Kenya, 1 November: 'Maisha Zone' initiative aims to end mother-to-child transmission of HIV

© UNICEF/NYHQ2010-2289/Nesbitt
Mentor Mother and Mothers2Mothers site coordinator Jacklin Akinyi Odongo plays with her daughter, Natalie Aki Amor, at Kisumu East District Hospital.

By Michael Klaus

KISUMU, Kenya, 1 November 2010 – For 26-year-old Jackline Odongo, an ordinary day back in 2008 turned out to be the most extraordinary one in her life. On that day, she went for her first antenatal care after she was pregnant with daughter Amor. It was also on that day when she received the shocking news that she was living with HIV.

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

Beaten up and thrown out of her house by her husband, Jackline took refuge at a friend's house. She only regained her hope with the help of a support group made of mothers just like her. “I met my fellow mothers who were pregnant and the ones who were already with babies,” recalled Jackline. “Through their support, I was strengthened…. I said, ‘If all these women could live with HIV and if all these women – or most of them – their babies were HIV-negative, then why not me?’”

Under the mentor mother's guidance, she went through prevention of mother-to-child transmission of HIV services and took her antiretroviral medications regularly. She later gave birth to a healthy baby girl - Amor, who is now one year and a half old, and free of HIV. The experience also empowered Jackline. As one of the first women who received support from the mentor mothers group, two years later, Jackline became a mentor mother herself.

Just recently, she was greeted warmly 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 Esat District Hospital in Kisumu, located in Kenya’s Nyanza Province, to celebrate the global launch of the Mother-Baby Pack, an innovative approach for prevention of mother-to-child transmission, or PMTCT.

© UNICEF/NYHQ2010-2287/Nesbitt
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.

Improving access to treatment

The simple yet revolutionary Mother-Baby-Pack can have a significant impact on increasing the number of babies born free of HIV. 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.

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. Initially, some 30,000 packs will be distributed to pregnant women living with HIV. 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. Scaling 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 Mentor Mothers – women living with HIV, 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 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.



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More stories from Kenya


25 October 2010: UNICEF Radio speaks with Jackline Akinyi Odongo, a 'mothers2mothers' site coordinator who counsels women in Kisumu, Kenya about preventing HIV transmission.
 AUDIO listen

29 October: UNICEF Executive Director Anthony Lake speaks to CNN Correspondent David McKenzie about the Mother-Baby Pack.

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