Empowering Communities to Reduce the Spread of HIV from Mother to Child

South Africa Partners is empowering communities in the Eastern Cape to help reduce the spread of HIV from mother to child. We are working in partnership with PATH, an international NGO; with the Department of Health of Eastern Cape; and HISP-SA, an NGO working on Health Management Information Systems. Together with MANEPHA, an advocacy network of people living with HIV/AIDS (PLHIV), South Africa Partners is helping communities develop strategies to reduce mother to child transmission of HIV. Strategies include the development of effective methods for educating community members, and strengthening relationships between health facilities and communities in order to increase the uptake of services.

The project is funded by the US Government’s PEPFAR program, through CDC in South Africa.  The project seeks to increase the number of women and newborns who participate in current Prevention of Mother to Child Transmission (PMTCT) programs in three local service areas (LSA) of the Eastern Cape. Approximately 200,000 women annually become pregnant in the Province, and about 28 percent are likely to be HIV positive.

The selected LSAs, King D. Sabata, Mbashe, and Mnquma, are located along a stretch of the N1 highway in what was formerly known as the Transkei homeland.  The roles of the implementing partners will reflect each organization’s unique expertise. PATH, the managing partner, provides technical, programmatic, and financial leadership; HISP-SA is responsible for the monitoring and evaluation component of the program; and South Africa Partners leads the community support and mobilization interventions that include both trainings and public workshops for local non-profits, community HIV/AIDS initiatives, and local residents. The entire team works closely with the Eastern Cape Department of Health, which has approved the strategy and goals of the project. The Eastern Cape Department of Health is the largest partner, providing human resources, facilities, and the structure within which all clinical activities will take place.

The project uses three strategies to meet its goals. Each of these strategies works at a different level of health service delivery:

• Provincial DOH level – coordinates critical support systems such as policies, training, and supervision (strategy 1);
• Health facility level offers PMTCT and related services (strategy 2);
• Community level, where awareness of and support for PMTCT—especially among women of reproductive age, their partners, and their families—are critical to the uptake of services (strategy 3).

The project’s messages are designed to increase the number of pregnant women who access antenatal and HIV services, and to increase access to and the use of medications that decrease the likelihood of newborns contracting the virus from their mothers.  It also works to strengthen and improve post-partum support for both mother and child.

Additionally, the project provides information about support for infant-feeding choices and helps clients assess their needs, considering issues such as the risk of stigma and discrimination.  The project provides holistic psychosocial support to HIV positive women, including information, support and referral services for living as an HIV positive woman for reproductive and other health decision-making issues.  The project’s emphasis on community mobilization increases knowledge about PMTCT, promotes understanding of PMTCT as the equal responsibility of men and the community, and works toward transforming current norms, stigma and discrimination that hold women solely responsible for having HIV and transmitting HIV to children.

One of the clear priorities of the Eastern Cape Department of Health is to broaden the role of the community in promoting, supporting and utilizing PMTCT services.  This includes providing health education; reducing stigma; generating demand for services; working with the partners and families of HIV positive women to increase support for PMTCT; developing community networks for client follow-up; and strengthening tangible links between the community and the facility.  Underlying these interventions is the need to build the capacity of community networks and organizations to implement and monitor programs.  Interventions include strengthening HIV prevention programs, providing PMTCT information and reducing stigma in the community; strengthening peer support for HIV positive pregnant women to increase demand for and adherence to PMTCT and ARV regimens; and improving community-facility collaboration to increase local ownership and utilization of services.