2. NGO BIBAA LUNDI ANNE OMAM Reach Out Cameroon PhD(Student); Microbiology "DIFFICULTIES IN ACCESSING PMTCT SERVICES IN POST-CONFLICT ZONES OF BAKASSI IN THE SOUTH WEST REGION OF CAMEROON"

3. Background of Study In Cameroon, out of approximately 1,057,162 pregnant women expected at ANC, only 557,257were seen at first ANC in the year 2013 In rural areas very few of pregnant women who reach the health facility are attended to by skill personnel. Most health interventions and PMTCT programs in hard to reach and post conflict communities are ineffective.

4. Background of study ANC is almost non existent in post conflict communities This study sought to identify the difficulties faced by women in post- conflict areas in accessing PMTCT services This study falls within the framework of Reach Out Cameroon’s PMTCT project in Bakassi, Funded by the Positive Action for Children’s Fund

5. Background - Situation of Bakassi SWR-as post conflict area Four maritime Councils (communes) that border Nigeria Conflict zones where Cameroon and Nigeria (fought for 13 years); area rich in petroleum products. The arm conflict had effects which are still being felt today. Currently pirates and Bandits are the caused of the insecurity of the area

6. Situation of Bakassi SWR-as post conflict area High prevalence of HIV (18% of pregnant women test HIV positive from Jan – June 2015) Poor health infrastructure, low literacy rate, highly immigrant population of Nigerians Most communities are riverine communities Insecurity

7. How was done? - Methodology 41 focused group discussions in 21 villages from July 21st - August 7th 2014. Three teams of two research assistants were deployed to conduct Focus Group Discussions (FGD) in communities. With consent from participants, information was collected by note taking following the guided questionnaire and tape recording of participant responses A total of 417 participants (Male=216, Female= 201).

8. RESULTS - Difficulties faced in accessing PMTCT Constant threat of kidnapping or pirate attacks faced by women in these enclave communities contributed largely to the poor use of health facilities. The under-equipped nature of the health centers

9. RESULTS - Difficulties faced in accessing PMTCT Most participants acknowledged giving birth at home or in churches, since it was safer and health facilities were too far off. The poor state of the roads especially during the rainy seasons also accounted for most home deliveries.

10. RESULTS - Difficulties faced in accessing PMTCT Most communities are surrounded by water, thus further hindering movement especially during high sea tides Lack of information, ignorance, cultural factors, and the non-willingness of male partners in attending clinics with women were highlighted. Stigma and discrimination is still very high in these communities. The myths of family planning prevents women from using these services.

11. Recommendations - Strategies to increase access to services Collaborate with military, local and administrative authorities. Advocacy with traditional, religious and administrative leaders Comprehensive community education Involve community leaders as peer educators Train Traditional Birth Attendants and integrate them within health facilities

12. Recommendations - Strategies to increase access to services Outreach programs for pregnant women Provide motorbike and speed boat ambulances Adequately equipped health centers Resource centers for information and services to prevent MTCT, treat, care and support PLHIV

13. THANKS FOR YOUR KIND ATTENTION