A PROMISE KEPT: THE SUN RISES IN ANAMBRA STATE “LIGHT OF THE NATION”
Anambra State – “Light of the Nation”, is located in South-East Nigeria. The State is bounded by Delta State to the west, Imo State to the south, Enugu State to the east and Kogi State to the north. Anambra State has one of the highest population densities in Africa. The 2012 population projections estimates that there are about 249,206 pregnant women in the state (RHFA 2013). The state has the highest HIV prevalence in the South East region (8.7%), the fourth highest in the country, with about 20,328 pregnant women infected with the virus (2010 Sentinel Survey). Approximately one-third of pregnancies in HIV infected women will culminate in HIV transmission to the baby without effective “Prevention of Mother to Child Transmission (PMTCT)” of HIV/AIDS interventions. Based on its high prevalence, Anambra State was identified as one of the 12+1 states that contribute 70% of Nigeria’s “mother to child transmission (MTCT)” burden. In 2013, the 12+1 states were earmarked by the Government of Nigeria for phase 1 of Nigeria’s PMTCT scale-up efforts towards elimination of mother-to-child transmission of HIV (eMTCT).
Family Health International (FHI360), through the “Strengthening Integrated Delivery of HIV/AIDS Services (SIDHAS)” project, with funding support from United States Agency for International Development (USAID), partnered with relevant government stakeholders to conduct a baseline assessment of 829 facilities in the state. The goal was to derive a baseline profile of antenatal care (ANC) services in the state to aid effective planning for scale up of services for eMTCT in Anambra State. Armed with findings from the baseline assessment and the alarming gap in PMTCT service availability, utilization and the absence of the requisite human resource and infrastructural environment needed for a successful eMTCT scale up, FHI360 proceeded to map its strategy for stakeholder engagement and effective dissemination of the findings of the rapid health facility assessments (RHFA) and developed state-specific, costed PMTCT scale-up plan that would guide expansion of PMTCT services.
On the 9th of April, 2013, FHI360 mobilized key stakeholders in HIV response at the state and federal levels (State Ministry of Health and NACA) and development partners (UNICEF and PPFN) on a targeted advocacy visit to the former Governor of the State, Mr. Peter Obi. The results of the RHFAs and state specific 2-year (2013-2015) eMTCT scale up implementation plan were presented to him. Faced with the documented findings, the governor committed to ensuring the dissemination of the eMTCT scale up implementation plan to a wider audience.
At the groundbreaking dissemination event on the 28th of June, 2013 supported by FHI360, Mr. Peter Obi presented the well-articulated results of the RHFAs and the eMTCT scale up plan to the state. In the excitement of the day and in keeping with his promise to proactively support the state HIV response, Mr. Peter Obi pledged to procure “Rapid HIV Test Kits” (RTKs) for all 616 facilities providing antenatal services for pregnant women in the state. This commitment was made in the presence of traditional leaders, national level stakeholders, implementing partners and women groups among others. The Governor’s pronouncement was further confirmed at subsequent public engagements and media chats, some of which were covered by the Daily Times and other newspapers in a news item captioned “Anambra Govt. to Spend N1bn on HIV Test Kits” (available at http://www.dailytimes.com.ng/article/anambra-govt-spend-n1bn-hiv-test-kit). True to his word, Mr Peter Obi awarded a contract to the tune of N200M in March 2014 for the procurement of RTKs for the state.
The RTKs finally arrived the state in January 2015 and were received by the incumbent Governor of the state, Mr. Willie Obiano. The RTKs are categorized as – Determine – 210,000 tests, Unigold – 49,000 tests and Stat Pak – 45,500 tests, and are being warehoused by the Anambra State Agency for the Control of AIDS (ANSACA). The distribution has already commenced to facilities providing HIV/AIDS services. As at February 23, 2015, a total of 13,200 tests of Determine, 3,100 tests of Unigold and 500 tests of Stat Pak were received and distributed to SIDHAS supported sites. Community Based Organizations (CBOs) engaged by ANSACA under World Bank-HAF project and other health facilities (private and public) which are currently not being supported by any program have been earmarked to receive RTKs in order to increase HIV testing and counselling in the state.
FHI360 through the SIDHAS project and with support from USAID will sustain efforts towards increasing multiple testing points at supported health facilities and intensify community outreaches to ensure there are no missed opportunities. It is evident that Anambra State, “Light of the Nation”, has set in motion actions that will guarantee the realization of the goal of early detection, prevention of mother to child transmission (PMTCT) of HIV and ultimately “elimination of mother to child transmission (eMTCT) of HIV. The “Sun has indeed risen” for the people of Anambra State.