A.32.Implementation of PMTCT programme in Mzuzu
C. Capello, I. Olek, M. Scott, M.
Objective and Scope: In the framework of the national PMTCT programme, PMTCT services have been integrated in Mzuzu Central Hospital (MZCH) and Mzuzu Health Centre (MZHC) with the support of Medecins du Monde Canada. The paper illustrates the results from May 2004 to February 2005.
Methodology: Delivery of optimal PMTCT services and community sensitisation are the main project components. All ANC bookings receive PMTCT education; group pre-test counselling is offered to new ANC bookings. Pregnant women undergo testing and post-test counselling individually; group infant feeding counselling sessions are held. Initially administered exclusively in Maternity, NVP tablets are delivered as take-home drug to eligible women. HIV exposed infants received NVP syrup following national guidelines. Clients and infants are followed-up up to 18 months.
Results: 29.060 people (6.668 males; 22.392 females) were sensitised on PMTCT in Mzuzu. 446 Health Workers received PMTCT education, with 82 trained as PMTCT Providers. 3.346 pregnant women received PMTCT information and 1.737 were pre-test counselled (52% of new ANC bookings); 98% of them accepted to be tested; 100% of the tested women received their result. The HIV prevalence rate is 15% (No=255). 65 HIV positive women took NVP at labour; 71 HIV-exposed infants received NVP. 48 PMTCT clients have attended at least 1 follow-up visit. 211 partners were tested for HIV.
Conclusion: Pregnant women are willing to know their HIV status but still HIV positive women fail to take or receive NVP; partner involvement is low; fear of discrimination, the long distance from the service delivery point and the scarce partner participation seem reasons for the high dropping out rate.
Recommendations: A proper monitoring and follow-up system could provide more information on the rationales behind the low uptake on the PMTCT