Taking Practical Steps to Improve the Health of Mothers and Babies and Reduce the Vertical Transmission of HIV in the Mutasa Region of Zimbabwe

Megan Dunbar, Pangaea’s VP of Research and Programs, recently returned from a working trip to Zimbabwe that was focused on the ongoing implementation of Pangaea programs that are aimed at providing economic opportunity for young women at risk for HIV, as well as reducing HIV and maternal and infant mortality.  

Megan’s visit included the Mutasa region of Zimbabwe – a rural, agricultural district that has been hard hit by HIV and where the response to the disease has been lagging behind other districts.  Africa University is in Mutasa and researchers there, including Dr. Abigail Kagwende, are partners with Pangaea in a new effort to improve maternal and infant health.

Pangaea’s work in Mutasa is focused on helping to strengthen the existing public health system’s efforts to identify expectant mothers who have HIV and bring them and their infants into treatment.   Many of the necessary building blocks are in place, including newly appointed provincial and district level public health officials focused on improving the system, readily available ARV drugs, and existing public health facilities and staff including the Hauna District Hospital, 25 rural clinics, and over 120 village health workers.

Feedback from the front-line health worker suggests that there are several areas where relatively simple interventions might have a big payoff in terms of bringing women into care. These include training nurses at rural clinics to administer HIV rapid-testing and deliver babies and improving communication between village health workers and rural clinics. An exciting and cost-effective innovation could also be the creation of maternal waiting homes, where HIV expectant positive women can readily get the care and support they need, and once their babies are born, post-natal and HIV care can be provided.

Next steps for Pangaea will be to begin providing cell phones to village health workers and the staff at rural clinics so that patients in remote villages can more readily be linked with care at the clinics or district hospital.  To complement the cell phone program, Pangaea is also considering providing clinics with solar-powered lanterns that could both recharge the phones and provide needed electric light to clinic facilities that currently don’t have power.  The Pangaea team is also looking into the cost of building four to six-bed maternal waiting homes associated with each of the 25 clinics that would not require additional staffing, but would provide HIV positive mothers with a place to wait just prior to delivery, to ensure facility-based delivery greatly improving the likelihood that they and their babies will receive appropriate treatment.

“Our team is very hopeful that making some of these very modest investments in local infrastructure, combined with targeted training of existing personnel, can pay big dividends in terms of bringing more women and children into care,” says Megan. 

 We’ll be reporting on the progress of these efforts in future posts.