Case study

Helping HIV positive mothers have HIV negative children

A DFID funded project is helping to increase the number of HIV negative babies that are born in South Africa

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South Africa has the highest number of HIV and AIDS cases in the world, with around 1,000 South Africans dying from the disease every day. Stigma and discrimination against people with HIV remains unacceptably high and women suffer disproportionately from the disease.

Zanele Mbatha is 1 of the 3 million women over the age of 15 living with HIV in South Africa.

“When I heard I was pregnant, as well as being HIV positive, I got very scared. I didn’t know what to think or do, and I didn’t want to face up to my illness,” she explains.

She couldn’t believe that she or her baby would be able to live a healthy life and was close to losing hope.

Help was on hand though in the form of a community-based health care worker, who was able to counsel her in her home. Gradually she began to come to terms with her situation.

“It is difficult to accept, but once you have accepted it and you listen to the rules and whatever you are advised to do, it becomes easier,” she says.

Preventing transmission

The training of community-based care workers was just one part of the Accelerated Plan for the Prevention of Mother to Child Transmission, also known as the A-plan.

UK aid from the Department for International Development, along with other partners, worked with the South African government to improve the management of the national prevention of mother-to-child transmission programme (PMTCT). It improved the quality of care HIV positive pregnant women receive by encouraging them to make use of PMTCT services at clinics and hospitals.

The A-Plan helped to break down community and social barriers to the programme and equipped women with the information and support they needed to ensure a long and healthy life for them and their families.

Video: preventing HIV transmission between mothers and children

Video: preventing HIV transmission between mothers and children

“I used to hear about negative babies being born from positive mothers, but I didn’t believe it,” says Zanele.

“Now I do believe it, because my child is negative, even though I am positive.”

DFID funded the pilot phase of the A-Plan in 6 districts, including Zululand in KwaZulu-Natal province, where Zanele lives. There the percentage of HIV infected women receiving treatment to reduce mother to child transmission has increased from 65% to 93%. Almost 100% of HIV exposed babies now get the correct treatment at birth and CD4 cell count testing for pregnant women (which shows how well the body is responding to the HIV virus) has improved from 92% to 100%.

Due to the pilot’s success, the South African government integrated it into the national health system’s countrywide response to HIV. Even though DFID is no longer funding the A-plan, UK aid played its part in helping to ensure that more HIV negative babies are born to HIV positive mothers throughout South Africa. 

Bright future

Talking to the community-based health worker gave Zanele the confidence she needed to visit her local clinic and receive further treatment and support.

“At the clinic they advise that we must disclose to our partners. They even ask us to write down the name of the person we are going to disclose to, and I chose to disclose to my husband,” says Zanele.

With time, he too came to terms with Zanele’s HIV status and was encouraged to take a HIV test.

“I think my future is bright because I am healthy now that I am on treatment and my baby’s future is also bright. Once I tested and I was counselled it opened my mind. My whole outlook has changed.”

Facts and stats

There are 5.7 million people living with HIV in South Africa. Of that, three million are women over the age of 15 years and 280,000 are children.

On average, nearly 1 in 3 pregnant women are HIV positive.

There are an estimated 1.4 million AIDS orphans.

A 21% increase in maternal deaths between 2005 and 2007 is attributed to HIV.

During the pilot phase of the A-Plan, the HIV testing rate of pregnant women increased from 91% to 96%. The HIV positive rate at six weeks among babies exposed to HIV dropped from 10% to 4% in the same period.

UK aid support to A-Plan provided training for a total of 171 community health care workers across all six priority districts in South Africa. In addition, district facilitators were sent to each region to help manage the programme and a series of 25 open day events helped ensure that the PMTCT message reached a wide audience.

Published 22 November 2010