CHAZ

CHAZCHAZ Each Community CountsEach Community CountsCommunity Leadership Spearheading PMTCT Program to

Improve Health Outcomes of HIV Exposed Babies, at Nangoma Hospital, Zambia

Dr. Dhally Menda MD, MPH, MBA

Maternal and Newborn Health Conference for Zambia’s Mothers and Babies

01st November 2012

www.chazhealth.zm.org

http://www.chazhealth.zm.org/

CHAZ Background Information CHAZ Background Information

“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2

Formation & Membership• Formed in 1970 ( Catholic and Protestant Medical Committees)• Interdenominational (Catholic and Protestant) umbrella organisation

for 146 CHIS in 10 Provinces:• 36 Hospitals & 81 RHCs & 9 Training Schools • 29 CBOs

Health Services Coverage• CHAZ is the second largest provider of health services in Zambia. • MoU with the MoH: Grant- Staff Secondment – Essential Drugs

PMTCT and ART Sites • PMTCT: 61• ART: 51

National Strategic Framework

HSS in 146 CHIs

HIV & AIDS

TB Control

Malaria Control

Sensitizations PMTCT: 13,157

ART: 48,979Awareness Campaigns

MNCH

CSS≥ 500 CBOs

Mentoring & TA

C&T: 361,111

MC: 7,453

CHAZ Health Programmes CHAZ Health Programmes

Background Background


• Nangoma is a Mission hospital is situated in the rural Central Province • ART and PMTCT programs: Initiated in 2006 – Support: GF ATM• Catchment: 80,000 & Polygamous society • HIV prevalence rate among pregnant women aged 15-40: 9.5%. • Home Deliveries (60%) due to: Long distances, Traditional beliefs,

Myths and Stigma. – Exposed babies at risk of getting HIV

•Sensitized the Senior Chief (Shakumbila) and all his entourage on the importance of PMTCT.•Lobbied the Chief to have all pregnant women deliver from HF •Home Delivery Penalty: Goat

MethodMethod

Method Cont’d Method Cont’d


To improve the PMTCT outcomes, the Hospital ART/PMTCT Team came up with an HIV Prevention Strategy that embraces all community members. Throughout 2010, the ART/PMTCT team:

•Recruited mothers to join the Mothers’ Support Groups, to encourage networking and fight against discrimination

•Recruited Adherence Supporters Workers to help in client (mother/infant pair) defaulter tracing

•Involved men, through community leaders and hospital staff, to come with their wives for all Antenatal Clinic visits

•Encouraged HIV +ve pregnant women, living in distant areas from the health facility, to stay at the Maternity Waiting Home, when they enter their 3rd Trimester of pregnancy.

•Encouraged all ANC clients to undergo VCT as a couple.

•Provided ART and/or ARVs Prophylaxis to the mother-baby pair

•Provided EID.

Results Results


The community leadership and members embraced the initiative and took

the project to the next level.

As a result:

HF deliveries increased from 60% in 2008/09, to almost 100% in 2010.

Figure 1: Improvement in health facility deliveries

Result Cont’d Result Cont’d


Out of the 72 HIV +ve mothers who delivered at Nangoma Hospital:

93% of delivered babies with a negative HIV PCR test.

Among the 24 women who delivered at home (no PMTCT intervention), from outside the chiefdom, 20% of their babies had a positive HIV PCR test (P=0.05).

Figure 2: Improvement in health facility deliveries

Conclusion Conclusion


PMTCT interventions with a strong community involvement have a positive impact on the health outcomes of HIV exposed babies (Avert HIV infection).

Involvement of the community through community leadership, can help rural based Health Facilities improve:•ANC attendance, •Couple Counseling, and •Health Facility deliveries

Acknowledgment and Thanks Acknowledgment and Thanks


Thank you

God bless

Acknowledgement:

Co-Authors:M.M. Bwalya, P.M. Mulenga, J. Simutowe, M. Zulu, S. Hambilika, K. Sichinga

Partners:MoHGFATMNangoma Hospital StaffNangoma Community

Documents

CHAZ