CURRENT PROJECT

The goal of this project is to develop new and complementary aspects for PASCIH's PMTCT ARV Program, so that it may address community health needs through health promotion/education, health worker training and the development of a PMTCT curriculum based on PASCIH's learnings to date, and psycho-social support for families affected by HIV/AIDS participating in the PASCIH PMTCT Program.

PROJECT BACKGROUND:

Southern Africa suffers under the massive AIDS epidemic with 21% of all pregnant women being HIV infected. Prevention of Mother to Child Transmission of HIV (PMTCT) is a critical priority, but also must be balanced due to the need to provide adequate and safe infant nutrition. As adequate and safe nutrition necessitates breastfeeding (which can transmit the virus) these goals can be in conflict. The WHO has recently issued new guidelines for safe breastfeeding which include either provision of combination antiretroviral therapy (ARV) to the mothers to decrease the breast milk viral load and preserve the mother's health, or provision of infant nevirapine throughout breastfeeding. Exclusive breastfeeding for 6 months, followed by supplemented breast feeding for a further 6 months are new recommendations. These recommendations are very different from older guidelines, and necessitate extensive education of health care professionals, mothers and community members.

PASCIH has been working in Lusaka, Zambia since 2006, and has achieved tremendously successful quantitative biomedical results from their prevention of mother to child transmission (PMTCT) ARV Program. Their pilot program, which involves 280 HIV positive pregnant and breastfeeding women, decreased the infant rate of HIV positivity from 12.3 to 1.3% at 6 weeks of age (when compared to a cohort treated using the previous approach in the same region 2 years earlier). Furthermore the combined endpoint of HIV positivity or death fell from 16% to 5.8% using their new regimen. This very low transmission rate is the lowest yet seen in an African cohort.

In order to ensure continued positive impacts from the Program, PASCIH is collaborating with IDRF to build a project management, community outreach, and capacity building component into the existing ARV Program. This project will act to complement and support the existing ARV Program activities while developing new aspects for the PMTCT ARV Program so that it may address community health needs through health promotion/education, health worker training and the development of a PMTCT curriculum.

GOALS & OBJECTIVES:

• Contribute to the reduction of MTC transmission rates through building upon and supporting PASCIH's ARV Program
  
• Enhance safe motherhood options through the promotion of safe breastfeeding, as well as the provision of education, psycho-social, and food security support for HIV+ mothers
• Reduce infant mortality rates, and promote mother-child heath, through education and support
• Increase community education around women's and maternal health within the HIV/AIDS environment, thus increasing awareness and decreasing stigma
• Enhance the capacity of health care workers to provide strong and accessible maternal and infant health care for families affected by HIV/AIDS
• Enhance the organizational knowledge of the Program so as to best be able to support participants, as well as promote collaboration at the local level
• IDRF will support PASCIH through providing project management regarding fundraising, institutional memory, project cycle management, and reporting, thus enabling optimal project transparency, sustainability, and long term efficacy
  

PLANNED ACTIVITIES:

• Creation and Dissemination of Educational Resources
• Education & Support for HIV+ Women in the Program
• Health Worker Training - Physicians and Nurse Practitioners
• Community Education and Mobilization Sessions for Community Leaders and Stakeholders
• Food Security to Enable Safe Motherhood Options
• Provision of Medical Care
• Mapping Assets
  

Partner: Mt Sinai Hospital (Peter A. Silverman Centre for International Health, PASCIH)

To see pictures from the project, click the image below