September 21, 2023

Lara Adejoro

The National Coordinator of the Association of Women Living with HIV and AIDS in Nigeria, Assumpta Reginald has said that the uptake of antenatal care, facility delivery, and early infant diagnosis coverage of human immunodeficiency virus is low.

Reginald, however, said the low uptake of facility-based services by mothers is not peculiar to women living with HIV.

Reginald said this on Thursday in Abuja at the advocacy workshop for mentor mothers on the uptake of prevention of mother-to-child transmission of HIV and Early Infant Diagnosis (EIDs) services, and 16 days of activism and a close-out ceremony of four days of training organised by ASWHAN with funding support from UN Women.

She said “I am aware that the ongoing national strategic plan is moving forward to plan for the elimination of mother-to-child transmission of HIV. This is an extremely good development. We are, however, still far from this vision.

“In 2020, the prevention of mother-to-child transmission coverage was 37 per cent. The uptake of ANC, facility delivery, and EID coverage is still very low. 

“This low uptake of facility-based services by mothers is not peculiar to women living with HIV. The national data on the use of the facility by women reflect that what you see with women living with HIV is a reflection of what is happening in Nigeria.

“There is evidence of good practices that success of PMTCT programming in Nigeria. All the evidence for improving maternal uptake of facility services points to the need to invest in community structures and systems. PMTCT or Elimination of mother-to-child transmission as it is called now will require active community engagement to make the needed difference.

“We as community members have a huge concern about the poor will to invest in community systems to drive what concerns us. Investments in community systems to drive PMTCT is poor, inconsistent, and done with tokenism. It is a bridge of our rights to care to know about best practices and not institute this.

“Nigeria has success stories to tell about how the Mentor Mothers program can make the needed paradigm shift with PMTCT services. We can build on the lessons learnt with the Mentor Mothers program and bring this program to scale up. However, building and bringing to scale up cannot be done with the current practices of poor remuneration or inconsistent engagement of mentor mothers. Mentor mothers need to be developed as a national program with all systems and structures to support its implementation. Community systems and structures also need to be given the due visibility to drive and do what it is specialized to do.

“The USAID localisation agenda, PEPFAR, Bill and Melinda Gates, and Global Fund all speak to the need to strengthen community response and ensure the community owns their response. If there is any place where the realisation of this localisation agenda needs to be grounded in Nigeria, it is with the PMTCT programme. Funding of facility care services to the exclusion of community care services cannot move the country from a PMTCT programme paradigm to the EMTCT programme paradigm.

“Women having positive babies is not a data matter. It is a source of emotional turmoil for any woman. The emotional and physical pain of nursing a child who could have been born HIV Negative is not what anyone here will want to go through. We all have the responsibility to spare all women from such agony when we have the tool and the technical knowledge to make it happen.”

According to her, PMTCT policymakers and programmers need to develop the will to make the needed change happen.

“ASWHAN can actively play a role in this respect. ASWHAN is a network that has the coverage to support community programming for PMTCT or EMTCT. Direct funding for ASWHAN-led community-based activities, to support delivery by skilled personnel, in systems and structures that promote PMTCT and EID uptake will make the needed difference.

“ASWHAN is a willing partner. We have been doing and will continue to do what we know how to do best – support women living with HIV to live high-quality lives with family and children.”

Meanwhile, the Programme Director, Global Fund-supported National Aligned HIV/AIDS Initiative, Christy Laniyan, said there is a need for every woman to know their HIV status.

“We must ensure that every woman who becomes pregnant tests for HIV, knows their result just like they will test their packed cell volume to know whether they are anaemic. 

“If a woman is pregnant and anemic, she may die, and she may give birth to a low-birth-weight baby but once she knows she is anaemic, there are things she will be given that can increase her blood, make the baby be born healthy, so is the same with a pregnant woman who is HIV positive.

“When she knows her status, there are enough technology and tools in hospitals to help her deliver an HIV-negative baby. It will be good to have a generation of children in Nigeria who are not HIV positive to achieve the EMTCT,” she said.

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