attendants, the faith based organisations and pharmacy shops may end up being referred to hospitals very late, when complications develop. Now that maternity services are subsidised, they should patronise government hospitals because we (medical health workers) are here to help.”
Certainly, a listening hear and understanding heart is ensuring that pregnant women see coming for antenatal care as essential aspect of preparing for a healthy baby, irrespective of the mother HIV status.
“In our facility, we take time out to ensure we become friends with the pregnant women as they come. We treat them well and ensure the confidentiality of their HIV status while continuing counseling that their husbands should know of their HIV. This is to ensure that their husbands, if are found HIV positive, can also access care and counseled on their sexual activity and family planning. This is in a bid to ensure the family lives healthy and well, “ Mrs Queen Briggs, Assistant Chief Nursing Officer, Braithwaite Memorial Specialist Hospital, Port Harcourt, declared.
Ensuring safer mothers and healthy HIV-free babies is possible. In fact, Dr Abiola Davies, in an update of elimination of mother-to-child transmission of HIV in Port Harcourt’s meeting of Journalist Alliance for Prevention of Mother to Child Transmission of HIV (JAP), said relatively simple actions could reduce cases of Nigerian children that become HIV-positive –induced adequate antenatal care, family planning, exclusive breast feeding and antiretroviral therapy (ARV).
What is good HIV “combination” prevention? According to her, “a tailored response addressing both immediate risks and underlying causes of vulnerability to HIV.
This includes behavioural changes such as delay in onset of first intercourse, reduction in sexual partnerships, condom use; biomedical strategies such as safe blood products, safe needles and prevention of vertical transmission (PMTCT), as well as structural approaches addressing the social, economic, political, environmental and legal factors which directly affect HIV risk and vulnerability.”
According to her, elimination of mother-to-child transmission of HIV and HIV in babies requires a convergence of agenda; something for everyone – health, nutrition, girls’ education and empowerment, opportunity for adolescents, protection.
In order to ‘eliminate’ MTCT and AIDS in children by 2012, Nigeria must attain reduce HIV incidence by 50 per cent among women aged between 15 and 24 years; reduce unmet need family planning by 100 per cent for HIV positive women; increase coverage of ARVs by 90 per cent (including for women needing ARVs for their own health); as well as imbibe the notion of ‘treatment as prevention’.
According to her, sexual as well as mother-to-child transmission of HIV transmission rates are significantly lower with effective antiretroviral therapy (but certainly not zero!). In addition, people living with HIV if better are better placed and motivated to model prevention behaviours and to disclose HIV infection to their partners and families.
http://tribune.com.ng/index.php/your-health/24641-hiv-free-babies-antenatal-attendance-is-the-way-to-go