Category Archives: Zambia

HIV and Family Planning Needs Are Linked, and Demand an Integrated Approach

By Chip Lyons, EGPAF President and CEO, and Suzanne Ehlers, Population Action International (PAI) President and CEO

Originally published on Science Speaks: HIV & TB News

With the conclusion of the international London Summit on Family Planning earlier this month, the global health community has shifted its focus to the International AIDS Conference in Washington, D.C.

It is exciting to see tangible global action around these health issues, and each warrants dedicated focus with political and financial commitments. But having these two separate conferences – on two different continents within two weeks of one another – obscures an important reality: family planning and HIV are inextricably linked, especially for HIV-positive women who are pregnant or may become pregnant.

Approximately 17 million women worldwide are currently living with HIV, with more than a million new infections in women of reproductive age each year. And while addressing unmet family planning needs is essential for all women, family planning services are particularly critical for HIV-positive women who want to postpone pregnancy due to HIV-related illness, or want to access medicines and services that will allow them to give birth to an HIV-negative child.

While conferences like the ones being held in London and Washington help marshal political will and focus public attention on family planning and HIV as important global health issues, we must also ask the question: couldn’t we be accomplishing more with an integrated approach?

Many organizations like ours specialize in a particular public health area, but the women we serve have diverse needs. For example, Esnart, a 32-year-old woman in Zambia, must take a day off of work each month to access HIV treatment. She leaves before dawn traveling two hours on two different buses, just to line up to receive her medication. If she needs any other health services, such as family planning, she must join another line.

As she says, “It is not like it is integrated where you access it at the same point…When you’re done with one service, then you move on to another [line]. People get there as early as four in the morning just to queue up.”

This is just one example on the ground of how women’s health services can be divided, to the detriment of the women who need them. These divisions are often present all the way up to health policy planning and funding decisions. By bridging this artificial divide between HIV and family planning, we have an opportunity to accelerate progress on both fronts by delivering life-saving services together, and learning from each others’ stumbles and successes.

In her speech to the delegates at AIDS 2012 yesterday, Secretary of State Hillary Clinton said, “Women want to protect themselves from HIV and they want access to adequate health care. And we need to answer their call.”

We must not repeat the mistakes of the past by discussing women’s health in a fragmented way. Global health organizations should be committed to ensuring that these issues are discussed and acted upon in a more integrated manner. This means looking for opportunities at all levels to effectively deliver comprehensive care to women and their families, especially those affected by HIV/AIDS.

Although it often occurs outside the public spotlight, the real promise of global meetings like the Family Planning Summit and International AIDS Conference is fulfilled after people leave the conference halls and return to their countries to act on the priorities set forth – one hopes helping women like Esnart access these services more efficiently.

Both the science and the experience of women all over the world show that reproductive health and HIV are interrelated. It is our hope that those leaving London and Washington, D.C. this July can join forces to support the programs, policies, and funding needed to make meaningful progress on both of these issues.

Leave a Comment

Filed under Advocacy, Chip Lyons, EGPAF, IAC 2012, PMTCT, Zambia

Using Mobile Technologies to Eliminate Pediatric HIV: Evidence the Future is Bright for mHealth

By Michelle Betton

Photo: Dr. Seble Kassaye (Left) and Dr. John Ong’ech (Right)

Mobile health technology (mHealth) is a pretty hefty topic to delve into at 7 a.m., but this morning’s mHealth presentation at IAS – sponsored by the Elizabeth Glaser Pediatric AIDS Foundation, mHealth Alliance, and Johnson & Johnson – provided encouraging insight into how mobile technology can positively affect pediatric HIV work.

Several studies over the past few years have highlighted the impact of mHealth on pediatric HIV, which were cited by William Philbrick, consultant with the mHealth Alliance. Findings showed that when receiving SMS (short message service) messages and reminders, women were more likely to attend antenatal visits – one study showed this increased by as much as 25 percent through the use of mobile phones. Additionally, women were 57 percent more likely to adhere to HIV treatment when receiving SMS reminders and health information. Other areas in which SMS messaging has improved outcomes are exclusive breastfeeding, stigma, and water and sanitation.

EGPAF’s Seble Kassaye described a pilot study in Kenya to address the high prevalence of HIV in Nyanza Province. Kenya was a good test case, as 63 percent of Kenyan households have mobile phones. Mobile phone technology was used to reinforce key messages for women and men around maternal and child health, exclusive breastfeeding, prevention of mother-to-child transmission of HIV, and male involvement. An important point to note about the messages is that they were HIV-neutral; some women and men share mobile phones with others, so neutral messaging was important to protect study participants from stigma. Despite positive feedback from the study such as increases in exclusive breastfeeding among women who received the messages, barriers still hinder the full effectiveness of mHealth, particularly fear of stigma.

Merrick Schaefer of UNICEF illustrated Programme Mwana, a project that has now been scaled up nationally in Malawi and Zambia to decrease turnaround time for clients to receive HIV test results, and to manage health systems in real time. The program consists of two components: Results160, which is focused on health systems and targets clinic staff; and RemindMi, a community-focused application that helps community health workers follow up with and report on client health status through SMS. Results160 allows clinic staff to alert central laboratories through SMS that samples have been sent for testing; in return, laboratories send electronic test results to clinic staff, which are sent to clients (confidentiality is preserved through PINs). RemindMi alerts community health workers to follow up with clients around child births, clinic visits, and adherence to medications.

Overall, the future seems bright for mHealth interventions, although some issues, like stigma, need to be addressed for optimal effectiveness in the long run.

Leave a Comment

Filed under Kenya, Malawi, Uncategorized, Zambia

“Eliminating pediatric AIDS and keeping mothers alive from an implementation perspective” – Satellite Session on best practices, programmatic barriers and bottlenecks in the field

By Alex Ekblom

On Sunday, EGPAF, mothers2mothers (M2M) and Johnson & Johnson (J&J) hosted a satellite entitled “Eliminating pediatric AIDS and keeping mothers alive from an implementation perspective – best practices, programmatic barriers and bottlenecks in the field.” This was a four-part/panel series of presentations moderated by John Donnelly, a journalist from GlobalPost.

EGPAF Swaziland’s Caspian Chouraya

The first part had to do with country-level approaches around building capacity of HIV service implementers, which highlighted Kenya’s mentor mothers approach (where HIV-positive mothers are trained to coordinate access to and retention in care among other HIV-positive mothers), EGPAF-Zimbabwe’s experiences in reducing costs of all-level health care worker training by reduction in time of training and facilitators (saving $185.00 per participant), and SAATHI’s experience in engaging the private sector to increase local PMTCT capacity (including collaboration of 17 NGOs to increase private site coverage, which has reached 1.2 million women with PMTCT care).

The second panel focused on supporting continuity of care and featured m2m’s work on mother mentors in retaining women through use of smartphones and SMS reminders, and NASCOPs implementation of a courier system to shorten turnaround time for early infant diagnosis of HIV.

The next panel was centered around how to create demand to increase uptake of PMTCT. Examples included the use of m2m mentor mothers, who increase quality of care to clients by relieving health worker burden/task shifting, EGPAF-Zambia’s integration of syphilis and HIV testing (through innovations in rapid testing) and the use of 8 steps to roll out effective integration, and EGPAF-Lesotho’s implementation of integrated health services and the use of Family Health Days, or mobile health services which offer a variety of testing and treatment options for HIV, opportunistic infections.

EGPAF Zambia’s Susan Strasser

The final panel focused on data use and highlighted m2m’s “let’s SOAR” initiative, which included a quarterly data review component, where site coordinators could review daily recorded data and assess areas for needed improvement, EGPAF-Swaziland’s data collection and review mentorship activities, EGPAF-Rwanda’s implementation of an excel macro tools to issue feedback to supported facilities through reports of facility and district data (from which facilities could see where improvements were needed), and EGPAF-Tanzania’s experience implementing quality improvement initiatives to strengthen pediatric care.

Delegates brought interesting questions into the discussion. One of which was how can we better prioritize the “keeping their mothers alive” portion of the global plan. It’s an important point for upcoming work on elimination of MTCT.

Leave a Comment

Filed under EGPAF, Global Plan, Implementation, India, Kenya, Lesotho, MCH, mHealth, Pediatric Treatment, PEPFAR, PMTCT, Rwanda, Swaziland, Syphilis, Tanzania, Zambia, Zimbabwe

Upcoming EGPAF Session: Overcoming Barriers to Implementing Global Plan

By Robert Yule

Join EGPAF, mothers2mothers, Johnson & Johnson, and our other partners at this upcoming session on overcoming implementation barriers to the Global Plan.

This fast-paced session – moderated by Global Post’s John Donnelly – will feature people working on the front lines of program implementation from high-burden countries and representing various implementing organizations. Each presenter will raise a specific challenge, explain how it was addressed, describe the result, and share what is being done next.

The audience will have the opportunity to interact with presenters for further discussion of implementation barriers and solutions.

“Eliminating Pediatric AIDS and Keeping Mothers Alive from an Implementation Perspective – Best Practices, Programmatic Barriers, and Bottlenecks in the Field”
Sunday, July 22, 1:30 – 3:30 PM
Mini Room 1

Leave a Comment

Filed under Global Plan, Implementation, India, Kenya, Lesotho, Malawi, PMTCT, Rwanda, South Africa, Swaziland, Tanzania, Zambia, Zimbabwe