Integrated Approach to Improving Maternal and Child Health among HIV Positive Pregnant Mothers and Exposed Infants in Eastern and CentralKenya

Rosemary Njogu, Jonesmus Wambu

Abstract

To achieve elimination of pediatric Human Immunodeficiency Virus (HIV) through mother-to-child transmission, more focus is required on accelerated maternal Highly Active Antiretroviral Therapy (HAART) for HIV positive pregnant women and monitoring of Elimination of Mother-to-Child Transmission activities. This paper articulates integrated approach used by APHIAplus KAMILI project to improve Maternal and Child Health (MCH) services in eleven counties Eastern and Central Kenya. The main gaps at baseline included lack of integrated HIV services to MCH, low maternal and infant prophylaxis, lack of follow-up for mother-baby pairs. APHIAplus KAMILI has put interventions to ensure integration of HIV services in MCH. These include mentorship, training of the health care providers and mentor mothers, and offering of comprehensive services to HIV positive pregnant mothers. Methodology Data collection A retrospective data review was conducted in 153 health facilities where APHIAplus KAMILI had been working from 2011 to 2014. Data on was collected using government reporting tools at the facility, aggregated and uploaded to District Health Information System (DHIS) and A+K database for electronic storage. Data on early infant diagnosis was obtained from NASCOP EID website. Data was analyzed using MS excel and presented in bar graphs and line graphs. Findings Over 85% of HIV positive pregnant mothers received HAART and their infants received prophylaxis between 2011 and 2014. During this period, 80% of HIV exposed infants were exclusively breastfed. The number of HIV exposed infants who were positive and on ARVs increased from 9.3% in 2011 to 52% in 2014. Over the same period, there was a drop of 2.1% in the number of HIV exposed infants who turned positive. Conclusion Acceleration of health services and integration of HIV services to MCH lead to improved management of HIV positive pregnant mothers and their infants and significantly contributes to elimination of pediatric HIV.