Jamra primary scholl for children affected by HIV/AIDS, drugs or poverty, Senegal (c) Nell Freeman/Alliance Participants in the Photovioce project, Ecuador © Marcela Nievas for the Alliance
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HIV services contributing to improvements in maternal health


Serah and her children Alex and Edge © Nell Freeman for the Alliance

MDG 5 on improving maternal health aims to facilitate universal access to reproductive health services by 2015.

In Kenya where Alliance linking organisation KANCO works, AIDS related deaths have fallen by one third since 2002 but the government estimates more than 32,000 babies a year still become HIV positive and around 1.1 million women are living with HIV.

In this article we hear Serah’s story which demonstrates how women in Kenya are tackling the challenges they face and taking control of their lives.

Serah Wangare, age 32, is mother to Alex, 14, and Edge, 4 months. ‘I’ve had HIV for at least 14 years. After I delivered Alex, my first born, I was very weak and later found to be positive. Luckily he is healthy and very supportive.

‘In 1997 I found out I was pregnant again. I had Frederick but he was very sickly. Even at three, he couldn’t walk. Then in 2001 he was very sick, but ARVs weren’t free then. He passed away at the age of four.’

Serah had taken Frederick to the Blue House Clinic, in Mathare, a slum area of Nairobi.  The Clinic is supported by KANCO (the Kenya AIDS NGO Consortium) and the International HIV/AIDS Alliance.

At Blue House, women can access whatever they need to give their babies the best possible chance of coming into the world HIV negative.  Mothers are routinely tested during pregnancy and full Prevention of Mother to Child Transmission (PMTCT) services from pregnancy to six months after birth is provided.

Sadly, for Serah Frederick died there in her arms. She was completely heartbroken.

‘I decided that I would never have another baby and I would never go to the Blue House again because he had died there.’ But she did go back in 2004 after an attack of herpes. ‘They asked me “why did you run away?”and I said “because my son passed away here”. Then they told me that I could still have another child.’

With the support of staff at the Clinic, Serah began taking ARVs for six years before deciding to get pregnant again.  ‘I didn’t know I was pregnant for five months. When I found out I was worried as my CD4 count should have been 500 but was only 244.’

When she was seven months’ pregnant, Serah went into labour – and went straight to the local district hospital.  Due to the stigma, no one came to help her deliver baby Edge; she went through labour all on her own. Due to his prematurity, he was only 1.7kg when he was born and so was in an incubator and on a drip for the next two months. Once he reached 2kg, she had to breastfeed him every two hours.

So far, he has tested HIV negative.

‘He has to have another test, but we are hopeful. I am practising exclusive breast feeding. The Blue House gave me lots of information so I could choose whether to breastfeed or use formula. I chose breastfeeding but I am worried about this because one of my nipples is cracked. I can only use one nipple.’

She has many other day-to-day challenges which impact on the families health and wellbeing. Serah lives with her husband, her two sons, and her teenage nephew in one room, with the curtained off bed just feet from the front door. They have electricity but no running water.

‘I want to see the kids grow up. I had three sisters but I am the only one left. I also look after my nephew, who is 18 and has epilepsy. I want all of them to have a good education but it is hard when we have no regular income.

 ‘My husband is positive and finds it difficult, the whole situation. He has no job so he’s around the house all the time.

‘Now I know you can live positively, I may have another child. But for the moment, I need to take care of my CD4 count, so we use condoms and depo-provera.’

Serah’s story highlights the reality for many women across Africa where it is a daily struggle to have healthy lives and babies. Women make up 50% of HIV positive people in Africa – the fastest growing group. They face stigma, discrimination and gender inequality which further limits their access to maternal and sexual health services.

But for the first time in 30 years, evidence is showing that the efforts made to reduce maternal mortality have led to a drop in deaths worldwide of more than 35%.

One reason is the contribution HIV services have made to women accessing health services. Providing both HIV and reproductive health services in the same room can increase the uptake of both.

    Due to the stigma, no one came to help her deliver baby Edge