The experience of a professional, the Municipal HIV/AIDS Supervisor
I am working in the Municipal Health Department in Maquela do Zombo as the Municipal HIV/AIDS Supervisor and I am also responsible for the HIV testing centre. Maquela is an area with favourable conditions for mosquito breeding as it has a lot of rain throughout the year. The idea of community awareness and bringing health services right into the community does change people`s lives. I have experienced a higher turn up at antenatal clinics in our municipality and attendance without default. We had a history of pregnant women who did not attend antenatal consultations. They preferred to give birth at home, where no malaria prophylaxis was administered, and no HIV testing was done, thereby putting women at a higher risk of getting malaria and also of infecting the unborn baby in the case of those mothers who were HIV positive. With women and children under five being the most vulnerable group with respect to malaria, community awareness has influenced a higher-turn up among pregnant women at antenatal consultations.
What does this mean for the municipality? A lot of women have been attending antenatal clinics, which means they are monitored throughout their pregnancy. Since the Community Health Agents began informing and mobilising pregnant women to attend the clinic, we have been testing them for HIV. We also administer malaria prevention (prophylaxis) and this has reduced malaria cases among these women. For those who test HIV positive, they go on treatment right away so that they reduce the risk of infecting the unborn baby. Moreover, their health is monitored and they experience a safe delivery without complications.
Last year I had the chance to participate in training for HIV testing for the Community Health Agents. This was a step forward for the municipality in general because it opened up the possibility of taking testing to the people. Some people do walk in to get an HIV test at the centre and some get tested for HIV as a routine test – for example when someone is ill and is asked to take an HIV test - but many more are not prepared to spend time coming here. This training to enable Community Health Agents to conduct HIV testing was a bit of a game changer. We started an HIV home-based testing campaign as we had almost 4000 HIV test kits which were about to expire and during that campaign, we tested 2,094 people in the community itself and in the barracks.
In 2018, we registered only one new HIV case among pregnant women who come for antenatal consultations. This shows control and behaviour change. I have also seen higher adherence among people on ART. Since 2017, we have not experienced ART drop-out. We have 100% adherence for all those who are on ART and TB treatment. This adherence is also for HIV home-based testing. With sufficient tests we can help our country to reach 90/90/90. There are a lot of good practices happening among families and awareness campaigns have a great impact in our communities. The project has also inspired the municipality so that in 2019 the idea is for pregnant women to be accompanied to antenatal clinics by their spouses and get HIV counselling and testing together as couples. Openness and support among couples is to be promoted.
Municipal HIV/AIDS Supervisor