Transcript Slide 1

CHAZ
Each Community Counts
Community Leadership Spearheading PMTCT Program to
Improve Health Outcomes of HIV Exposed Babies,
at Nangoma Hospital, Zambia
Dr. Dhally Menda
MD, MPH, MBA
Maternal and Newborn Health Conference
for Zambia’s Mothers and Babies
01st November 2012
www.chazhealth.zm.org
CHAZ Background Information
Formation & Membership
• Formed in 1970 ( Catholic and Protestant Medical Committees)
• Interdenominational (Catholic and Protestant) umbrella organisation
for 146 CHIS in 10 Provinces:
• 36 Hospitals & 81 RHCs & 9 Training Schools
• 29 CBOs
Health Services Coverage
• CHAZ is the second largest provider of health services in Zambia.
• MoU with the MoH: Grant- Staff Secondment – Essential Drugs
PMTCT and ART Sites
• PMTCT: 61
• ART: 51
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
CHAZ Health Programmes
Malaria Control
HSS in 146 CHIs
TB Control
CSS≥ 500 CBOs
Mentoring & TA
HIV & AIDS
PMTCT: 13,157
Sensitizations
ART: 48,979
Awareness
Campaigns
C&T: 361,111
MC: 7,453
MNCH
National Strategic
Framework
Background
• Nangoma is a Mission hospital is situated in the rural Central Province
• ART and PMTCT programs: Initiated in 2006 – Support: GF ATM
• Catchment: 80,000 & Polygamous society
• HIV prevalence rate among pregnant women aged 15-40: 9.5%.
• Home Deliveries (60%) due to: Long distances, Traditional beliefs,
Myths and Stigma. – Exposed babies at risk of getting HIV
Method
• Sensitized the Senior Chief (Shakumbila) and all his entourage on
the importance of PMTCT.
• Lobbied the Chief to have all pregnant women deliver from HF
• Home Delivery Penalty: Goat
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
Method Cont’d
To improve the PMTCT outcomes, the Hospital ART/PMTCT Team came up with an
HIV Prevention Strategy that embraces all community members. Throughout 2010,
the ART/PMTCT team:
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Recruited mothers to join the Mothers’ Support Groups, to encourage
networking and fight against discrimination
Recruited Adherence Supporters Workers to help in client (mother/infant
pair) defaulter tracing
Involved men, through community leaders and hospital staff, to come with their
wives for all Antenatal Clinic visits
Encouraged HIV +ve pregnant women, living in distant areas from the health
facility, to stay at the Maternity Waiting Home, when they enter their 3rd
Trimester of pregnancy.
Encouraged all ANC clients to undergo VCT as a couple.
Provided ART and/or ARVs Prophylaxis to the mother-baby pair
Provided EID.
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
Results
The community leadership and members embraced the initiative and took
the project to the next level.
As a result:
HF deliveries increased from 60% in 2008/09, to almost 100% in 2010.
Figure 1: Improvement in health facility deliveries
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
Result Cont’d
Figure 2: Improvement in health facility deliveries
Out of the 72 HIV +ve mothers who delivered at Nangoma Hospital:
93% of delivered babies with a negative HIV PCR test.
Among the 24 women who delivered at home (no PMTCT intervention),
from outside the chiefdom, 20% of their babies had a positive HIV PCR test
(P=0.05).
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
Conclusion
PMTCT interventions with a strong community involvement
have a positive impact on the health outcomes of HIV
exposed babies (Avert HIV infection).
Involvement of the community through community
leadership, can help rural based Health Facilities improve:
• ANC attendance,
• Couple Counseling, and
• Health Facility deliveries
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
Acknowledgment and Thanks
Acknowledgement:
Co-Authors:
M.M. Bwalya,
P.M. Mulenga,
J. Simutowe,
M. Zulu,
S. Hambilika,
K. Sichinga
Thank you
God bless
Partners:
MoH
GFATM
Nangoma Hospital Staff
Nangoma Community
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2