February 2011

March 7 Event: Global Health at the Crossroads

Come to a film screening and panel discussion that includes several of ICAP’s country directors. This is a unique opportunity to meet health experts from all over the world, and see what innovations are being made in the field.Details

ICAP Webinar Grand Rounds Available

ICAP’s Clinical Unit in New York has begun hosting this series of online webinars.  Featured archived sessions are available online:

Mental Health and HIV: a Practical Approach to Managing Mental Illness, with Fran Cournos

Microbicides & HIV Prevention, with Jessica Justman

Peer Educator Training Materials Updated Per New WHO Guidelines

The 2009 ICAP-developed Comprehensive Peer Educator Training Curriculum and Implementation Manual has recently been updated to reflect the new World Health Organization guidelines. 

ICAP, along with Ministries of Health and other local partners, has been supporting the implementation of innovative peer educator programs in several African countries. Peer education programs support greater and more meaningful involvement of people living with HIV in services and help tackle the human resource demands of HIV care by supporting task-shifting to trained lay counselors. 

The materials are available for adaptation by ICAP programs, as well as organizations and implementing partners planning to start or scale-up peer education programs. 

Final Report Available for Third Annual PMTCT Pediatric Conference in Kenya

ICAP’s Third Annual PMTCT/PEDS Conference took place in November 2010 in Mombasa, Kenya. The theme of the meeting was “Saving Mothers, Saving Children,” and the conference brought together over 90 participants from 11 countries. The overall goal of the meeting was to review the 2010 revised WHO guidelines for PMTCT, pediatrics, infant feeding and adult antiretroviral therapy, discuss implementation implications of the new guidelines, and continue to support ICAP country teams in the successful design and implementation of PMTCT and Pediatric programs that improve and promote maternal and child health and pediatric HIV-free survival.

The meeting’s final report is available here.

About ICAP

ICAP was founded in 2004 at Columbia University’s Mailman School of Public Health. Now a global leader in HIV/AIDS services, ICAP supports work at more than 1,200 sites across 15 countries in Africa. More than one million people have received HIV services through ICAP-supported programs.

For more information about ICAP, visit
here.
For more information about ICAP leadership, visit here.

Supported by Doris Duke Charitable Foundation, Bill and Melinda Gates Foundation, William and Flora Hewlett Foundation, Robert Wood Johnson Foundation, Henry J. Kaiser Family Foundation, Stephen Lewis Foundation, John D. and Catherine T. MacArthur Foundation, National Institutes of Health, David and Lucille Packard Foundation, Rockefeller Foundation, and Starr Foundation.


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SMS PRINTERS IN KENYA ALLOW TIMELY HIV PCR RESULTS

Despite the availability of effective antiretroviral drugs for prevention of mother-to-child HIV transmission (PMTCT) and national PMTCT program, more than 6,000 children a year in Kenya acquire HIV during pregnancy, labor, or breastfeeding. If these children are not promptly diagnosed and rapidly initiated on appropriate care and treatment, they are likely to succumb to HIV within just a few years.  The challenge for the health system is how to identify such children in an efficient and effective way, and to ensure that they are started on life-saving antiretroviral therapy.

In line with national efforts in Kenya, ICAP supports the testing of all babies born to HIV-infected mothers, six weeks after delivery when they are brought to health facilities for routine immunizations. Diagnosis of HIV in young children is dependent on the use of a special PCR (polymerase chain reaction) test that detects the presence of HIV in the blood, a test that is only available to the public at the laboratories in Nairobi and Kisumu. A well-functioning system should start with obtaining dry blood spot samples from children. The specimens would then be transported to laboratories, and test results would be returned to the source health facility, which would in turn provide the test results to mothers and families. Should the test prove the child is HIV-infected, the facility would start the appropriate care and treatment.

But delivering these test results remains a challenge in this required cascade of events, particularly for health facilities that are located in hard-to-reach rural areas. Combining laboratory technology with mobile phone technology, the availability of a short message service (SMS) printer at such facilities offers a solution to this challenge.

Using SMS, a feature more commonly found in mobile devices, the SMS printer essentially works similar to a mobile phone. The printer transmits a PCR test result in moments from the central laboratory to the health facility, where it is automatically printed out. Once received by the health facility, the assigned health care worker transcribes the results to the patient’s file and HIV-exposed infant register awaiting collection by the mother on the appointment date. If the test is positive and the mother does not turn up for the appointment, the nurse contacts her via mobile phone. Mothers without mobile phones are tracked down by peer educators.
 
Working with Clinton Foundation, which provides the machines, ICAP has installed SMS printers in 20 rural health facilities in Kenya and worked on establishing the process for recording and acting upon such results. Tests that took as long as six weeks now can be done in as little as two weeks. This has subsequently reduced the time it takes to begin treatment for HIV-infected children.

Mother Support Groups in Ethiopia Help Women Take Charge

Banchi Abebe, a self-supporting mother of two, is a mentor mother at Sabian Health Center in Dire Dawa Administrative region, one of the four regions supported by ICAP in Ethiopia.  She was among the first to be enrolled in the Mother Support Group program, a part of the facility’s PMTCT program.

The support group initially focuses on empowering women like Banchi to share their stories and talk openly about HIV, and then to empowers them to start building more self-directed lives.

Through the Mother Support Group, Banchi has learned to openly talk about her HIV status. Banchi now leads a group of 35 women living with HIV who are involved in income-generating activities. Largely dealing in dried foodstuffs, they have now earned about 80,000 Ethiopian birr (about U.S. $5,000), a substantial amount for a country with a per capita annual income of roughly U.S. $630.

Since the program started in 2007, one group of mothers has completed participation in the program, which starts during pregnancy and lasts for at least 18 months after giving birth until the mother knows the final HIV test results of their child. The Sabian Health Center is now working with its second and third groups of mothers and children.

The program includes discussion sessions three times a week. Sr. Selamawit Mulugeta, the mother support group site coordinator for Sabian Health Center, further explained, “Monday morning is for mothers with children more than six months of age. Wednesday morning is for mothers with children under the age of six months, and Wednesday afternoon is for pregnant mothers. In each session, the mentor mothers raise issues and discuss how to take care of their children in a manner to reduce risk of HIV transmission to their babies.  They also get information on the importance of family planning and how to prevent sexually transmitted infections.”

The program started four years ago with four pilot sites established to improve PMTCT services. It sought to provide practical advice and psychosocial support to pregnant women and breastfeeding mothers with HIV, help mothers adhere to HIV medicines for PMTCT and their own treatment, and provide proper infant feeding practice. In addition, Mother Support Groups helped inform women about family planning, helped them disclose their HIV status, provided a forum to talk about HIV services in understandable terms, and linked mothers to facility and community resources.

Banci commented, “I got peace of mind and was relieved seeing my baby free from HIV. I wanted others to have that feeling, and ease their burden by sharing my experience.”

The Mother Support Group program has currently been implemented in 24 health facilities, with 24 site coordinators and 77 mentor mothers. So far, 316 group members have received training to generate their own incomes. Additionally, 591 breastfeeding and 223 pregnant women regularly attend the program, and 504 HIV-exposed infants are on follow-up.

ICAP Materials Showcased on “Women, Children, and HIV” Website

The “Women, Children, and HIV: Resources for Prevention and Treatment” website, a project of the UCSF Center for HIV Information (CHI), features resources on the prevention and treatment of HIV infection in resource-limited settings. The site has developed an ICAP-specific webpage featuring ICAP materials, including the Zambia Pediatric Provider-Initiated Testing and Counseling (PITC) curriculum and the Comprehensive Peer Educator Training Curriculum and Implementation Manual. These ICAP resources are made available for adaption by organizations and implementing partners wishing to start or scale-up public health programs. The site is a result of a collaboration between ICAP and The University of Medicine and Dentistry of New Jersey-François-Xavier Bagnoud Center.