Tag Archives: Zambia

July 23, 2012 · 4:53 pm

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.

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Filed under Kenya, Malawi, Uncategorized, Zambia

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· 3:18 pm

“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.

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

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July 22, 2012 · 1:11 pm

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

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

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July 18, 2012 · 12:15 pm

EGPAF’s Statement on UNAIDS Report on HIV/AIDS

By Robert Yule

Today UNAIDS released a new report on the global AIDS epidemic. Read the Foundation’s statement about the progress made preventing and treating new HIV infections in children and their mothers worldwide, and areas of continued need.

Also see below for ten useful facts and statistics taken from UNAIDS’ Global Plan progress report:

Washington, D.C. – On the eve of the XIX International AIDS Conference in Washington, D.C., a new report released by UNAIDS shows significant progress in the battle against pediatric HIV and AIDS. It also highlights some key areas of improvement needed to reach our goal of ending new HIV infections in children and keeping HIV-positive mothers and children alive and healthy.

According to UNAIDS, about 330,000 children were newly infected with HIV in 2011 – a drop of 60,000 from the previous year. Particularly promising was a reported 25% decrease in new pediatric infections since 2009 among the 21 countries in sub-Saharan Africa identified as high priority by the Global Plan to end HIV among children.
“The significant decrease in new pediatric infections in sub-Saharan Africa is clear evidence that global efforts are turning the tide of the epidemic in children in the part of the world where it is needed most,” said Chip Lyons, President and CEO of the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF).
The report also predicts that several countries where EGPAF works – such as Kenya, Swaziland, Zambia, and Zimbabwe – are on track to meet the ambitious 2015 target to eliminate new pediatric HIV infections.
Key to achieving this for all countries is universal access to services to prevent mother-to-child transmission of HIV (PMTCT). The report shows that investments in scaling up PMTCT are bearing fruit. For HIV-positive women living in low- and middle-income countries, PMTCT access has increased significantly – from 48% of in 2010, to 57% in 2011.
“One point of particular concern is that a relatively low percentage of mothers are receiving PMTCT drug regimens in the breastfeeding period, the time in which a significant amount of transmission to infants occurs,” said Lyons. “Too few mothers are also receiving antiretroviral treatment for their own health, which is vital to their survival and for the care of their children.”
For those children living with HIV, testing and treatment remains critical. According to UNAIDS, only 28% of HIV-positive children received antiretroviral treatment in 2011. While this is a slight increase from the previous year, it is still woefully inadequate. Without early identification and treatment, half of children with HIV do not survive to see their fifth birthday.
“As the global health community gathers in Washington for the AIDS 2012 conference, this report shows us where more work is needed, but also where momentum is on our side,” said Lyons. “It should encourage us to rededicate our efforts and our resources to even greater decreases in HIV infections and AIDS-related deaths in children, and to not let up until we get to zero.”
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Filed under Pediatric Treatment, PMTCT, UNAIDS

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