[pronut-hiv] PMTCT: Cameroon - Rural Children in Trouble!

["ProNut-HIV" <pronut-hiv@healthnet.org>]

Cameroon Tribune (Yaoundé)

22 November 2007
Martin Nkematabong

Medical studies have shown that every year, about half a million children under 15 are infected by HIV in developing countries, and that more than 90 per cent of the infections result from mother-to-child transmission (MTCT) during pregnancy, labour and delivery, or breastfeeding. The studies further indicate that without prompt and adequate interventions, 20 to 45 per cent of babies born to HIV infected mothers will become infected.

As early as 2000, the prevention of mother-to-child transmission (PMTCT) became one of government's health priorities. The PMTCT program was officially integrated into existing public health systems, with necessary services to be provided by all antenatal and delivery clinics. Reports say many health care units in urban areas are gradually integrating the program, contrary to its timid take-off in rural settings.


Studies published by the National AIDS Control Committee in 2003 showed that the MTCT rate is so much low in urban Cameroon where antiretroviral component is associated with high rate of artificial feeding than in rural zones where the health systems remain poorly resourced, with tiny opportunities to voluntary counseling and testing (VCT) for pregnant women.

The question of achievable standards of care in poor resource rural communities in Cameroon has therefore remained a major challenge: the challenge of overall prevention of HIV in mothers and fathers, the provision of adequate VCT in antenatal clinics, a comprehensive package of intervention during pregnancy, labour and after delivery, the provision of infant and maternal nutrition within the socio-economic realities, advocacy, program communication, and other supportive measures such as community mobilization to address the issues of stigmatization, violence against infected women and the marauding voices of witch doctors.

Consider rural North West. Studies show that the vast majority of pregnant women in enclave rural areas still lack access to antenatal clinics, and consequently have never been tested of HIV. In suburbs of Nwa, Njikwa, Benakuma, Fru-awa, Misaje and Ako, many women are still delivered at home by native doctors, while the few who are tested hesitate to accept their status for fear of isolation from family members or to avoid the wrath of a violent husband.

Moreover, the cost of artificial diet to substitute breast milk is far beyond the reach of poor rural mothers. Partial statistics from 19 health districts in the North West show that many pregnant rural women are tested only in labour rooms, and that more than 80 per cent of infected mothers stick to exclusive breastfeeding.

"Stigma remains a major hurdle among pregnant rural women," said Dr Lazarus Kongyuy of the PMCT Focal Point for the North West. " They sometimes fear to accept drugs or practice conventional methods of infant feeding which may expose their health situation," the medic noted.