The following is the second in a three-part series of I-TECH success stories from Ethiopia.
In Ethiopia, only 24 percent of HIV-positive pregnant women receive antiretroviral therapy (ART) to prevent transmission of the virus to their children (UNICEF, 2012). The importance of counseling for these pregnant women is critical to increase treatment rates and ensure more children are born HIV-free.
In 2009, the International Training & Education Center for Health (I-TECH), with support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), began managing support groups for HIV-positive pregnant women and mothers in three regions of Ethiopia: Axum, Gondar, and Dubti.
This case management program, which came to a close at the end of 2014, was the first of its kind in the country, training a group of 63 mentors to counsel pregnant HIV-positive mothers on optimal child-rearing practices and offering psychosocial support to help them adhere to prevention of mother-to-child transmission (PMTCT) programs.
Yirgalem Taye is one of the trained mentors from the Mother’s Support Group based at St. Mary’s Hospital in Axum, Northern Ethiopia.
In addition to urging mothers to follow treatment regimens, “we encourage mothers to give birth in a hospital to reduce the risk of transmission during delivery,” says Yirgalem. “We teach mothers breastfeeding practices, family planning, as well as the importance of disclosure to a partner and the need to get all partners to come and test with us.”
Offering consolation, solidarity, and friendship
Alem Tsehaye sits by a bowl of smoldering frankincense while playing with her 7-month-old baby girl, Heyab.
In 2009, Alem tested HIV-positive, forcing her to change her plan to move abroad and work as a domestic servant. In 2013, she became pregnant, which caused anxiety about the well-being of her child. She enrolled herself in the Mother’s Support Group at St. Mary’s Hospital and started to receive counseling.
“I learned that it’s possible to be HIV-positive and have a HIV-negative child,” says Alem, “which might not have been possible had I not joined the group.”
Alem notes the consolation and solidarity she derived from spending time with other young mothers in the support group. “If one of us came to the group feeling low, we would build each other up again,” she says. “I have made new friends. Between us we continue sharing the support within the community.”
One of the biggest challenges facing a woman diagnosed with HIV is disclosure to her husband. If a person with HIV status fails to make a disclosure to his or her partner, the uninformed partner becomes a risk to home and community health. One role of a Mother’s Support Group mentor is to mitigate this risk by encouraging group members to inform their partners so that they can be tested without delay.
Real results for child and mother
From 2009 to 2014, nine hundred mothers were enrolled in the mentorship program at Gondar University Hospital. Out of those 900 births, only 72 infants – or 8 percent – tested HIV-positive. The World Health Organization estimates that, in the absence of any intervention, transmission rates can range from 15-45 percent.
Outside the Mother’s Support Group ward at Gondar University Hospital is a courtyard where a group of young mothers sit doting over their babies. Many of these mothers do not have an appointment but have come to see their mentors.
“The mothers love the support and security of this small community group,” says Rachel Birhanu, a mentor. “The mentors attend their children’s birthdays and ceremonies. We have become close. They confide in us and know we are the few people who will listen and not judge them.”
The I-TECH program may have come to an end, but the Mother’s Support Groups are acknowledged for their comprehensive service delivery and for their successful efforts to reduce the number of HIV-positive babies born in Ethiopia – and to increase the productivity and well-being of HIV-positive mothers.
Helen Alebachew has two children. In 2007 she discovered her HIV-positive status after undergoing a test while suffering from tuberculosis. She says she benefited from learning about HIV-friendly family planning practices and coping strategies within the group.
“The solidarity I experienced in the mother’s group saved me from losing my mind,” Helen says while roasting coffee beans in a pan over a small fire. “After starting ART treatment, I made a fast recovery and was soon living a normal life again.”