CHAZ
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Transcript of CHAZ
CHAZCHAZ Each Community CountsEach Community CountsCommunity Leadership Spearheading PMTCT Program to
Improve Health Outcomes of HIV Exposed Babies, at Nangoma Hospital, Zambia
Dr. Dhally Menda MD, MPH, MBA
Maternal and Newborn Health Conference for Zambia’s Mothers and Babies
01st November 2012
www.chazhealth.zm.org
CHAZ Background Information CHAZ Background Information
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
Formation & Membership• Formed in 1970 ( Catholic and Protestant Medical Committees)• Interdenominational (Catholic and Protestant) umbrella organisation
for 146 CHIS in 10 Provinces:• 36 Hospitals & 81 RHCs & 9 Training Schools • 29 CBOs
Health Services Coverage• CHAZ is the second largest provider of health services in Zambia. • MoU with the MoH: Grant- Staff Secondment – Essential Drugs
PMTCT and ART Sites • PMTCT: 61• ART: 51
National Strategic Framework
HSS in 146 CHIs
HIV & AIDS
TB Control
Malaria Control
Sensitizations PMTCT: 13,157
ART: 48,979Awareness Campaigns
MNCH
CSS≥ 500 CBOs
Mentoring & TA
C&T: 361,111
MC: 7,453
CHAZ Health Programmes CHAZ Health Programmes
Background Background
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
• Nangoma is a Mission hospital is situated in the rural Central Province • ART and PMTCT programs: Initiated in 2006 – Support: GF ATM• Catchment: 80,000 & Polygamous society • HIV prevalence rate among pregnant women aged 15-40: 9.5%. • Home Deliveries (60%) due to: Long distances, Traditional beliefs,
Myths and Stigma. – Exposed babies at risk of getting HIV
•Sensitized the Senior Chief (Shakumbila) and all his entourage on the importance of PMTCT.•Lobbied the Chief to have all pregnant women deliver from HF •Home Delivery Penalty: Goat
MethodMethod
Method Cont’d Method Cont’d
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
To improve the PMTCT outcomes, the Hospital ART/PMTCT Team came up with an HIV Prevention Strategy that embraces all community members. Throughout 2010, the ART/PMTCT team:
•Recruited mothers to join the Mothers’ Support Groups, to encourage networking and fight against discrimination
•Recruited Adherence Supporters Workers to help in client (mother/infant pair) defaulter tracing
•Involved men, through community leaders and hospital staff, to come with their wives for all Antenatal Clinic visits
•Encouraged HIV +ve pregnant women, living in distant areas from the health facility, to stay at the Maternity Waiting Home, when they enter their 3rd Trimester of pregnancy.
•Encouraged all ANC clients to undergo VCT as a couple.
•Provided ART and/or ARVs Prophylaxis to the mother-baby pair
•Provided EID.
Results Results
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
The community leadership and members embraced the initiative and took
the project to the next level.
As a result:
HF deliveries increased from 60% in 2008/09, to almost 100% in 2010.
Figure 1: Improvement in health facility deliveries
Result Cont’d Result Cont’d
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
Out of the 72 HIV +ve mothers who delivered at Nangoma Hospital:
93% of delivered babies with a negative HIV PCR test.
Among the 24 women who delivered at home (no PMTCT intervention), from outside the chiefdom, 20% of their babies had a positive HIV PCR test (P=0.05).
Figure 2: Improvement in health facility deliveries
Conclusion Conclusion
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
PMTCT interventions with a strong community involvement have a positive impact on the health outcomes of HIV exposed babies (Avert HIV infection).
Involvement of the community through community leadership, can help rural based Health Facilities improve:•ANC attendance, •Couple Counseling, and •Health Facility deliveries
Acknowledgment and Thanks Acknowledgment and Thanks
“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2
Thank you
God bless
Acknowledgement:
Co-Authors:M.M. Bwalya, P.M. Mulenga, J. Simutowe, M. Zulu, S. Hambilika, K. Sichinga
Partners:MoHGFATMNangoma Hospital StaffNangoma Community