25 July 2012

Tanzania: Iringa HIV-Infected Children, Families for Better Quality Care

WITH an HIV/Aids prevalence rate of 16 per cent, the highest in the country, Iringa region is not in an admirable position. The national prevalence rate stands at 5.7 per cent, according to statistics. If this were a race, accolades for the region would have been in order but unfortunately it's not.

It's sad and the picture gets grimmer as the Iringa Regional Medical Officer, Dr Robert Salim, admits that keeping proper track on the prevalence rate among children in the region has proven very difficult. Enrollment for treatment is also far higher among adults than children. Experts say that it has come to their attention that many parents are afraid of enrolling their children for HIV/Aids treatment and eventually care to the detriment of the latter's health.

National data shows that a total of 48,000 children are infected with HIV each year because of an acute shortage of Prevention of Mothers to Child Transmission (PMTCT) services in the country. According to statistics, there are also 217,704 new infections annually.

Further, a total of 596 people are infected with HIV every day, among them 118 being children infected by their mothers. According to experts, the problem persists because of lack of services to patients. Only six out of ten women access the PMTCT services through 12.5 per cent of health facilities offered, they said. Experts add that 21,500 out of 43,300 infected infants usually die before their second birthday while 14,450 die before their fifth.

The remaining babies will need life-long treatment, but the cost of maintaining their lives will be high to their families and the nation. Iringa, however, just a week ago received a shot in the arm. HIV-infected children and their families in the region will now be provided with free care and treatment. This was made possible after the Regional Hospital signed a memorandum of understanding with an American non-governmental organization (NGO), Baylor College of Medicine Children's Foundation-Tanzania.

Iringa became the third region to receive free of charge high quality care and treatment to HIV-infected children and their families after similar services were introduced in Mwanza and Mbeya regions in 2011. Baylor-Tanzania is part of Baylor International Pediatric Aids Initiative (BIPAI) network. Its Executive Director, Dr Michael Tolle, said recently that children are a vastly underserved population in the region hard hit by HIV/Aids.

Thus their project is unique in that it targets children from families that are struggling and mostly from remote parts of the country. The NGO aims to conduct a program of high quality, high impact and highly ethical pediatric and family HIV/Aids care and treatment and it is wholly funded by the American aid agency USAID and is in the country on invitation by the Ministry of Health and Social Welfare.

Besides their core function of providing free care and treatment for HIV-infected children and their families, the organization also aims at increasing local health professionals through education, mentoring, clinical attachments and opportunities to go abroad for specialized training, thus ensuring a sustainable system for the country's future. According to Baylor-Tanzania IPAI Clinical Director, Dr IJ Brenda Anosike, among their activities include testing and counseling (early infant diagnosis), family focused model of care, outreach in terms of enhancing case findings and improving quality of care.

She adds that other activities they perform are treatment of TB, malnutrition and other HIV related conditions, adolescent focused services such as teen clubs, sexual and reproductive health education and psychological support, medical education as in training, side-by-side mentorship and clinical attachments and community sensitization and orphan and vulnerable children advocacy. Although the organization has only started to operate in the region, TMO Dr Salum could not conceal his enthusiasm to work with them.

"Assistance from the organization is highly appreciated because we have a serious shortage of pediatricians to provide better care for children. This is a timely intervention and they have opened our eyes to many issues," says Dr Salim. Dr Salim further says that with assistance from Baylor they have become aware of the extent of the problem among children and families and that according to the agreement, they will start assisting children and families through the regional hospital in Iringa Municipality and in Makambako.

BIPAI has operational presence in Uganda, Lesotho, Swaziland, Botswana, Malawi, Ethiopia and Kenya and assists an estimated 100,000 people in the continent, Dr Tolle said. He said that in Tanzania the NGO has served some 2,000 people since it started operating in 2009 in the Lake Zone (Mwanza at Bugando Medical Centre) and Southern Highlands Zone (Mbeya Referral Hospital) before adding Iringa to its areas of operations.

VCT Coordinator and Counsellor with Baylor, Bernadetta Mwambungu, told this paper that the project takes them to rural parts of the country to find children and families that have been affected and assist them. "At times we come across orphans whose guardians are not aware that the children are affected or some are just not given proper care and we help them," she said. The project also offers psychological support for teenagers who have been affected through teen clubs where they informed of their status and encouraged never to give up hope.

The project's Monitoring and Evaluation Coordinator, Moses Chodota, said that among the things they do to restore hope and confidence to affected youths is to empower them psychologically. "They get relief when they are assured that they too can lead as ordinary lives as possible, that they will grow up and get married and start families of their own," he said. Assistance from Baylor-Tanzania comes at a time when the pang of the global financial crisis is being felt as donors have started cutting back on financing HIV/Aids national response budget by 20 per cent.

A very important donor had walked out. In 2009, the US President's Emergency Plan for Aids Relief (PEPFAR), the biggest financier of HIV/Aids programmes in Tanzania has reduced its budget for the purchase of ARVs in 2009 and 2010, and also introduced a freeze on its overall budget in the rest of Africa.

The US contributes 59 per cent to Tanzania's 95 per cent HIV/Aids national response budget, a huge chunk of it which comes from donors. With a reduction in the response budget, over 200,000 people were infected with HIV, including 43,000 children. Intervention by Baylor-Tanzania could therefore never been timely, but time will tell.

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