HIV/Aids
For Every Child, Health
Challenges
Chad is one of the countries in Africa that is the most affected by the AIDS epidemic with an overall prevalence of 1.6 per cent according to DHS/MICS from 2014-2015.
Aware of this situation, the government has undertaken a number of measures, such as : free care for those living with HIV PLWHA, the delegation of tasks, the monthly health meeting led by the President of the Republic, the adoption of diverse policy plans in the fight against AIDS, the advocacy of the First Lady in the elimination of HIV transmission from mother to child, and pediatric care, the prevention and care of adolescents.
Despite this commitment from Chad’s authorities in the areas of prevention and care of HIV/AIDS, only 22 per cent of HIV-positive children from 0 to 14 have access to retroviral treatment.
- The integration of screening in pediatric services is lacking. The proximity of maternity hospitals and pediatric services in district, provincial and natioinal hospitals should foster the care of the at-risk children, but such is not the case. The monitoring of these children is clearly not oriented systematically by pediatric services. The lack of arrangements for proper screening demotivates mothers who wait too long to know the serological status of their child. The monitoring of these children is clearly worse than that of their mothers.
- The availability of ARV is often irregular. Despite the availability of ARV and inputs, one finds poor coverage for the antiviral treatment of children, the supply of reagents for pediatric PCR is far from sufficient.
It is characterized by delays of input delivery, purchase of products that are unsuitable or in insufficient quantity reflecting the absence of coordination between the actors of the users’ organization and those in charge of the purchases.
75 per cent of seropositive pregnant women are on retroviral treatment versus 54 per cent of adults.
The prevalence of HIV is seven times higher in urban areas (4.3 per cent) than in rural areas (0.4 per cent).
The prevalence among young women rises with age. It is at 1.2 per cent among 15-19 olds, at 1.8 per cent among 18-19 olds and 2.4 per cent among 23-24 olds. It is lower among boys (0.7 per cent)
Medical care for pediatric HIV has a very limited role in the policy documents, and implementation is affected by weak supervision at the operational level. Data collection for children is incorrect.
Solutions
The HIV and AIDS component targets three large results of the national programme
The elimination of HIV transmission from mother to child (EMCT)
- The primary prevention of HIV and sexually transmitted diseases
- The prevention of unwanted pregnancies for HIV+ women
- The PMTCT itself in care and community
- The care of the woman and child in the family : the support, the proper care and treatment of HIV+ mothers, their children and their families.
These 4 pillars define the anchoring of the EMCT in the health and community institutions. They integrate family planning, Prenatal Consultation, management of the pregnancy, including assisted childbirth and the continuity of care.
Prevention and the care of pediatric AIDS (0-14 years old)
The prevention and care of HIV among children aged 0-14 ans is closely linked to the continuum of care and mangement of the mother-child pair, i.e. the promoting of the Prenatal Consultation, screening, obstetric care, screening and monitoring of the newborn and infant. The children who have eluded PMTCT are identified, screened and cared for through different entry portals , such as the therapeutic nutritional units, pediatric consultations and family screening, which is one of the important remedial approaches.
The prevention and care of AIDS among adolescents and youth (aged 10-24)
UNICEF supports the government in developping approaches and implementing high impact interventions to define the scope of areas of vulnerability to infection in youth and adolescents in the context of Vision 90-90-90 of UNAIDS. That means screening 90 per cent of people in need, treating 90 per cent of them and having 90 per cent of the latter without a detectable viral load. UNICEF is working with cultural organisations (Reading and Cultural Centre), youth organizations for prevention, screening, care of HIV and the promoting of reproductive health. The interventions among youth and adolescents integrate innovations : the use of numerical platforms (U-Report) and the commitment of youth to screening and peer counseling.
