Prevention of Mother-to-Child Transmission (PMTCT) Project

Project goal

To improve the health of HIV-infected pregnant women, their partners and families; and to better engage men in HIV prevention and support for their HIV infected, pregnant partners, ultimately contributing to prevention of new HIV infections in Botswana.

Objectives

  • Expanded and enhanced facility-based counseling, psychosocial support, education, and referral mechanisms for HIV-positive pregnant women and their families linked with follow-up support activities.

  • Enhanced engagement of males in the prevention of sexual and MTCT of HIV and in supporting their HIV- positive female partners in preventing transmission of HIV to their infants.
  • Improved pediatric and maternal outcomes through strengthened linkages and referral systems for HIV-positive women and their infants post-delivery.
  • Communities will have adopted norms, values, and attitudes that support behaviors and practices to prevent HIV, accept PLWHA, and encourage the full participation of men and women in HIV testing, prevention, care, and treatment programs

Activities

  1. Provide follow up support to ensure pregnant women with AIDS-defining conditions access ART.

  2. Provide one on one and group peer sessions emphasizing ARV adherence with newly identified HIV+ expectant mothers and post-partum women with infants up to the age of 18 months (through immunization days and other clinic/community interactions)
  3. Provide psychosocial support and empowerment counseling to all HIV positive pregnant women identified through ANC and post-partum
  4. Provide education on infant feeding practices and ARV/ART adherence to family members of HIV positive expectant mothers and post partum mothers
  5. Facilitate referrals for HIV+ expectant and post partum mothers to key referral services, including ART, family planning, partner testing, etc.

Target group

Pregnant and post-partum HIV positive women, their partners, families and community members

Location

Selebi Phikwe, North East (Masunga), Bobirwa, Lobatse, Kgalagadi South (Tsabong), Maun, Tutume, Mahalapye and South East.

Rationale

While pregnant HIV-positive women in Botswana have the advantage of greater access to PMTCT programs than other African countries, many of their other needs are not being met. They often do not receive adequate psychosocial support and counseling services. Clinic staff are unable to offer support because they are already overstretched. Mothers, grandmothers, aunts, husbands or partners, and traditional leaders play important roles in pregnant women’s and mothers’ lives, especially those living with HIV, yet these influential relatives sometimes do not understand HIV-positive mothers’ needs or hold traditional beliefs that contradict PMTCT practices. They can become a barrier to PMTCT practices such as safe infant feeding and follow-up infant testing. A young, HIV-positive, often single mother, especially in a rural area, can find it difficult to adhere to prophylaxis and the clinic-provided guidelines to keep herself and her baby healthy. Research in Botswana has found that “few women were informed about available community resources for support. Less than a third of all respondents were informed about their eligibility to receive a food basket or about where to go to meet other HIV-positive women.” To prevent HIV transmission overall, male gender norms, attitudes and behaviors—all greatly influenced by culture and tradition—must change. Successful efforts to foster male norms that encourage safe behaviors related to HIV might also promote greater male support for PMTCT. A review of the data on current PMTCT programs and male involvement in Botswana clearly shows that it is difficult for pregnant women and mothers with HIV to prevent MTCT in the face of the aforementioned challenges and inadequate support from the health system, their families, their partners, and the community.

Planned impact

Botswana aims to have zero transmission of HIV infection from mother to child.

Partners

AED now called FHI360, Ministry Of Health and Wellness and Pathfinder