By Michael Klaus
KISIMU, Kenya, 1 November 2010 – During the better days of her marriage, Jacklin Akinyi Odongo gave her daughter the name Amor. What she experienced after confessing to her husband that she was HIV-positive, however, had nothing to do with love. Beaten up and abandoned, Ms. Odongo took refuge with friends.
|VIDEO: 29 October 2010 - UNICEF's Kun Li reports on the launch of the Mother-Baby Pack as part of an initiative to reduce mother-to-child HIV transmission in Kenya. Watch in RealPlayer|
Ms. Odongo’s story has a happy ending, though. She was greeted warmly late last week by UNICEF Executive Director Anthony Lake, representatives of the Kenyan Government and other partners – as well as a big crowd of mothers and children. They had all come to the District Hospital in Kisumu, located in Kenya’s Nyanza Province, to celebrate the global launch of the Mother-Baby Pack, an innovative approach to prevention of mother-to-child transmission, or PMTCT.
Kenya introduced the Mother-Baby Pack on Friday as part of its ‘Maisha’ initiative to create a zone free of mother-to-child transmission of HIV. (‘Maisha’ means ‘life’ in Kiswahili.) The initiative aims to eliminate mother-to-child transmission by 2013 in Nyanza and Rift Valley Provinces, where about half of all Kenyan children with HIV live, and by 2015 in the whole country.
Improving access to treatment
The simple yet revolutionary Mother-Baby-Pack could have an impact on increasing the number of babies born free of HIV. A pregnant woman’s first antenatal visit is a vital opportunity to be tested for HIV and prevent transmission of the virus to her baby. The Mother-Baby Pack builds on this opportunity by making it easy for mothers to start PMTCT treatment from the first visit – and to continue it throughout their pregnancy and beyond.
|From left: Ministry of Medical Services Director Francis Kimani, Kisumu East District Hospital Superintendent Dr. Aggrey Otieno Akula and Nurse Carolyne Kemunto Gichana discuss the Mother-Baby Pack with UNICEF Executive Director Anthony Lake in Kenya.|
The pack combines highly efficacious anti-retroviral (ARV) drugs and prophylactic antibiotics for one pregnant woman and her newborn child from 14 weeks of gestation until six weeks after delivery. It promotes easier storage, distribution and management of PMTCT medications, while reducing the chance of pharmaceutical shortages in clinics.
Health workers in antenatal clinics will distribute the treatment packs to pregnant women who are living with HIV but do not yet need ARV treatment for their own health. This will help to improve access to PMTCT, particularly for women in remote areas, since they can administer the drugs at home.
UNICEF developed the Mother-Baby Pack in collaboration with the World Health Organization and with financial support from UNITAID, the US Government and the Clinton Health Access Initiative, among others. The drugs in the pack are financed by UNICEF National Committees in Japan, Germany, the Netherlands, Austria and the United States. The cost of producing one pack is around $70.
|Dr. Catherine Kidiga explains the contents and uses of the Mother-Baby Pack to health workers during a presentation at Kisumu East District Hospital in Kenya's Nyanza Province.|
The roll-out of the Mother-Baby Pack in Kenya marks the beginning of a phased implementation in four African countries, also including Cameroon, Lesotho and Zambia.
In each of the countries, UNICEF will closely monitor and evaluate the acceptance of the Mother-Baby Pack by these women and their families. Once the initial phase is complete, distribution of the pack will be expanded to other areas and other countries.
Meeting the ‘Maisha’ challenge
While the adult HIV-prevalence rate in Kenya is declining, some 60 infants are still being infected through mother-to-child transmission every day. Meanwhile, following a period of rapid progress in providing pregnant women with preventive services, the percentage of women actually receiving PMTCT treatment has stagnated.
|At Kisumu East District Hospital in Nyanza Province, Kenya, UNICEF Executive Director Anthony Lake speaks during the launch of the Mother-Baby Pack as part of the ‘Maisha’ initiative to prevent mother-to-child transmission of HIV.|
A further scale-up of PMTCT has been hampered by low utilization of antenatal care services – with less than a half of all pregnant women completing four antenatal care visits and more than a half giving birth at home.
The Maisha initiative addresses these barriers through a combination of interventions. In addition to the distribution of the Mother-Baby Pack, the initiative aims to increase the number of deliveries assisted by skilled birth attendants. This is to be accomplished through intensified follow-up care for pregnant women by community health workers, and through financial incentives for health facilities that improve their performance.
PMTCT efforts are to be enhanced, as well, by using SMS text-messaging technology to increase the number of children who are tested soon after birth. And behaviour-change communications will encourage stronger involvement in PMTCT activities by the male partners of pregnant women.
The Maisha initiative also involves so-called Mentor Mothers – women living with HIV/AIDS, who participated in a PMTCT programme and now help other women deal with the stigma associated with HIV and the challenge of adhering to treatment. The Mentor Mothers urge pregnant women to bring their young children to health facilities for testing.
Mr. Lake of UNICEF commended the Kenyan Government for its commitment to pursuing all of these approaches to saving young lives.
“These powerful initiatives build on decades of innovation, cooperation and partnership dedicated to maternal and child health,” he said.” Taken together, they represent the next wave of progress in the long fight for a generation free of HIV and AIDS.”