Posts Tagged ‘VCT’

Web of Positive Living

At the weekly ART meeting, the “Prevention of Mother-To-Child Transmission” (PMTCT) staff reported on the number of children from their program who have been confirmed HIV-positive.

Mothers are given a single dose of nevirapine, to be taken during labor (whether they deliver at home or in the hospital), and children born at the hospital to HIV-positive mothers receive short-course AZT, in an attempt to deter transmission of the virus. Each case that the PMTCT staff reported had a story. Some examples:

  • Mothers enrolled in the program for their first birth, but neglected to contact the hospital during a subsequent pregnancy
  • Faced with substantial travel costs, some mothers played their (rather, their children’s) chances – delivering without PMTCT ARVs
  • Mothers from a certain village failed to deliver at the hospital, afraid the care-seeking behavior would reveal their status

These mothers might bring in their children for testing after 18 months, or only if symptoms present. This delay in determining HIV-seropositivity dramatically decreases the child’s chances of survival. Because the drugs (single-dose at birth, followed by a one-week course) are so effective in halting vertical transmission of HIV, every child born HIV-positive to women enrolled in the PMTCT program is deeply troubling.

After talking with hospital staff, we’re going to integrate the new SMS network into the hospital’s Voluntary Counseling and Testing (VCT) services. As part of their post-test counseling, every client who tests positive will be paired with an HIV-positive CHW with a cell phone. Many of the CHWs we have trained to text are committed members of the HIV-positive community – leaders of support groups, impressively drug-adherent, and people who spread a ‘Positive Living’ message.

These CHWs, along with their mobiles, will provide HIV-positive individuals a link to hospital services, a way to privately ask questions, and someone to look over their health. It will also provide a means by which to track pregnancies for HIV-positive patients, and follow deliveries for mothers in the PMTCT program.

Above – the fourth group of CHWs. After the training session, Alex and I situated each CHW’s ID pin on the map of the catchment area. As promised, new colors appeared – youth counselors and reproductive health volunteers are now connected to the hospital.
At the week’s medical meeting, a new category was reported – “SMS Follow-Ups” – for the TB and ART programs.

Posted: July 20th, 2008
Categories: HIV/AIDS Care, Home-Based Care
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Putting Technology to Work

Above – another happy group of health workers, the program’s newest inductees. By the end of next week, there will be 50 phones in the field – next Wednesday, we’re adding Reproductive Health and Youth Counseling volunteers to the network.

Below, you’ll see some of the CHWs re-teaching SMS steps to the rest of the group – a key component of the training sessions.

Once the session ended, a few of the CHWs reviewed their notes:

Walking through a village this afternoon, I happened upon three separate barber shops, each advertising Phone Charging services.

Malawians understand mobiles. It’s time to put the technology to work.

Next week, amid further CHW orientation, we’re holding comprehensive training sessions for hospital staff – so that TB officers, ART directors, pediatric nurses, PMTCT coordinators, clinicians, and VCT volunteers alike can use FrontlineSMS to contact the CHWs.

Posted: July 12th, 2008
Categories: HIV/AIDS Care, Technology, Tuberculosis Management
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