Mother-Baby Pack Delivers Infant HIV Prevention in a Box. 25/3/10
A new Mother-Baby pack for HIV positive women aims to revolutionize the prevention of mother to child transmission (PMTCT) in several African countries.
By Allyn Gaestel
25 March 2010
A new Mother-Baby pack for HIV positive women aims to revolutionize the prevention of mother to child transmission (PMTCT) in several African countries.
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Components of the color-coded Mother-Baby pack contain antibiotic and ARV medications for HIV-positive pregnant women and their newborns.
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Many women in developing countries are unable to access formal health centers throughout their pregnancy and delivery due to logistical difficulties and lack of infrastructure. Historically when women visited a health center, they would be tested and told to return for further PMTCT services. However, many women have to travel far to reach health centers and some cannot afford the transportation costs, so many are unable to return. Dr. Chewe Luo, senior advisor for HIV/AIDS at the United Nations Children’s Fund (UNICEF) told MediaGlobal “When we look at globally where we are with antenatal access, we can actually say that it is up to around 70 percent of women that come at least once but then when you look at how many women are coming back to deliver, we’re seeing that slightly less than 50 percent, it’s about 48 percent who come back to deliver in a health facility.”
In the long run it would be best to build more health centers equipped with PMTCT care. But given the current situation, UNICEF, in partnership with the World Health Organization (WHO), has developed the Mother-Baby pack. The pack and the programming around it aim to take advantage of any contact women have with formal health structures and enable women to access the necessary medicines to prevent transmission of HIV to their baby, even if she cannot deliver at a health center.
The Mother-Baby pack is a box clearly separated into three sections for antenatal, delivery, and post delivery. Each section has all the necessary medicines women would take if they were delivering in a health center. The pack is clearly labeled with pictures to communicate when and how to take the medicines, so women can follow the guidelines whether or not they are literate.
The Mother-Baby pack is designed to streamline the process of distributing PMTCT medicines. Luo said, “One of the main thrusts of this work is to simplify how these drugs can be delivered to mother and also to simplify the messaging with the provider and also to simplify the planning for these drugs for the program managers.” Mothers will be able to keep their medicines straight given the simple packaging, care providers have a visual tool to explain the continuum of care to mothers, and program managers will be able to order the packs in bulk, instead of trying to maintain stocks of all the different medicines included in the packs.
The pack is designed to generate discussions between the health care provider and the mother about what continuing care is necessary and how she can build support mechanisms in her community. Luo told MediaGlobal, “We’re hoping that this particular intervention can actually improve the access to services by mothers because it allows for a focused discussion around what this mother is going to go through throughout the care continuum and not just that one particular visit.”
UNICEF also partners with mothers-to-mothers support programs and local midwives to engage communities to work in solidarity with women outside of the official health centers to ensure they have a community to support their medical regime.
An ongoing debate exists in the development health field around the issue of providing expanded access to medicines without extensive oversight by health officials. Experts worry that with open access to medicines such as the drugs included in the Mother-Baby pack there will be a greater possibility for patients to misuse the medicines and develop toxicity or resistance. However, Luo explained, “Mothers, when it comes to care and support, will normally follow the advice of what the providers tell them.”
Furthermore, the project builds upon an existing program in Lesotho that has provided women with PMTCT medicines since 2007. The program has been very successful in increasing access to medicines, so UNICEF is expanding on the model and launching a pilot program for the Mother-Baby pack in Lesotho, Zambia, Tanzania, and Kenya. Luo also emphasized that during the pilot project, UNICEF will be monitoring any negative repercussions of the expanded access to drugs.
The Mother-Baby pack pilot project will begin in July 2010.