Marseille 2007
Marseille 2007
Abstract book
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Abstract #138  -  Challenges in the provision of PMTCT services in North Rift Province, Kenya
Session:
  39.1: Treatment (Parallel) on Tuesday @ 14.00-16.00 in HC Chaired by Robin Hamilton, Raffaele Visintini
Authors:
  Presenting Author:   Dr Stanley Bii - MINISTRY OF HEALTH, Kenya
 
  Additional Authors:   
Aim:
Issues: The North Rift Province of Kenya covers an area of 100,000 km2 with a population of 4 million. The HIV prevalence is 5%. The expected number of pregnancies annually in the region is 134,000 (3.4% annual growth rate) with 6,700 mothers expected to be HIV infected. PMTCT services were initiated in 2002 and the services are available in about 60% of the health facilities in the region. Services available include counseling and testing of pregnant women for HIV, provision of single dose nevirapine for HIV infected women and exposed infants and counseling on safe infant feeding and family planning for the women.
 
Method / Issue:
PMTCT programme review.
 
Results / Comments:
Project: In 2006, 62,408 women accessed ANC services in facilities offering PMTCT services and 54,121 (87%) of them were tested for HIV. 3,252 (5%) were HIV infected. The PMTCT coverage in the region is only 47%. Only 1,050 (32%) of mothers accessed nevirapine (16% of expected) and only 800 (25%) infants accessed nevirapine (12% of expected). The project is still based on single dose nevirapine.
 
Discussion:
Lessons learnt: The main challenges affecting provision of PMTCT services in the region include lack of PMTCT services, low ANC attendance (70%) and late attendance with 75% of women attending ANC in the 3rd trimester. The average number of ANC visits is also low at only 3 visits per woman. Most women deliver at home (69%). lack of formula feeds for HIV exposed infants and poor followup for HIV infected mothers and their infants are some of the other challenges. There is also lack of HIV diagnostic equipment for infants (PCR), lack of basic equipment including delivery kits and delivery beds and poor infrastructure. Other challenges include high levels of poverty, high illiteracy levels, lack of male partner involvement in PMTCT and shortage of health care workers. For successful implementation of PMTCT, the above challenges need to be addressed. Formula milk for infants and use of AZT/nevirapine regimen for antiretroviral prophylaxis should be provided as basic minimum.
 
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