Child protection & HIV/AIDS actions enhance access to HIV care and fight against child marriage

Kamuli District recorded a 20 per cent increase in teenage pregnancies in 2020

By Alex Taremwa
ARVs on display at a health centre in Kamuli
26 May 2021

The integration of HIV/AIDS and child protection interventions has improved access to services in HIV care, mobilized leaders to denounce child marriages and built capacity to tackle violence against women and children in Kamuli District.

Throughout most of 2020, Kamuli had a 66 per cent retention rate in HIV care for children aged 0-14 years, well below the recommended national average of 95 per cent. However, the district’s fortunes changed after Mothers2Mothers (M2M) implemented catalytic interventions to end child marriages and HIV/AIDS.

With funding from the FNS Charity Campaign, the district has in five months (December 2020-April 2021) reached full retention in care for children in all the four selected health facilities; Kamuli General Hospital, Kamuli Mission Hospital, Namwendwa Health Centre IV and Nakandulo Health Centre IV.

All children aged 0-14 living with HIV continued to receive Antiretroviral Therapy (ART) in addition to 12 children who were newly identified and enrolled into care since December when the project started.

One of the newly identified children is 12-year-old Isaac*(not real names). Isaac, the second born in a family of seven children was often sickly. His parents tried local remedies in futility until they decided to visit Namwendwa Health Centre IV for medical assistance.

*Isaac talking to a mentor mother
*Isaac walking with a mentor mother

“We already knew our status because our first-born child had tested positive for HIV/AIDS but because we had followed all guidelines, we did not think Isaac would contract the disease too,”

Isaac’s father recalled.

To their dismay, Isaac tested positive for HIV/AIDS and had to be enrolled into care immediately. Sarah Nabirye, the mother mentor who enrolled him explained that Isaac contracted the virus from breastfeeding beyond the recommended time.

“Some of the poor families do not have money to buy supplementary feeds for their children. As a result, mothers keep them on breast milk past the one-year mark. By this time, the baby has developed teeth and can bite the mother’s breast. When the blood interacts with its soft gum in the mouth, chances of the baby contracting HIV are very high,” she explained. 

Isaac is now in Primary Four and is studying to become a doctor – an inspiration he derived from Sarah Nabirye, the mother mentor who saved his life.

He has learnt to swallow his antiretroviral drugs diligently and to eat well for his body to keep suppressing the virus. Isaac has a very low viral load and his parents have had five more children, all of whom are HIV negative.

Health education at health centre in Kamuli
Training on positive parenting

Besides having a high HIV prevalence rate, Kamuli District also recorded a 20 per cent increase in teenage pregnancies in 2020, exacerbated by the closure of schools due to the COVID-19 pandemic.

At Namwendwa Health Centre IV, for example, Dr. Gonzaga Mankumba, the Health Facility In-Charge said that half of the mothers who visit for antenatal care services are less than 20 years.

M2M saw an opportunity to integrate health interventions with child protection to create synergy within the district. The project brought together four seemingly parallel district offices to work together to end HIV/AIDS and child marriages in the district.

 “Most of the adolescents who get who do not return for treatment, do so because they lack stability at home. When girls get pregnant at school, their parents shun them, and their partners are also financially unstable. As a result, adhering to drugs becomes a challenge,” explains Mildred Ajio, the Prevention of Mother-to-Child Transmission (PMTCT) Focal Person at Namwendwa Health Centre IV.

The integration of HIV/AIDS and child protection interventions has improved access to services in HIV care, mobilized leaders; local, religious and traditional to denounce child marriages and built district and sub-county capacity to tackle violence against women and children by training parents in their respective Village Savings and Loan Association (VSLA) on positive parenting skills.

Police officer engaging a community member
Police officer at the home of a community member to solve a family violence

The project dubbed ‘Catalytic Interventions to end Child Marriages and HIV/AIDS’ has also enhanced knowledge among adolescent peer educators to teach their colleagues at schools and in communities about their rights.

However, some sections of leaders and community members in Kamuli District have pleaded with the funders to extend the project for at least one year.

Dr. Mankumba argued that due to the COVID-19 restrictions, some of the interventions targeting adolescents should have been implemented in schools but because the schools were closed, some adolescents may not have benefited.  His voice was echoed by the Assistant District Health Officer In-charge of Maternal, Child and Adolescent Health, Moses Lyagoba who said that the district had just started ripping benefits of the project.

 “If the project is extended, we would be able to cover the rest of the sub-counties in the district and achieve the 95 per cent mark for all target groups in knowing their HIV status, enrolment in care and retention,” he added.