- A few health facilities do CD4 count for HIV positive mothers once a month at a small fee while others do not do at all due to lack of logistics
- CMEs are irregular in most health facilities
- Facility deliveries are low despite high antenatal attendance. To overcome some of the challenges mentioned above, PREFA has done the following:
- Trained health workers on PMTCT-EID strengthening program
- Trained VHTS on PMTCT so that they can pass on the message to the communities thereby promoting uptakes of the services. The VHTS are also used to do home visits to all mothers and babies on day 3 postpartum so that anyone with health complications is referred to the health facility.
- Procured infection control materials like gloves, cotton wool, jik, soap and mama kits to supplement what Ministry of Health supplies to the healthy facilities
- Facilitated Health Sub-District teams to have regular support supervisions and meetings to the health facilities so as to ensure knowledge is translated in to action
- Facilitated transport for CD4 samples and results for all pregnant mothers
- Empowered and encouraged health facilities to have regular CMEs.
- Encouraged facilities to include both PMTCT and MNCH topics on the list for health talks given to expectant mothers.
- Supported some districts to recruit health workers for busy health facilities to reduce on the work load.
There are plans to provide mama kits which will be given at the time of labour with hope that it will attract expectant mothers and hence increased number of facility deliveries. The messages to the community which were focusing on PMTCT only have been revised to include maternal, new- born and child health.
VHTs are being oriented at the health facilities they are attached so that they can assist health workers to triage, take weight and record on busy clinic days. This is in anticipation that it will reduce work load.