Prevention of Mother to Child Transmission: A Panacea for an HIV- free Generation Mobilizing Community Members for Uptake of PMTCT Services: Approach and Strategies

What is ‘Community’? A group of people with diverse characteristics who are linked by common ties including shared interests, social interaction or geographical location”

Why Mobilize Community Members in PMTCT To: better understand and address sociocultural and other barriers to PMTCT engender local ownership and sustainability decentralizing services and scaling up coverage

Roles of Community in PMTCT as defined by Global Plan 1.Serve as extension workers; 2.Provide services, referrals and linkages; 3.Help plan and monitor programs; 4.Enter into charters with government authorities to strengthen accountability; 5.create demand;

Roles of Communities in PMTCT as defined by Global Plan 6. Maximize community assets. 7.Address challenges to service uptake; 8.Involve male partners and families; 9.Reduce stigma and discrimination; 10. Participate in communication campaigns;

Intended Outcomes for Mobilizing Communities Outcome 1: improved supply of comprehensive PMTCT services Outcome 2: increased uptake of PMTCT services Outcome 3: an enabling environmnt for PMTCT.

Improving supplies of PMTCT Services Extend the workforce Link with community/faith-based organization Monitoring program through civic partici- pation

Increase uptake of PMTCT Services Communicating for social and behavior change Providing Peer Support Maximizing Assets and addressing economic constraints

Enabling Environment for PMTCT Scale-Up Advocating for PMTCT and the right to health Promoting Engagement in Policies and strategies

Range of Stakeholders in PMTCT General Community Members/Groups: Community leaders, Women’s Groups, Men’s Groups, NGOs/CBOs/FBOs, Relevant Specific Members/Groups: Pregnant women, Service Provider for Pregnant women/babies, People Living with HIV (especially women)

Keynotes in Community Mobilization for PMTCT meaningful involvement of networks and communities of people living with HIV will enhance PMTCT scale-up; Building on existing community structures rather than working in parallel to them – improves program efficiency, effectiveness and sustainability

IICWIN Experience with Project: Akinyele PMTCT Plus Positive Escort Identified and worked with a Contact Person Defined the Stakeholders/Gate keepers/ Com- munity Members/Groups Paid Advocacy Visits to Community Leaders Conducted Stakeholders Forum Capacity Building for key community groups Linked with 3 PMTCT Centres (UCH, Catholic Hospital Oluyoro & St Mary’s Eleta)

A Contact Person A Community Health Worker who is conversant/works with the community and the health facility.

Defined the Stakeholders/Gate keepers/Community Groups Community Leaders Women’s groups Community Birth Attendants Association and members People Living with HIV The pregnant women

Advocacy Visits to Community Leaders With the facilitation of the Community Liaison Listed and visited the leaders of identified groups Purpose: Sensitization about the subject matter, and obtain their buy-in

Conducted Stakeholders Forum Purpose: sensitization, obtain commitments to work together on PMTCT High level attendance – Baale of the community, Local Government Chairman’s wife, Primary Health Coordinator, Women’s Leader, Community-Birth Attendants reps, leaders of other relevant groups About 50 participants were in attendance

Capacity Building for community groups Engaged  Community Birth Attendants &  People Living with HIV

CBA Sensitization Sensitized and trained about 100 CBAs in Akinyele and Lagelu LGA on PMTCT, especially importance of HCT for pregnant women Outcome: - Increased requests for outreach to their facilities – Conducted 117 outreaches to 33 CBA facilities in 1 year and tested 2000 pregnant women - Increased referrals of pregnant women from smaller CBA places to IICWIN for HCT

Training of PLHIV as Positive Escorts 16 PMTCT experienced PLHIV trained & 11 designated as Positive Escort (PE) Each identified Positive Pregnant Woman is attached to a PE who counsels, escorts to PMTCT Centre and follow-up through home- visits and telephone 8 PE followed up 78 Positive Pregnant Women and 32 live babies in the 1 st year with mixed results