Millennium Villages Blog

Philip visiting Lilian and Faith

It is 10:50 am on a cloudless August day in Western Kenya. The HIV and AIDS Counselor from Sauri Health Centre and I have taken the short drive to the home of Lilian Awino Adhiambo, a 32 year old mother of 6 children aged 9 months to 13 years.

At first sight, this is just another busy rural household, filled with the clutter of small feet. But Lilian’s health situation is special: she is one of 10 HIV positive women participating in Sauri’s Preventing Mother-to-Child Transmission (PMTCT) support group. Four years ago, Lilian’s life changed overnight: she tested HIV positive and lost her husband to AIDS in the same month.

Lilian started receiving antiretroviral (ARV) drugs from the provincial hospital in December 2006. In July 2009, she became pregnant again. During a visit to the health centre, Lilian started to get counseling on PMTCT thanks to the Millennium Villages Project mother-to-child transmission free zones project. This new partnership with UNAIDS aims to reach virtual elimination of mother-to-child transmission of HIV in the Millennium Villages, including Sauri. To reach this ambitious but attainable goal, the program in Sauri has four main objectives: (1) Primary prevention of HIV infection among women of childbearing age, (2) Preventing unintended pregnancies among women living with HIV, (3) Preventing perinatal HIV transmission from women living with HIV to their infants and (4) Providing appropriate treatment, care and support to mothers living with HIV and their children and families.

The counseling provided to Lilian that day included information on the need to continue taking ARVs for her own health and that of her baby, the importance of delivering at a health facility and, in the event where she opted for breastfeeding, the need to do exclusive breastfeeding for the first 6 months. A few months later, Lilian delivered twins at the Yala Sub district hospital, another health facility supported by the project. On delivery, both babies received PMTCT services and Lilian opted not to breastfeed. Unfortunately, one of the twins died at 6 weeks due to pneumonia. The other who survived is Faith Omondi, and hers is a story of hope.

Lilian with her family outside their house

When she was 2 months old, Faith underwent early infant diagnosis, a required procedure for the accurate HIV testing of newborns, and tested negative. At the time of our visit, she had undergone another confirmatory test at 9 months and was also negative. Lilian couldn’t be happier. The early infant diagnosis services offered at the facility allowed her to put her mind at ease. Though for Lilian, the wait was too long: the test results took more than 3 months because the diagnosis is usually done at a laboratory in Kisumu, the closest city but 60 km away. Dry blood samples are taken from the remote facilities to the sub district hospital and then transported to the laboratories in Kisumu. Currently, the MVP and other partners are working towards reducing the turnaround time for the results to less than a month.

As part of expanded PMTCT programs, and more specifically the fourth objective described above, Lilian’s other children have also received HIV testing and counseling. Two of them are HIV positive and were placed on ARVs.

Thanks to the integrated model of the MVP development work, Faith Omondi is also benefiting from a complete set of nutritional interventions, including high energy therapeutic peanut butter from the Sauri health centre to boost her nutritional status. At birth, she was provided with high energy flour but has now been changed to the peanut formula. Lilian reported that Faith’s nutritional status has improved tremendously. At the time of our visit Faith weighed 5 kgs. Although still underweight for her age (9 months), Lilian reported that she had improved and gained 500 grams in the last month.

During her frequent visits to Sauri clinic, Lilian was also counseled on family planning, as part of the second objective of PMTCT described above. She is currently on a 3 months injection pill which she combines with condom use. Family planning is an important component of preventing transmission of HIV from mother to baby.

Sauri clinic, where Faith has received life saving counseling, is one of 9 health facilities within the MVP that are implementing this innovative MTCT free zones project to prevent babies from HIV infection. Overall, the PMTCT services in Sauri are currently well aligned with national guidelines and the quality of services provided is higher than other average health facilities of a similar level.

It is the goal of the MTCT free zones project that with the continued work of the MVP and through the partnership with UNAIDS, HIV/AIDS services in Sauri will continue to be improved to reach the ultimate goal of virtual elimination of Mother to Child Transmission of HIV.

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