World AIDS Day 2014

Closing the Gap: Amref Health Africa calls for joint action to reduce maternal deaths related to HIV/AIDS

 
As the 2015 deadline for the Millennium Development Goals approaches, countries are focusing their efforts on meeting the Millennium Development Goals (MDGs). MDG 6 calls for global efforts to halt and begin to reverse the HIV/AIDS.

The world has made great progress towards the global vision of zero new infections, zero discrimination and zero AIDS-related deaths. Similarly, tremendous progress has been made in the last 15 years towards the Millennium Development Goal of halting and reversing the spread of HIV. Nevertheless, HIV is still a great global concern. According to UNAIDS, 22 million people were living with HIV in sub-Saharan Africa in 2012, 58 per cent of whom were women, while 230,000 children were newly infected. Of particular concern is that HIV is a leading cause of death among women of reproductive age in Africa.
 

A health worker counsels a client during a Counselling and Testing session


The main reasons for this state of affairs are inadequate scaling up of prevention strategies, and limited access to reproductive health services as well as HIV treatment and care. In fact, pregnant women living with HIV are less likely than treatment-eligible adults overall to receive antiretroviral therapy. Treatment coverage among children living with HIV in 2012 was less than half that of adults, underlining the importance of addressing specific needs of women and children to reduce the negative impact of the epidemic.

As an international African organisation working side by side with communities, Amref Health Africa believes that by focusing on the health of women and children one can improve the health of the whole community.

Amref Health Africa joins the world in celebrating the World AIDS Day 2014 under the theme “Close the Gap”. For Amref Health Africa, closing the gap means empowering and enabling individuals and communities everywhere to access the services they need. This theme accurately reflects our work: Amref Health Africa aims to bridge the gap between the people in the community and the formal health system by giving communities knowledge, skills and means to transform their health as well as supporting peripheral health facilities to fulfill their mandate. We are particularly concerned about the continent’s high maternal mortality, to which HIV/AIDS is a major contributor. We must ensure that prevention and treatment services are widely accessible to women to reduce maternal deaths and to save babies from infection.

Through its interventions in countries, Amref Health Africa seeks to close the gap in various areas:

Closing the gap in access to comprehensive HIV and reproductive health services
In Uganda, Amref Health Africa has supported 18 government health facilities to introduce an integration model of service delivery to offer voluntary medical male circumcision, HIV counselling and testing, management of sexually transmitted infections, and linkage to other services such as ART, family planning and infertility disorders.
 
Closing the HIV testing gap  
In the Northern Arid Lands of Kenya, more than 62,000 individuals were counselled and tested for HIV and received their test results. Of the 349 clients who tested HIV positive, 92% were linked to care and treatment.

In Tanzania, Amref Health Africa reached a total of 218,774 people (115,512 males and 103,262 females) with HIV Testing and Counselling (HTC) services, through 42 outlets that provided onsite and outreach HTC services. In addition 1,203 women and 185 children were reached with prevention of mother-to-child-transmission (PMTCT) services in four districts.

Closing the gap in treatment and care
In the informal settlement of Kibera in Kenya, Amref Health Africa has been implementing a care and treatment project since 2003. The project provides HIV testing and counselling, PMTCT, care and treatment of children and adults with HIV, and TB/HIV diagnosis and treatment, using an integrated model of health care provision. To date, there are more than 4,000 HIV-positive adults and children receiving care and treatment in the slum area. HIV testing and counselling is provided to all the women receiving ante-natal care in the facility. Those who test positive are started on antiretrovirals to reduce the risk of mother-to-child transmission.

Closing the gap in PMTCT services
Since January 2012, Amref Health Africa in Ethiopia has been implementing Biruh Tesfa (Bright Hope) Community-based Project with the objective of reducing the transmission of HIV from mother to child, and alleviating the impact of HIV/AIDS on women and children in Addis Ketema sub-city.  

In the past year, 4,128 pregnant women were counselled and tested for HIV, 37 mothers received ARVs to prevent passing of infection to their children. Major approaches used to reach the communities include strengthening the referral system through mobile technology and provision of weekend health services for male partners.

Closing the gap in men’s involvement
According to the Uganda AIDS Indicator survey (2011), the national adult prevalence of HIV was 7.3%, up from 6.4% in 2006, with married couples in heterosexual relationships accounting for 43% of all new infections. The situation called for a more comprehensive HIV prevention approach beyond advocating abstinence and faithfulness.

The Scaling Up Comprehensive HIV/AIDS Prevention Project contributes to the reduction of new infections by offering a biomedical intervention; Voluntary Medical Male Circumcision. In Uganda, where the coverage of male circumcision is just 26% with men characteristically being poor seekers of health services, the intervention is geared towards bridging an important gap. The service is linked to other services, enhancing its uptake. So far, the project has facilitated 200,000 circumcisions in six districts in central Uganda, with the service an accompanying rise in couple counselling and uptake of HIV services.

To reduce maternal and child deaths through HIV/AIDS, Amref Health Africa calls for increased joint action between governments, civil society and the private sector in order to leverage available resources for efficiency and effectiveness of interventions, and strengthening of health systems to comprehensively address women’s health.