Delivering PMTCT services in Malawi
By Victor Chinyama
Alice Chipeni looks forward to her young baby being tested for HIV. The thought is enough to fill many minds with dreadful expectation but for Alice, it is one more step in a long journey that began in 2004.
Her baby was born in the UNICEF supported programme to Prevent Mother to Child Transmission of HIV at Kasungu District Hospital where his odds of contracting HIV were shortened by a third. At 13 months, Alice’s baby is five months away from the penultimate step, the HIV test which will formally confirm his negative status and graduate him from the programme. For Alice, that will be the fulfilment of her dream to have an HIV free baby, long nurtured when she became pregnant in 2007.
Alice’s HIV status was confirmed in 2004 after several months of futile battles with a persistent cough. On and off several treatments, an x-ray finally confirmed tuberculosis and Alice was immediately put on treatment. A relapse of the disease a year later prompted her nurse to suggest an HIV test.
“After the results were confirmed, I was put on antiretroviral treatment,” she says. “I was as thin as a stick but after sometime I began to regain my weight and my appetite was back.”
Alice’s husband refused to have himself tested. He blamed her for everything and left to join his other wife. Alice, a teacher, was earning enough to support her children and to afford her nutritional needs. In 2007, she became pregnant by her husband.
The doctor advised her to continue the antiretroviral treatment. To prevent contracting the HIV virus soon after birth, her baby was given the antiretroviral drug and co-trimoxazole, an antiobiotic that reduces the incidence of opportunistic infections like pneumonia among children. Alice was also given an insecticide-treated net for preventing malaria and iron tablets. Through a provision from the World Food Programme, she was also given maize, beans, and vegetable oil.
Alice opted not to breastfeed her baby, a decision she was later to regret.
“I had big problems affording the infant formula,” she says. “I didn’t really understand what I had chosen until I began spending MWK12, 500 (USD 83) every month on infant formula alone, which was more than my monthly salary”
Had her counsellor followed guidelines recommended by the World Health Organisation, Alice would have chosen infant formula only after satisfying herself that she could not only afford the cost but also that it will always be available and accessible to her and her baby.