PREFA PMTCT Community Intervention Performance

During the reporting period the community department in collaboration with the 40 district partners promoted the acceptability and uptake of PMTCT services by sensitizing community leaders and members on PMTCT services,, training of village health team members on issues for referrals and follow up at community level, conducting joint home visits for HIV+ mothers and their exposed babies by VHTs and the health workers and supporting other HIV prevention and care community activities as planned by the districts. This was in fulfillment of the program objective on supporting the community of HIV. activities that promote the uptake of PMTCT services in the 40 districts.

In terms of achievements, 584 VHTs were oriented districts to enable them interface with the VHTs on community data collection tools, 59 radio talk  show events on topics like discordance and male involvement were conducted on PMTCT, 168 community education sessions were carried out through which referrals were made for ANC, facility deliveries and HIV exposed infants, 543 home visits were made jointly by the health workers and the VHTs, and support was extended to some 22 PHA groups within the districts to sensitize their communities on  HIV and PMTCT in particular.

Challenges and Lessons

Besides the achievements made, there were challenges encountered which included the low motivation of VHTs  and PHAs due to the weak coordination capacity of the district  health teams, and inadequate documentation by the VHTs which leaves a lot of substantial achievements not recorded. Notably also is that most health workers are still struggling to recognize the role of VHTs in bridging the gap between the health facilities and the larger community. VHTs receiving adequate support can potentially fill the current gaps in our weak referral systems and are likely to succeed when engaged at the facilities within their localities where they are attached.

The lessons that have been drawn over time from the challenges above reveal that the health facilities that have embraced the VHT concept have realized the fruits of community linkage where health workers have a strong bond with the surrounding communities. VHTs counsel mothers and their families within the community to go and benefit from the PMTCT services at the at the health facilities. Secondly, the local leadership which appreciates their role in this initiative are likely to be more pivotal in the PMTCT mobilization drives and also effectively promote the concept of volunteerism. Thirdly, the VHTs and PHAs should be fully involved in awareness creation because they play complementary roles in supporting the programme objectives aimed at achieving virtual elimination of mother to child transmission of HIV.

PREFA will continue to undertake a number of initiatives to improve their technical assistance to the districts to enable them interface with the VHTs more productively. Strategies on the motivation of the community workers will continually be devised and implemented to strengthen the management  functions of the district leadership as well as the systems in place and study the benefits of using translated IEC materials.

Overall, while focusing on the achievement made  within the reporting period, the challenges encountered and lessons learnt, there is a need to devise strategies with district and other implementing partners aimed at improving the quality of technical sup- port, strengthening the commitment of the district leadership to community activities as a means to improving our community PMTCT service delivery.