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Tackling the risks of childbirth for HIV-positive women in southern Sudan

© UNICEF Sudan/2005/Ashton
‘Grace’ keeps busy with embroidery but mourns her baby who died last year, probably from AIDS-related complications. Since then UNICEF has begun to provide antenatal services, including interventions that reduce mother-to-child transmission of HIV.

RUMBEK, Sudan, 5 December  2005 – “What’s done, is done,” whispers Grace* as she rests in the shade, but the searching look she gives her husband, Oliver*, and the little mound of dirt behind her, betray the fact that her grief is still fresh.

The mound close to Grace’s thatched home in the heart of southern Sudan is the grave of her 1-year-old son. He died a year ago this month, almost certainly of an AIDS-related cause. HIV was most likely transmitted to him during pregnancy, birth or breastfeeding. Grace believes her husband infected her, though Oliver is not convinced. The couple only realized they were HIV-positive after their son had already died.

The question of who is to blame for their infection and their baby’s death still hangs between them – unanswerable – threatening their marriage. Grace is trying to move on. She knows she needs to concentrate on staving off the onset of AIDS, but she feels she cannot recover from her pain. Too often she remembers the two hours she walked from the hospital back home with the body of her dead son, limp in her arms. 

Were Grace to become pregnant today, the outcome could be very different. Now at her local hospital in Rumbek – and in 13 other locations across war-torn southern Sudan – clinics supported by UNICEF have started to provide antenatal services, including interventions that reduce the chances of mothers transmitting HIV to their children.

Every day around the world there are nearly 1,800 new HIV infections in children under 15; most are associated with mother-to-child-transmission. In the absence of any intervention, in 25 to 40 per cent of cases, an HIV-positive pregnant woman will pass the virus to her baby during pregnancy, birth or through breastfeeding. For the first time women in Rumbek are now able to access Nevirapine, the anti-retroviral drug that suppresses the HIV virus in their blood as part of maternal health services supported by UNICEF.

UNICEF is also backing a ‘Safe Motherhood Initiative’ which aims to provide a full package of antenatal services, including counselling and testing for HIV. An estimated 95 per cent of births take place at home in southern Sudan, and things often go wrong. “The clinic gives us a chance to talk to women with potential birth problems and ask them to come to hospital for their delivery,” says Margaret Aguti, who runs the Initiative’s clinic in Rumbek. “Since we started each [woman] we asked has shown up.”

*These names have been changed



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