Challenges in preventing mother to child HIV spread

Agnes John (not real name), who gave birth at the Wuse General hospital, shares the same experience.She was diagnosed with the virus at Wuse General Hospital when she became pregnant. “I thank God for this hospital, if not for the counselling and care I would have died, but today, see my baby and I looking […]

Agnes John (not real name), who gave birth at the Wuse General hospital, shares the same experience.
She was diagnosed with the virus at Wuse General Hospital when she became pregnant. “I thank God for this hospital, if not for the counselling and care I would have died, but today, see my baby and I looking healthy. My baby is negative, and I am told I can live for a long time and look after her if I continue taking my drugs.”
“I did not believe it could happen but see now, it is indeed possible, to be positive yet give birth to a negative baby,” she says.
With such an intervention that promises a next generation free of HIV/AIDS, Nigeria recorded over 60,000 children infected with the virus in 2012-a figure higher than that of any other country in the world. and it is a source of worry that experts have described as alarming.
The 2013 Progress Report On The Global Plan: Towards The Elimination Of New HIV Infections Among Children By 2015 And Keeping Their Mothers Alive, revealed that not much has been done since 2009 till date to improve prevention of mother-to-child transmission, which is responsible for the alarming infections.
Hurdles of the Nigeria PMTCT response
According to the United Nations, Nigeria accounts for one-third of all new HIV infections among children in the 21 priority countries in sub-Saharan Africa, the largest number of any country.
“Progress here is therefore critical to eliminating new HIV infections among children globally,” said the report, but it added: “Nearly all indicators assessed show stagnation and suggest that Nigeria is facing significant hurdles.”
The hurdles are indeed significant as they range from issues of discrimination and stigmatization, manpower, funding and behavioural change among those affected and infected.
Discrimination and stigmatization
The president of Network of People Living with HIV/AIDS (NEPHWAN), Edward Ogeniyi has on numerous occasions cited the non-passage of discrimination and stigmatization bill as one of the greatest hurdle of the HIV/AIDS response in Nigeria.
If the bill is not passed, the country’s progress against HIV/AIDS would be lost, he said in a Daily Trust interview.
“People need to feel protected by law; pregnant women should be able to come out freely without fear that they would be discriminated against to access drugs and treatment.”
It is a sentiment shared by Rilwan Mohammed, executive of the FCT Primary Health Care Development Board, emphasising a need to disabuse people’s mind about the disease.
He lamented that a lot of discrimination follows the ailment which unfortunately discourages people from knowing their status, which he added is a big blow to the response.
Manpower, services at health facilities   
Another sore point in the response is availability of PMTCT services in health facilities, especially in rural areas.
The Executive Secretary of the National Primary Health Care Development Agency (NPHDCA), Dr Ado Mohammed touring some northern states recently acknowledged that PMTCT services were provided mostly in secondary and tertiary health facilities, and only found in very few PHC.
According to him though several survey has shown that PMTCT is dearly needed in the rural communities because of the prevalence of the disease among women and children, the government has difficulties integrating PMTCT services in the PHC.
Providing services at the facilities comes with questions: who to provide the services, are the facilities equipped adequately and are the personnel trained to handle such a specialised field?
“Our greatest problem in the FCT is manpower, we have succeeded in pulling our women to come out to access this intervention but now we are faced with the problem of manpower,” says Dr Uche Okoro, project manager for FCT’s Agency for Control of AIDS.
“Most of the women come for ante-natal but refuse to come and deliver at the facility which defeats the essence of the intervention.”
According to him, most PHC are poorly staffed, funded and lack the right equipment or drugs which discourages the women from seeking care there.
“These PHCs are under the authority of the local government it is their duty to make sure that that primary health care functions in terms of employment, in terms of commodities availability. So we are having challenges at that level of making sure that the right health care worker at that level are  available at all the time.”