1. Community Innovation in eMTCT Learnings from Positive Action for Children Fund
Durban
July 2016

2. Who are we?
An initiative of ViiV Healthcare
157 partnerships (current) + capacity building
eMTCT and paediatric HIV focus
Smaller community groups (avg grant about £15,000 p.a.)
Capacity building support

3. In 21 priority countries, since 2009... 60% drop in new infections
Huge Progress
In 21 priority countries, since
60% drop in new infections
1.2m infections averted amongst children
Significant reduction in children infected perinatally over 270,000 -> 110,000 p.a.
Children on treatment 15% -> 51%
Source: UNAIDS Press Release; June 2016 (

4. How leaky a cascade? Primary prevention
Low awareness, lack of understanding, poor sex education, lack of power & rights, cultural & religious beliefs...
Preventing unintended pregnancies
Low awareness of F.P, lack of power & rights, unwillingness of men to accept condom use, willingness to accept disclosure from partner
PMTCT
Late presentation at clinic, loss to follow-up
Supporting Mothers
Job’s done?, have to think beyond health, women spend time in community

5. Plugging remaining leaks
Primary prevention
Low awareness, lack of understanding, poor sex education, lack of power & rights...
Preventing unintended pregnancies
Low awareness of F.P, lack of power & rights, unwillingness of men to accept condom use
PMTCT
Late presentation at clinic, loss to follow-up
Door-to-door outreach
Edutainment
Community testing
Working in schools
Clinic Referrals
Working with community leaders – raising awareness, changing by-laws
Supporting Mothers
Job’s done?, have to think beyond health

6. Plugging remaining leaks
Primary prevention
Low awareness, lack of understanding, poor sex education, lack of power & rights...
Preventing unintended pregnancies
Low awareness of F.P, lack of power & rights, unwillingness of men to accept condom use
PMTCT
Late presentation at clinic, loss to follow-up
Edutainment
Working in schools
Clinic Referrals
Door-to-door outreach
Supporting Mothers
Job’s done?, have to think beyond health

7. Plugging remaining leaks
Primary prevention
Low awareness, lack of understanding, poor sex education, lack of power & rights...
Preventing unintended pregnancies
Low awareness of F.P, lack of power & rights, unwillingness of men to accept condom use
PMTCT
Late presentation at clinic, loss to follow-up
Tracking people
Counselling & support
Accompanying people to clinic
Ensuring births happen in facility
Follow-up during breast-feeding & EID
Supporting Mothers
Job’s done?, have to think beyond health

8. Plugging remaining leaks
Primary prevention
Low awareness, lack of understanding, poor sex education, lack of power & rights...
Preventing unintended pregnancies
Low awareness of F.P, lack of power & rights, unwillingness of men to accept condom use
PMTCT
Late presentation at clinic, loss to follow-up
Ensuring continued access to care
Livelihoods – nutrition & financial (Savings, IGAs)
Risk reduction
Schooling
Counselling & peer support
Supporting Mothers
Job’s done?, have to think beyond health

9. Partners working across continuum
Primary prevention
Preventing Unintended Pregnancy
PMTCT
Supporting Positive Mothers & Families
Applications/Projects
Volume of
Life Concern
Mai Khanda
Pride Community
Health Organisation
Kabangwe
Case Studies
Addis Hiwot Rehabilitation & Reintegration Association
PATA C3 Partners

10. Life Concern, Malawi
Driving access to and uptake of PMTCT by strengthening existing healthcare infrastructure, promoting male involvement and encouraging broader community participation.
Fall in home deliveries, progress on access to and uptake of testing services has been impressive: in just 10 months, 813 couples were tested for HIV – compared to just 41 couples at baseline.

11. Pride Community Health Organisation, Zambia
Support Safe Motherhood Action Groups. These groups have facilitated couples counselling, identifying pregnant women who are yet to attend clinic.
Increases in male participation,
Number of pregnant women attending their first antenatal care appointment has tripled.

12. Addis Hiwot Rehabilitation & Reintegration Association, Ethiopia
Use mobile technology to provide home-based counselling, support, follow up and tracing those lost to follow up.
Between 2012 and 2015:
The number of pregnant mothers attending all ANC appointments rose from 457 to 692 p.a.
The number of lactating mothers who attended post-natal care visits near doubled, increasing from 142 to 263 p.a.

13. Kabangwe, Zambia
Focused on getting men to engage and take their women to clinic
Baseline 183 out of 486 (38%) women lost to follow-up during pregnancy
Within 5 months, 18% retained in care (male partner initiated visits)

14. Mai Khanda, Malawi
Women’s groups led by volunteer facilitators, identifying and solving problems specific to the local context.
Simultaneously, groups participate in income generating activities with profits used to fund bicycle ambulance, emergency transport funds and medical supplies to support safer births. One group raised over 300,000MWK.

15. Micro x Many = Big Effects!!
1.8 million reached
270,000 referred into the health system (for PMTCT care, ANC, and testing primarily)
167,000 births in facility
210,000 tests
20,000 testing positive
Source: October PACF Reporting

16. Selected Learnings
At a micro - level, huge impacts
Some things better than others
Communities can optimise investments made in health systems
Communities ensure people treated holistically, health not separate from rest of life

17. For more info: positiveactionforchildren@viivhealthcare.com
Thank You
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