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Closing the Gap: Amref Health Africa calls for joint action to

reduce maternal deaths related to HIV/AIDS


World AIDS Day 2014

As the 2015 deadline for the Millennium Development Goals approaches,


countries are focusing their efforts on meeting the Millennium Development
Goals (MDGs). MDG 6 calls for global efforts to halt and begin to reverse the
HIV/AIDS.

The world has made great progress towards the global vision of zero new
infections, zero discrimination and zero AIDS-related deaths. Similarly,
tremendous progress has been made in the last 15 years towards the
Millennium Development Goal of halting and reversing the spread of HIV.
Nevertheless, HIV is still a great global concern. According to UNAIDS, 22
million people were living with HIV in sub-Saharan Africa in 2012, 58 per cent
of whom were women, while 230,000 children were newly infected. Of
particular concern is that HIV is a leading cause of death among women of
reproductive age in Africa.

The main reasons for this state of affairs are inadequate scaling up of
prevention strategies, and limited access to reproductive health services as
well as HIV treatment and care. In fact, pregnant women living with HIV are

less likely than treatment-eligible adults overall to receive antiretroviral


therapy. Treatment coverage among children living with HIV in 2012 was less
than half that of adults, underlining the importance of addressing specific
needs of women and children to reduce the negative impact of the epidemic.

As an international African organisation working side by side with


communities, Amref Health Africa believes that by focusing on the health of
women and children one can improve the health of the whole community.

Amref Health Africa joins the world in celebrating the World AIDS Day 2014
under the theme Close the Gap. For Amref Health Africa, closing the gap
means empowering and enabling individuals and communities everywhere to
access the services they need. This theme accurately reflects our work: Amref
Health Africa aims to bridge the gap between the people in the community and
the formal health system by giving communities knowledge, skills and means
to transform their health as well as supporting peripheral health facilities to
fulfill their mandate. We are particularly concerned about the continents high
maternal mortality, to which HIV/AIDS is a major contributor. We must ensure
that prevention and treatment services are widely accessible to women to
reduce maternal deaths and to save babies from infection.

Through its interventions in countries, Amref Health Africa seeks to close the
gap in various areas:

Closing the gap in access to comprehensive HIV and reproductive health


services
In Uganda, Amref Health Africa has supported 18 government health facilities
to introduce an integration model of service delivery to offer voluntary medical
male circumcision, HIV counselling and testing, management of sexually
transmitted infections, and linkage to other services such as ART, family
planning and infertility disorders.

Closing the HIV testing gap


In the Northern Arid Lands of Kenya, more than 62,000 individuals were
counselled and tested for HIV and received their test results. Of the 349 clients
who tested HIV positive, 92% were linked to care and treatment.

In Tanzania, Amref Health Africa reached a total of 218,774 people (115,512


males and 103,262 females) with HIV Testing and Counselling (HTC) services,
through 42 outlets that provided onsite and outreach HTC services. In addition
1,203 women and 185 children were reached with prevention of mother-tochild-transmission (PMTCT) services in four districts.

Closing the gap in treatment and care


In the informal settlement of Kibera in Kenya, Amref Health Africa has been
implementing a care and treatment project since 2003. The project provides
HIV testing and counselling, PMTCT, care and treatment of children and adults
with HIV, and TB/HIV diagnosis and treatment, using an integrated model of

health care provision. To date, there are more than 4,000 HIV-positive adults
and children receiving care and treatment in the slum area. HIV testing and
counselling is provided to all the women receiving ante-natal care in the
facility. Those who test positive are started on antiretrovirals to reduce the risk
of mother-to-child transmission.

Closing the gap in PMTCT services


Since January 2012, Amref Health Africa in Ethiopia has been implementing
Biruh Tesfa (Bright Hope) Community-based Project with the objective of
reducing the transmission of HIV from mother to child, and alleviating the
impact of HIV/AIDS on women and children in Addis Ketema sub-city.

In the past year, 4,128 pregnant women were counselled and tested for HIV,
37 mothers received ARVs to prevent passing of infection to their children.
Major approaches used to reach the communities include strengthening the
referral system through mobile technology and provision of weekend health
services for male partners.

Closing the gap in mens involvement


According to the Uganda AIDS Indicator survey (2011), the national adult
prevalence of HIV was 7.3%, up from 6.4% in 2006, with married couples in
heterosexual relationships accounting for 43% of all new infections. The
situation called for a more comprehensive HIV prevention approach beyond
advocating abstinence and faithfulness.

The Scaling Up Comprehensive HIV/AIDS Prevention Project contributes to the


reduction of new infections by offering a biomedical intervention; Voluntary

Medical Male Circumcision. In Uganda, where the coverage of male


circumcision is just 26% with men characteristically being poor seekers of
health services, the intervention is geared towards bridging an important gap.
The service is linked to other services, enhancing its uptake. So far, the project
has facilitated 200,000 circumcisions in six districts in central Uganda, with the
service an accompanying rise in couple counselling and uptake of HIV services.

To reduce maternal and child deaths through HIV/AIDS, Amref Health Africa
calls for increased joint action between governments, civil society and the
private sector in order to leverage available resources for efficiency and
effectiveness of interventions, and strengthening of health systems to
comprehensively address womens health.