HIV/AIDS MTCT: Why Nigeria Must Scale Up Efforts

By Abdallah el-Kurebe

The Goal 6 of the Millennium Development Goals (MDGs) is aimed at combating HIV/AIDS, malaria and other diseases.

Although according the 2010 MDG Report, Nigeria had marked success as a result of the fall in the prevalence of HIV among pregnant young women aged 15-24 (5.8% in 2001 to 4.2% in 2008), records still show that some states still have high prevalence rates that require urgent policy attention.

Dr. Bala Abubakar, who specializes in Hematology/Public health and is Manager, Pathfinder International in charge of Sokoto/Kebbi office, said
“Globally, approximately one-third of children with HIV are born in Nigeria and HIV prevalence among women visiting Ante natal care (ANC) in 2010 in Sokoto and Zamfara states is 3.3% and 2.1%, respectively.”

According to him, while the National HIV prevalence is 3.4 percent, the same prevalence in Zamfara and Sokoto states are respectively 0.4 percent and 6.4 percent.

The government of Nigeria is committed to increasing coverage of PMTCT services from the current 15% to 90% by the end of 2015.

The National statistics of MTCT shows that 907,387 pregnant women have been counseled and tested and received results and the number of HIV positive women stands at 31,577.

“The number of HIV positive pregnant women that received ARV prophylaxis is 26,133; that of HIV exposed infants on ARV prophylaxis is 14,573 while the number of infants that received testing within two months of births stands at 19,446,” Dr. Abubakar further said.

He said that infants that received testing within the same period of births and tested positive 1,485 and 5,293 infants within two months of birth started on cotrimoxazole.

Reports indicate that globally, an estimated 53% [40–79%] of pregnant women living with HIV received antiretrovirals to reduce the risk of transmitting HIV to their infants. This is up from 45% [37–57%] in 2008 and 15% [12–18%] in 2005. “A large proportion continued to receive the less efficacious single-dose Nevirapine regimen,” Abubakar said.

Nigeria should scale up her efforts in combating MTCT because the country contributes 15 percent of global PMTCT gaps (second only to South Africa) in 2009.

There are however, numerous challenges to tackle MTCT one of which is the absence of consolidated and costed population-based scale up plans at both federal and state levels.

Abubakar also says that PMTCT programs are largely donor-driven with insufficient government supervision as well as poor Coordination, Monitoring & Evaluation of PMTCT services.

Other challenges, he said include, “Poor integration of HIV in Reproductive Health (RH) services; poor infant feeding counseling services; Early Infant Diagnosis (EID) to all PMTCT sites and children hospitals.

“Private sector absence is conspicuous in Technical Working Group (TWG). There is inadequate resources, Weak health systems, inadequate information on scope of PMTCT services nationwide, wide gap between attendees and deliveries health facilities and weak community and private sector engagement in PMTCT services delivery,” he explained.

On ways to tackle the challenges, the Doctor said that “coordination of health sector M & E, mentoring and supportive supervision, PMTCT monitoring and evaluation as well as supply chain management at all levels must be strengthened.”

There must also be continuous training of health care providers on service provision for PMTCT, including mobilization of adequate resources to support implementation of PMTCT scale up plan.

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