The Prevention of Mother-to-Child Transmission (PMTCT) has been around for a while now. Although the initiative has faced all manner of problems, its success is there for all to see in Ntchisi.
Naturally, people such as Catherine Banda should not have children. The HIV in her body is a risk not only to the baby, but herself too.
But growing up, Catherine always wanted to have a baby. She actually quit school before getting any qualification because she wanted a baby, but the HIV stood between her and her dream, a dream her aunties in Nthondo Village, Traditional Authority (T/A) Nthondo in Ntchisi groomed her to be.
Sitting at Ntchisi boma, Catherine clasps her baby, Boniface Bernard, a jolly fellow always wanting to break free from his mother’s grasp to crawl away purposelessly, his exuberance of youth ruling.
Boniface does not have HIV, and Catherine did not adopt him; she bore him and while she went into labour, she and her doctors knew very well that she had the virus that causes Aids.
The Prevention of Mother-to-Child Transition (PMTCT) programme is an international initiative that is aimed at reducing the transmission of HIV from infected pregnant mothers to babies in the womb, during delivery and breast feeding.
The programme began in July 2011 following recommendations by the World Health Organisation (WHO).
“When I fell pregnant and wanted to start my antenatal visits to the hospital, they tested my blood for HIV. You know, it’s mandatory for pregnant women to undergo the test. They found me HIV positive and told me to make sure that I report to the hospital in my eighth month,” said Catherine.
After she was diagnosed with HIV, her husband bolted, leaving her in stress and trauma, but that did not deter her from her dream of having a child, one who is free from HIV.
At eight months, she reported to the hospital and was given a Neverapine dosage, which is the core drug in the PMTCT process.
When the baby was born, it was also given its own dosage of Neverapine and when the tests were conducted months later the baby was HIV free.
“It gives one hope. You can now have kids! This was a mirage not long ago. I think if they say they want a future where there is no HIV, PMTCT is a good start. I will keep my baby safe, I make sure I don’t have sores around my breasts when I breastfeed my baby,” said Catherine.
She was speaking recently on the sidelines of an interface meeting of various players to discuss PMTCT issues in Ntchisi.
Mponela Aids Information and Counselling Centre (MAICC) partnered a consortium of Plan Malawi, Council for Non-governmental Organisations (Congoma) and Action Aids to assess the delivery programme, dubbed PMTCT Kalondolondo, in Ntchisi between December 2012 and February 2013.
The programme was run in collaboration with the Ntchisi District Health Office, National Association for People Living with Aids in Malawi (Napham) and community leaders.
Since 2010, 345 exposed children in the district have been tested; 34 diagnosed HIV positive, representing about 10 percent, while 320 were negative.
The good and bad news
Women such as Catherine are hindered from accessing the service by their own making or husbands and community leaders.
“Attitudes of women towards PMTCT is characterised by misconceptions and fear of losing their marriages if found positive. PMTCT is culturally understood as a maternal issue which most women believe men should not be involved.
“Women are not ready to go with their spouses to the hospital for fear that men will not have interest in them giving birth. It encourages stigma when one is known to be HIV positive and conjugal rights will be compromised with heavy condom use in wedlock like private relationships,” said George Kaunda, MAICC programmes officer.
Lack of knowledge is also an issue. Not knowing is what cost Monica Soko her child. She did not know about the programme, a situation that made her first child die of Aids-related infections.
But, courtesy of the programme, her current child does not carry the virus.
T/A Nthondo said lack of information on the issue and access to PMTCT services is one of the biggest factors that can mar its success and prevent the dream of creating an HIV-free generation.
“As a traditional authority, I am moving to make bylaws to punish mothers and birth attendants who connive to do home deliveries. The idea is to let women go to hospitals where such services are available,” said Nthondo.
He asked government and other stakeholders to involve community leaders in mainstreaming such programmes and not impose initiatives which may end up being rejected by communities.
Litness Chiumia, PMTCT director for Ntchisi, said ignorance poses a challenge in the implementation of the programme.
Chiumia called for more sensitisation to highlight the programme in communities.
Kalondolondo Programme managerJephter Mwanza agreed with Chiumia that sensitisation is crucial for the initiative.
“Sensitisation can help bridge the PMTCT gaps. Of course, there are other issues such as stock-outs of test kits, reagents and staff which also need to be looked into,” said Mwanza.