PMTCT services extended to health center IIIs and excites mothers

PMTCT services extended to health center IIIs and excites mothers

By Hope Mafaranga

In Ntungamo

“I never tested for HIV when I was pregnant because the health facility where such services were offered was far. I ended up infecting my first born,” These are the words of Stella Natuhwera of   Ndeija in Rwampara district.

Natuhwera says that the health where she could get services is at Itojo Hospital in Ntungamo district or Mbarara regional referral hospital about 40 and 50 kilometers respectively.

Natuhwera said that, after two years, she conceived and went to Bugamba Health Center III where she was started on treatment when her pregnancy was just three months.  Today Natuhwera is proud mother of a nine months HIV free baby girl.

Many women have infected their babies after failure to go to health because of long distance.

In 2010, Dina and Umar Mugarura their dream of having healthy babies was shattered after the couple tested positive to HIV.

Dina aged 33 and a resident of Rwashamire said  that she lost hope and almost aborted because she did not want to raise a baby with HIV.

 However her attitude changed after going to Rwashamire health center III and she was told about the EMTCT Option B+ methods.

“I was started on treatment when the pregnancy was three months and I have continued to take my one tablet which the nurses explained to me that was a new method of elimination of mother to child transmission (EMTC) Option B+ that would protect me my baby and making me healthier,” she said.

According to the Ministry of Health, since inception in 2000, the national PMTCT program has steadily scaled up to cover over 2,000 (40%) of the estimated 5,000 health facilities in the country.

However, the minister of health Dr Christione Ondoa said that despite the success in increasing geographical access to PMTCT services, some pregnant women are not being reached and many HIV positive mothers are being lost at some point. It’s from this point that they have enrolled the it to the lower health center IIIs in order to reach women in deep rural areas.

“About 82% of pregnant women were tested for HIV positive as of June 2012, only 68% of positive pregnant women received ARVs for PMTCT, and only 38% of their babies received ARVs prophylaxis after birth. To address these critical gaps, the ministry has embarked the new Option B+ guidelines for eMTCT to bridge the gap,” she said.

The transmission of HIV from mothers to their infants contributes significantly to global morbidity and mortality in children aged five years and below. 

Dr Andoa said that Uganda was for long considered a global yardstick in the fight against HIV and AIDS, having reduced its prevalence from a high estimated 30% in the eighties, 18% in the nineties, and a record 5% low in 2002. 

However, there are fears of increasing new HIV infections. The results of the 2011 Uganda AIDS Indicator Survey (UAIS) show that national prevalence now stands at 7.3% among adults aged 15-49 years, up from 6.7% in the 2004-5 national population-based survey, with HIV prevalence in South Western standing at 8.0%.

The executive director of Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) Dr Edward Bitarakwate said that previously, expectant mothers were on single dose of Nevirapine tablet and Syrup for mother and baby and HIV positive pregnant  were asked to do replacement feeding (infant formulae) while  HIV testing was voluntary.

Dr Bitarakwate said that now with EMTCT Option B+, ART will be started earlier in pregnancy, which he said will significantly reduce the rates of intrauterine transmission.

 “ART can be started at the woman’s first visit and in the first trimester reducing missed opportunities Transmission through breastfeeding will decrease because the mother will be on ART. Mothers can also breastfeed for a longer time hence contributing to increased HIV free survival through reduced HIV risk as well as morbidity and mortality from malnutrition,” he said.

The EMTCT method comes in the wake of the Global Plan Towards the Elimination of New HIV Infections among Children by 2015 and Keeping their Mothers Alive, which aims to reduce the number of children newly infected with HIV by 90% by 2015, and to reduce the number of women dying from HIV-related causes during pregnancy, delivery and post-natally by 50%, from a 2009 baseline.

“We want to use anti-retroviral treatment to not only prevent mothers from passing the HIV virus to their babies but also protect their own health and allow them live longer to look after their families,” Bitarakwate added.

FACTS ABOUT Option B+

Option B+

•           Initiation of ART earlier during pregnancy at or before 14 weeks

•           Giving ARV prophylaxis to baby for only 6 weeks

•           HIV+ mothers recommended to breastfeed for 12 months and beyond while on ART for the entire duration of breast feeding and for life

•           1st PCR at 6 weeks, 2nd PCR 6 weeks after Stopping BF, and Rapid antibody test at 18 months as infants will be breastfeeding for much longer time.

•           All children under 2 years old immediately eligible for ART

•           AZT replaces D4T as preferred first line treatment regimen

Lack of water threats lives in Rwampara

  Lack of water threats lives in Rwampara

By Hope Mafaranga

 People in Rwampara,  Mbarara district are sleeping on empty stomach due to lack of water. The most affected areas are Kashuro, Kyankyere and Kiyonga.

 Alfred Bikitwoho are resident of Kashuro says that the three villages share one spring and queue is too long to bear.

“When someone goes to fetch water at 3pm, he/ she will return after midnight when all children and the rest of the family members are a sleep,” he said.

He said the spring which was constructed  in 1984 to serve a small population can no longer do serve them because the household has grown from 200 in 1984 to over 800 now.

 He said that the challenge of water is time wasting and people have resorted to taking and using unsafe and clean water.

In a desperate move, James Nuwagaba has dug a 40fit pit to tap water that flows during rain seasons.  Nuwagaba who termed the water scarcity as a “curse” said that the area has been neglected by government and other stakeholders and as result people even spends a week without bathing.

“I am too desperate to save my family and animals from this curse of water scarcity.   Most of us here take weeks without bathing. ,” Nuwagaba said.

Before Nuwagaba concluded his statement, the Kashuru LC 1 chairman Geoffrey Begumanya interjected saying that: “You cannot fail to get water for cooking and drinking and you get water for bathing!

Begumanya appealed to government to put an engine and a reserver to pump water from the valley to the uphill to an end of suffering of the people there.

“We are gathering money as local people but we can’t raise 800m needed to put a gravity scheme, we urgently need government’s intervention before we die,” he said.

Begumanya also said that the water scarcity has also affected  the standard  of education and children’s performance, urging that they send children to fetch water and take a day to come back.

“Our children no longer go to school because they have to assist families to search for water,” he said.

Begumanya was on Wednesday speaking during a community dialogue that was organized by HEPS Uganda at Kashuro primary school, Ndeija Sub-county, in Mbarara district.

 The Executive Director of HEPS Uganda, Rosette Mutambi said that the issue is not only a water issue but also a health one.

She said that people of that area suffer from water borne disease and appealed government to address it..

“ The issue of health is threat to people’s lives because they suffer from water borne diseases which they should not have if at all they had safe and clean water. As a result, government spends much on drugs more than preventing the diseases,” she said.

The Mbarara Assistant Water Engineering Officer, Engineer Joseph Mucunguzi said  that people travel for more than 5 miles in search of water , adding that the only alternative is to pump water from the only one water point  which is located  in deep valley so that the people  in the mountains can get access to water.

He however explained that to pump the it, the district needs about sh 800m to construct a reserver which is too expensive to for the district.

“We acknowledge that people here are suffering but we a the district we cannot afford the gravity water scheme for them because we have to hire a consultant, surveyor  to see is possible to have water pumped. But gravity water scheme is  too expensive and the government of Uganda cannot afford it unless we get donors,” he said.

However the MP Rwampara Vincent Kyamadidi said sad that they have failed to managed to manage the problem because the place is too hilly.

“Water pumping is not realistic in this area because of its terrain. I am encouraging people to construct tanks and develop a culture of harvesting water rain. Otherwise we will continue sleeping hungry and suffering waiting for the government to pump water uphill,” Kyamadidi said.

 End.

Global Fund Targets $15 Billion to Effectively Fight AIDS, TB and Malaria

The Global Fund to Fight AIDS, Tuberculosis and Malaria announced a goal of raising US$15 billion so that it can effectively support countries in fighting these three infectious diseases in the 2014-2016 period.

 The Global Fund is determined to accelerate the gains achieved in recent years against AIDS, TB and malaria through strategic investment in programs that can save millions of lives and tens of billions of dollars in future costs. While acknowledging the challenging fiscal environment in many countries, the Global Fund and its partners point to the remarkable value for money that investing in health provides.

“We have a choice: we can invest now or pay forever,” said Mark Dybul, Executive Director of the Global Fund. “Innovations in science and implementation have given us a historic opportunity to completely control these diseases. If we do not, the long-term costs will be staggering.”

President Joyce Banda of Malawi, a leader in efforts to prevent and treat infectious diseases in Africa, said that raising money for the Global Fund was essential to defeat AIDS, TB and malaria.

“The progress we have made with the support of Global Fund and has shown us what we can do when we come together,” said President Banda. “Defeating these diseases is a shared responsibility. African countries are doing their utmost to provide human and financial resources for the health of their people. But we need strong support of the Global Fund to succeed.”

The Global Fund is convening a donor’s conference in Brussels on 9 and 10 April to present an overall needs assessment for the 2014-2016 period and an update on results and impact from recent years, which have helped achieve dramatic success in fighting AIDS, TB and malaria. Donors will be invited to a once-every-three-years pledging conference, known as the Global Fund’s Fourth Replenishment, in late 2013.

Working together with technical partners at WHO, UNAIDS, Roll Back Malaria and the Stop TB Partnership, the Global Fund formulated a needs assessment that demonstrates that raising US$15 billion would lead to a transformative effect in the incidence and death rates of HIV and AIDS, TB and malaria.

When combined with other funding, including an estimated US$37 billion from domestic sources in implementing countries and US$24 billion from other international sources, a US$15 billion contribution to the Global Fund would allow the collective work to address 87 percent of the global resource needs to fight these three diseases, estimated at a total of US$87 billion.  

Reaching the Global Fund’s goal, together with other funding, would mean that 17 million patients with tuberculosis and with multidrug-resistant tuberculosis could receive treatment, saving almost 6 million lives over this three-year period. This level of funding would prevent millions of new cases of malaria, and would save approximately 196,000 additional lives each year than with current funding levels by preventing a resurgence and renewed epidemic of malaria.

It would also mean preventing more than one million new infections of HIV each year – saving billions of dollars in care and treatment for the long-term. Antiretroviral therapy could become available to more than 18 million people in affected countries by 2016, up from 8 million in 2012.

Overall, effective funding means that collective efforts can turn what scientists call high-transmission epidemics into low-level endemics, essentially making them manageable health problems instead of global emergencies.

The new funding model recently launched by the Global Fund can achieve greater impact by encouraging ambitious programs and by focusing interventions and financing for specific populations. By reaching highly vulnerable, marginalized and stigmatized groups, including young women, sex workers, people who inject drugs, men who have sex with men and prisoners, more programs will maximize impact while advancing human rights.

The new funding model also strives to align investments in HIV, TB and malaria with national health strategies while strengthening health systems and serving as a platform for promoting the health of a person rather than only combatting specific diseases.

“We can defeat these diseases by working with partners,” said Dr Dybul. “Collectively, we know what has to be done, and we know how to do it. But we have to work together to succeed.”

 Ends.