Celebrating African Motherhood - Amref

TANZANIA
ANGAZA ZAIDI – Prevention of Mother to Child Transmission
(PMTCT)
Over the past ten years the death rates of mothers (578/100 000) and
newborns (32 per 1,000) have remained persistently high. National
AIDS-related morbidity and mortality in Tanzania is higher in women
of child-bearing age, and more than 60 per cent of new infections occur
among young people, particularly young women. About 90 per cent of
HIV infection in children below 15 years is acquired through their mothers.
Estimated prevalence of HIV among pregnant women at antenatal clinic
is 8.7 per cent. Given that about 1.4 million deliveries occur annually in
Tanzania, an estimated 122,000 women living with HIV deliver annually.
Without intervention 25-40 per cent of these women will transmit the
virus to their babies during pregnancy, delivery, or through breast-feeding.
Most children born with HIV die early in their infancy, while the underfi
ve mortality attributable to paediatric AIDS is 16 per cent. The Tanzanian
Government introduced a programme for Prevention of Mother-to-Child
Transmission (PMTCT) of HIV in 2000 as a critical element of the national
HIV response. AMREF’s work in PMTCT began in 2004 as a component
of the successful nation-wide ANGAZA VCT (Voluntary Counselling and
Testing) Project, now called ANGAZA ZAIDI (meaning ‘to shed more light’ in
Swahili). Following a decision by the Ministry of Health to allocate regions
to specifi c organisations, Ruvuma Region became AMREF’s PMTCT zone.
The project is implemented in three districts – Songea Urban, Songea
Rural, and Namtumbo.
HIV prevalence in Ruvuma, an agricultural region in southern Tanzania, is
5.9, just below the national six per cent average. In 2009, the death rate
for children under fi ve in the region was 90 for every 1,000 born. The
mineral-rich Ruvuma attracts people from diff erent parts of the country,
including neighbouring Iringa, which has the highest HIV prevalence in the
country - 15 per cent. The fact that 53 per cent of women in the region have
their babies at home raises the threat of HIV transmission from mothers to
children, considering that 90 per cent of HIV infection in children is passed
on in this way.
PMTCT has traditionally been facility-based, involving training of
health care providers, provision of supplies, and putting up necessary
infrastructure for its implementation. A way needed to be found to take
information and services to the large number of women who deliver
at home. AMREF devised an integrated programme that introduced
the direct involvement of communities by training community-owned
resource persons (CORPS) to take health messages to the villages. Through
public meetings and home-to-home visits, the CORPS talk about a range of
maternal and child health issues – from antenatal care and safe delivery,
to sexually transmitted illnesses, HIV and VCT. They help the community
to understand what PMTCT is about, and encourage women and their
husbands to go to the health centre. The project is deliberately designed
to encourage men to participate because they are main decision-makers
in the household; having them on board increases the chances of success
of the programme.
AMREF has also trained 400 health workers in 66 health centres to reinforce
the information given by the community volunteers at village level, and
has provided HIV test kits, delivery beds and other equipment to improve
services at the facilities. With the complementary facility-based and
community-based components, AMREF provides a vital link between
communities and health facilities, making the project highly eff ective.
FACTS AND FIGURES
• Maternal mortality in Tanzania is 578 for every 100,000
mothers
• 90 – the percentage of HIV infection in children arising
from transmission from mothers
• 2,181 – the number of community service providers
trained by AMREF in Ruvuma Region
• AMREF partners with a total of 66 service outlets, and have
trained a total of 400 service providers
• Community Health Workers have reached 87,914 people in
Ruvuma since 2004
DONOR
• PEPFAR funding through USAID
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