Supporting community driven Prevention of mother-to-child transmission of HIV (PMTCT)
The Ijaw community of Eastern Obolo have since the conception of Akwa-Ibom State in 1987 been a community distinctly set apart from the rest of the state. The only access to the Local Government Area (LGA) is a single two lane road built on marshland which is prone to flooding during the tropical rainy season. To buttress this point, it is one of two LGAs with more island wards than land. It had no secondary level healthcare facility until ten months ago and currently has only two doctors providing care to the whole community. Care for HIV infected persons, let alone HIV positive pregnant women, had been minimal till six months ago when FHI 360 with funding from USAID and the Akwa Ibom state government trained Community Health Extension Workers and nurses from the Health Centers and Health Posts on PMTCT.
Activation day at one of the little known communities Okoro-Inyong village was unique. The square was filled with a multitude of people. Amongst this mass of persons were representatives of the union of traditional birth attendants (TBAs). This group of persons has constantly bridged the midwife gap that exists in our hinterland communities being a ready source of support to the pregnant women in labor. Worthy of mention is the reality that TBAs have come to stay in the communities and that for PMTCT to succeed and culminate in elimination of mother to child transmission, TBAs must be recognized and collaborated with closely. To achieve this in Eastern Obolo, the need to create linkages with TBAs in the 10 community by trained Primary Healthcare Center (PHC) personnel was given due emphasis.
The result of this linkage creation was markedly evident at PHC Okoroette, where over 30 TBAs were in attendance during the activation exercise. They were aptly sensitized on the need to have their clients tested for HIV in order to protect the babies as well as the TBAs themselves. All TBAs in attendance willingly subjected themselves to HIV screening, pledged their commitment to the success of the PMTCT program, and promised to present all their clients for HIV screening. A recent visit to the community has shown an increased turnout of persons at the health centers and health-posts. The Head of the PHC operational base who received Integrated Management of Pregnancy and Childbirth (IMPAC) training recounts “When I came here being the only trained personnel it was difficult to provide PMTCT services to the pregnant women alone.”
The PHC Director explains further “We now have over 12 staff from six facilities trained on PMTCT. And we conduct outreaches to the communities on the waters. This has increased our reach. Our antenatal clinics were very scanty but each clinic day we now have over 20 women and they receive HIV testing and counseling. We have been able to place two pregnant HIV positive women on prophylaxis. It is most fortunate to have this kind of program at this time and we are trying to utilize it maximally.” This LGA like others activated during the course of the PMTCT scaleup has an IMPAC trained director and has several well trained staff. The impact of these trainings on the hard to reach communities has been obvious. There has really been a visible strengthening of the healthsector at the local government level.