The missing link
Malawi has made good progress towards eliminating mother-to-child transmission of HIV, but getting to zero remains a challenge. Find out how better linking facilities and communities can be a critical part of the solution.
Malawi has made good progress towards the goal of eliminating mother-to-child transmission of HIV. In just four years, the country has halved the number of new infections among children – from 21,000 in 2010 to 10,000 in 2014.1
But getting to zero HIV infection remains a challenge, and ensuring that pregnant and breastfeeding women living with HIV enrol in and remain on treatment is a critical part of the solution. In 2016, only 64 per cent of pregnant women living with HIV in Malawi received antiretroviral medicines for prevention of mother-to-child transmission of HIV (PMTCT), and about one third of them discontinued their treatment during the first year.2
Better linking of facilities with the communities that they serve can significantly improve health outcomes by supporting women enrolled in PMTCT programmes so that they do not drop out of care. Malawi, for example, is implementing innovative initiatives that bring community members and health workers together to address programme challenges.
For Biswick Kazembe, a community health worker in Kang’oma village, a bicycle provided through the Optimizing HIV Treatment Access (OHTA) Initiative enables him to follow up with patients who miss appointments.3 “This is so helpful, because we go to the home of the client when the client has missed an appointment to find out how they are,” he says. “Then we take them to the hospital to continue their treatment.”
The OHTA Initiative, which convened community members and health workers in eight districts between 2013 and 2016, illustrates the benefits of these links. By the end of 2014, OHTA (funded by Norway and Sweden through UNICEF) facilitated the start of HIV treatment for almost 52,000 pregnant women living with HIV.4
Given the positive results achieved by strengthening community linkages, the Chief of the Kakhome District dreams of improving links in other districts as well. He hopes that in doing so, ”Malawi may see an HIV-free generation”.5
1 United Nations Children's Fund, Children and AIDS, 'Malawi Case Study on Joint Community-Facility Review of PMTCT Dashboards', UNICEF, New York, February 2016, <www.childrenandaids.org/publication/malawi-case-study-joint-community-fa..., accessed 03 November 2016.
4 United Nations Children's Fund, Children and AIDS, 'Community-Facility Linkages to Support the Scale Up of Lifelong Treatment for Pregnant and Breastfeeding Women Living with HIV', <www.childrenandaids.org/publication/community-facility-linkages-support-..., accessed 03 November 2016.
5 United Nations Children's Fund, Children and AIDS, 'Malawi Case Study'.