Integrated Regional Information Networks - January 4, 2012
ADDIS ABABA, 4 January 2012 (PlusNews) - Ethiopia's new plan to
eliminate mother-to-child HIV transmission by 2015 cannot be
attained unless men are more meaningfully involved in
reproductive health, experts say.
"Among the pregnant women who come to our hospital, less than 10
percent of them come with their partners," said Etalem
Gebrehiwot, head nurse at the prevention of mother-to-child
transmission (PMTCT) wing of Gandhi Memorial Hospital. "Those who
find out that they are living with the virus usually face a
problem while taking medicines, given that most prefer to take it
without the knowledge of their partners."
Studies show that low male partner involvement is one of the
challenges to the success of the country's PMTCT programme.
According to experts, men's involvement in PMTCT can have a
positive impact on PMTCT by encouraging their partners to visit
antenatal clinics and have skilled health workers attend the
birth of their children. In a 2010 Kenyan study, male partner
involvement in PMTCT reduced the risks of vertical transmission
and infant mortality by more than 40 percent compared to no
"The biggest challenge we are currently facing is to convince
mothers to get tested in order to determine that they are
eligible for PMTCT services... the major reason for their
resistance is lack of consent from their husbands or partners,
who are more influential in family matters including this," said
Aster Shewa, who supervises Zewditu Hospital antiretroviral
service centre in Addis Ababa.
"Besides, after they know their status, most HIV-positive mothers
refrain from disclosing it, which usually impacts the way they
use PMTCT services and their effectiveness," she added.
Many men do not see the advantages of an HIV test; one father,
whose wife gave birth to a daughter in November 2011, told
IRIN/PlusNews: "We are married - what is there to test about?"
"At the moment, hospitals with PMTCT services are increasing, and
we have to work hard in convincing pregnant women, along with
their partners, to use health facilities with the service in
order to reach zero new infections," said Aster.
New national plan
The national accelerated emergency PMTCT plan - launched in
December 2011 - has three objectives: reaching 90 percent of
pregnant women with access to antenatal care services; ensuring
universal access by pregnant women to a skilled attendant during
delivery; and providing ARVs to at least 80 percent of
HIV-positive pregnant women.
An estimated 1.2 million Ethiopians are living with HIV,
including about 90,000 pregnant women; just 9.3 percent of
pregnant women who are eligible for HIV services are currently
receiving them. The number of Ethiopian women who visit antenatal
clinics is growing - from 616,763 in 2008-2009 to 796,099 in
2009-2010 - and the number of mothers receiving HIV testing as
part of PMTCT services has grown to over 70 percent, but just 6
percent of births are attended by a skilled health worker,
according to the UN World Health Organization.
"The new plan will focus on increasing the quality of services
that expectant mothers get in the health services and also retain
those who are using it. We intend to work on both in the demand
and supply side of the service," said Tadesse Ketema, a maternal
health adviser at the Ministry of Health.
"Through the health extension programme, the country manages to
create easy access for family planning services for many families
and that has worked so far. We are now planning to copy that in
the PMTCT programme to reach out [to] each pregnant woman and
give the service at their convenience," he added.
Ethiopia's "health extension programme" employs more than 30,000
lower cadre health workers to provide basic health care at
village level. The government also intends to use "health
development armies" - community groups mobilized to further
government health programmes - to create demand and convince the
community, including male partners, to benefit from nearby PMTCT