Ending new HIV infections among children is now not just a dream, but a reality. Governments around the world are finding innovative ways to reach this goal.
Eliminating new pediatric HIV infections will take coordinated efforts by national governments, local communities, and external partners. Governments must be equipped to meet the needs of their populations, and the programs that support HIV-positive people must help to deliver services to keep them healthy and help prevent new infections in un-infected people.
In the Republic of Kenya, the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) has been supporting interventions since 2000 that help the national government to improve delivery of health services to its citizens.
One example of that support is Kenya's Maisha project, instituted in 2010 and led by the government with support from the United Nations Children's Fund (UNICEF) and EGPAF. The goal of the project is to build the capacity of all levels of government and health facilities to provide services for the elimination of mother-to-child transmission (eMTCT) of HIV.
Since its inception, the Maisha project has made consistent strides to identify and keep women and children with HIV healthy while protecting new infants from becoming infected with HIV.
Integration of services is essential to providing comprehensive health care to women and families affected by HIV and AIDS. Maternal and child health, reproductive health, family planning, and HIV services are all integral to maintaining the health and well-being of families.
Specifically, integrating HIV and family planning services allows women to know their HIV status, maintain their health, and use family planning practices to give birth to HIV-negative children in the future.
Through the Maisha project, the Rongo District Hospital and 11 other health facilities in Nyanza Province are offering reproductive health services to all women of reproductive age while providing HIV services as part of general outpatient services, with the support of EGPAF and the Kenya National AIDS and STI Control Program (NASCOP). As a result, 90 percent of all clients who visit Rongo district hospital for medication or checkups have been counseled and tested for HIV, the first step in preventing transmission of HIV to infants.
Keeping accurate and complete data helps to determine the effectiveness of a health system. At Rabuor Health Centre in Kisumu County, a system has been developed to trace HIV-positive clients to their homes and communities. This allowed clinic staff to follow 82 percent of clients who missed follow-up appointments in 2012, 93 percent of whom returned to the facility for treatment.
"Through this system, we are seeing more pregnant women coming early for antenatal care (ANC) and completing all four ANC visits before delivery," said Edna Okombo, Rabuor Health Centre Nursing Officer.
Community engagement and support is often a large factor in maintaining the health of HIV-positive people. At Uriri Health Centre in Migori County, community health workers (CHW) collect data on regional households to ensure that health facilities are meeting the needs of the community. The data are then shared with the local communities, where they discuss ways to solve problems. Since the beginning of this initiative, CHWs are reaching 84 percent of households in the area, a 14 percent improvement in all supported health facilities.
In Kamrembo village in Ukwala district, a community-driven infant and young child feeding (IYCF) program associated with the Maisha project helps women to exclusively breastfeed their babies for at least six months. Mothers' breast milk provides essential nutrients and antibodies that keep children healthy. A combination of exclusive breastfeeding and the use of antiretroviral treatment can significantly reduce the risk of transmitting HIV to babies through breastfeeding.
Innovative projects like Maisha are turning the tide against pediatric HIV/AIDS. With coordinated efforts like these being made in the countries most affected by HIV and AIDS, the goal of eliminating pediatric AIDS is in sight.