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Elimination of Mother-to-Child Transmission of HIV taking shape in Uganda

By Catherine N. Makumbi

Alice Atugonza, 28 is living with HIV. When UNICEF Uganda team visited her at Hoima Regional Referral Hospital, Alice had just given birth to her fourth baby.

All her other four children are HIV negative, thanks to the Elimination of Mother to Child Transmission of HIV (eMTCT) interventions implemented by the Uganda government and its development partners. The Office of Uganda’s First Lady, Mrs. Janet Museveni, has since 2012 championed implementation of the country’s eMTCT plan through country-wide  regional advocacy and community dialogue, sensitization and mobilization eMTCT campaigns aiming at realising an HIV-free generation.

At the hospital, the smiling and happy looking Alice displayed a Nevirapine Syrup for her 1 day old baby. “The nurses have always encouraged us to do exclusive breast feeding while giving this syrup,” she explained.  Alice’s story is not different from Patience Aikoru’s who is also HIV positive and shares her testimony. We met Patience at her home in Kinubi village, Hoima municipality.  Patience also has 3 children, girls, who are HIV negative. Having utilised the same eMTCT package provided at government health centres she still wants to have a fourth child, preferably a baby boy.

“I do not care if my neighbours or people around me talk that I am HIV positive. Atleast I know my status. Most of them do not know their status. For me I am on treatment and I feel very okay,” she explained.

The First Lady’s eMTCT campaigns have resulted in an increase in the demand and supply of HIV-related services across the country, and provided a platform for stakeholder engagement and mutual accountability for effective maternal new born and child health service delivery.

On 23rd March, Mrs. Museveni launched the 8th Regional eMTCT campaign for mid-western region covering 14 districts (Kiboga, Kyankwanzi, Hoima, Masindi, Bullisa, Kiryandongo, Kibaale, Kasese, Kabarole, Kyegegwa, Kyenjojo, Kamwenge, Bundibugyo and Ntoroko).  The launch, in form of a public rally attended by about 10, 000 community members, was preceded by a Stakeholders’ meeting attended by development partners including UN agencies, American Embassy, USAID, Centres for Disease Control, the Minister of Health and his team, District Local Government Leaders and their Health Teams, Religious and Cultural Leaders, and implementing partners. The two months preceding the launch were characterized by deliberate acceleration of implementation of HIV service delivery activities, mainly HIV testing and counselling, safe medical male circumcision, Prevention of Mother-to-Child Transmission (PMTCT), Early Infant Diagnosis, enrolment of HIV infected individual in care and treatment, family planning and cervical cancer screening, both at community and healthcare facility level in the 14 districts. The rally and stakeholders meeting were supported by UNICEF on behalf of all UN agencies in Uganda.

Mrs. Museveni called on all people at individual, family, community, district and national levels to join hands in preventing new HIV infections especially among the young people in order to achieve an HIV free generation in Uganda. “If we continue walking the journey together, we shall end the HIV epidemic”, she added. The First Lady wondered why HIV/AIDS continues to be a big problem in Uganda when it is not in many countries.  She emphasised the unavoidable need for Ugandans to change the way they do things, including their sexual and reproductive health behaviour.

The UNICEF Representative in Uganda Ms. Aida Girma applauded the First Lady’s leadership and commitment towards advocating for, and supporting the health and wellbeing of mothers and children in Uganda. She noted Uganda’s significant strides towards meeting the goals of the Global Plan to eliminate new HIV infections among children and keeping their mothers alive, including 85% ARV coverage for HIV positive pregnant women who access antenatal care.  While major achievements have been realised, she noted the need to address salient issues to realise and sustain the goals. Ms Girma emphasized the following areas of focus: accelerating treatment for HIV infected children and adolescents: strengthening various elements of the health system, including integration of HIV and Maternal Newborn and Child Health services; promoting greater male involvement; scaling up family planning and reproductive health services; more focus on adolescent girls, promoting community involvement, strengthening partnerships and increase domestic funding for HIV/AIDs.

Uganda’s Minister of Health Dr. Elioda Tumwesigye regretted the increasing national HIV prevalence from 6.4% in 2005 to 7.3% in 2011. He attributed this to an irresponsible behaviour of concurrent multiple sexual partnerships, including cross-generational sexual relationships.  The minister implored religious and cultural leaders to utilise their platforms to spread prevention messages.

The Hoima District Health Officer, Dr. Joseph Ruyonga, noted that in the mid-western region of Uganda where the 8th eMTCT campaign event took place, the HIV prevalence is 8.2%, higher than the national average, calling for even more vigilance towards averting new infections in the 14 districts. 

Many Ugandan communities and families are now much more aware of the national PMTCT program and its benefits to their health. Individuals and couples testifying to these benefits are seen across all districts in the country. Dina Tumusiime and Godfrey Sebukyu, an HIV positive couple living in Kinubi village in Hoima district, are another testimony of these great strides. They have a healthy 3 year old son and the joy that he is HIV negative is all over their faces.
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