KENYA: Support groups boosting PMTCT uptake
About 56 percent of Kenyan women do not have their babies at a health facility
KAMWIMBI, 4 August 2010 (IRIN) - When Esther and Chrispus Ireri from the remote village of Kamwimbi in Kenya's Eastern district of Mbeere lost all three children in quick succession, they had no idea it was because of HIV infections.
"I had despaired after the deaths of our children one after the other; the pressure from the deaths... and hostility from in-laws and villagers were unbearable," Esther told IRIN/PlusNews. "At one time I considered running away from the marriage... I even thought I had been bewitched."
When she fell pregnant again, she was weak and suffered health problems; an HIV test in 2006 revealed she was positive.
"I knew very little about HIV then," she remembered. "It had never occurred to me that I could get infected; I thought only other people got the virus."
Under the Elizabeth Glaser Paediatric AIDS Foundation (EGPAF
)-initiated project Zingatia Maisha - Swahili for “carefully consider life” - Esther and seven other people living with HIV formed the "Wega wa Ngai" (Grace of God in the local Mbeere language) support group. When her husband tested negative for HIV, the support group helped him to stay with Esther despite pressure from his family.
"The discordance result only added to our woes," Chrispus said. "My parents and friends insisted I throw Esther out and marry someone HIV-free."
|We give health talks on PMTCT in the villages, but still some people don't believe until they see children born HIV-negative
The group now has more than 120 people, while 126 separate support groups have been formed in Mbeere district and neighbouring Embu district under the Zingatia Maisha initiative. Zingatia Maisha has helped link more than 15,000 HIV-positive people to support groups in Kenya's Eastern and Western Provinces.
They counsel HIV-positive patients, particularly pregnant women, and follow up in the communities to ensure they enrol early and adhere to antiretroviral treatment.
Preaching the PMTCT gospel
Caeser Njeru, who is chairman of a local HIV/AIDS support group, is one such volunteer. He said he endured ridicule with the pioneer support groups but the community eventually began to see their value.
"Twelve of us have been trained in counselling and adherence by Zingatia Maisha while the Embu [Roman Catholic] diocese has trained us in reaching out to pregnant women and to encourage them to know their status and seek treatment early," he told IRIN/PlusNews.
There are two volunteers for every village, who refer cases of new pregnancies to the support groups and health centres for testing and counselling.
"We now know it is possible for people who are HIV-positive to have children who are not infected... we give health talks on PMTCT [prevention of mother-to-child transmission] in the villages, but still some people do not believe it until they see children born HIV-negative," said Jackson Njiru, another HIV-positive volunteer.
Through PMTCT services, the Ireris have now been able to have two HIV-negative children. "Some people do not believe babies born of HIV-positive parents can be HIV-free, others want to confirm that I breastfed Diana [born in November 2009]... some predicted she would die sooner if she were breastfed," Esther said.
According to Rogers Simiyu, programme officer for EGPAF, Zingatia Maisha has had a significant impact on the numbers of people accessing PMTCT. At the five government clinics in Mbeere district, there has been a notable increase in the number of mothers staying on treatment and getting CD4 tests [to measure immune strength]. "There is also early diagnosis and early enrolment in treatment and care of children and general follow-ups of mother and child," he said.
More services needed
About half of Kenya's government health centres now offer PMTCT, but demand remains relatively low, mainly because about 56 percent of women still give birth at home. Community mobilization, especially at the grassroots level, is one of the key strategies the government is now using to improve uptake.
According to Lucy Matu, senior technical adviser for EGAF Kenya, it is crucial to ensure that women have the services available to them.
"It is possible to eliminate paediatric AIDS if we all seek early interventions and treatment and [provide] these services where pregnant women and their spouses can easily access them," she said.