SCOPE Presentation

Zerai Asgedom

January 28th, to April 7th 2013.

• The Role The Church Of North Gondar Diocese Can Play In Improving Antenatal Care (ANC) And Prevention Of Mother-to-Child HIV Transmission (PMTCT) Around the town of Gondar.

Introduction with the North Gondar Diocese.

Number of health center around the town of Gondar

• Maraki Health Cener• Tseda Health Center• Gondar or Poly Health Center• Gabriel Health Center• G-20 Health Center• Belagig Health Center• Azezo Health Center• Woleka Health Center

Antenatal Care

• The number of pregnant women that go through antental care around the town Gondar varies from one health center to another.

• It depends on the number of urban and rural kebeles that get service at the center.

• The predominantly urban health centers such as Gondar or Poly health centers have higher number of ANC visits than Woleka, Gabriel, Tseda, and Belagig.

Delivery room at Belagig Health Center

Prevention of mother to child HIV Transmission (PMTCT)

• The Federal Ministry of Health of Ethiopia (FMOE) has new policy since 2011 to have an HIV free generation.

• The number of PMTCT services as part of ANC services and as stand alone has grown exponentially in the last year and half.

Centers that provide PMTCT service

• Maraki Health Center• Tseda Health Center• Azezo Health Center• Woleka Health Center– The city of Gondar health office believes it is willing to

start PMTCT services at all health centers. It does not put into consideration whether they are ready or not. Woleka has only one mid-wife but the minimum requirements to start PMTCT service are two, it is manageable now due to small number of patients.

Maraki Pilot Project

• Started with participating six volunteer priests and six women at the beginning of the project.

• The even number of volunteers are designed to pair the priests and the women equally during the community outreach

• The volunteers received a five day training around ANC follow up, HIV/AIDS and PMTCT at Bahir Dar through Intra-health.

Continued

Continued

• Chain of command– Intra-health DICAC Volunteers’ coordinator

Volunteers.– Volunteers’ coordinator gets paid 300 birr per

month– Volunteers are paid 100 birr per month

Volunteers’ community outreach

• The areas they meet their community members are mainly their home, church, community gathering and Tsewa (Religious gathering on various saints day).

• They teach about the importance of delivery at health center; which would save the women and the baby from birth related complications at home.

• Encourage HIV counseling and testing. They usually talk to the women first as they are mostly stay home moms.

• The volunteers usually have better luck of convincing the husband’s of the pregnant women for HIV counseling and testing.

• They fill out a referral card and they send the men and women with the card.

Problems they encountered

• The community members got the misconception that the volunteers got paid large some of money for every referral card from an NGO.

• The nurses in the area stated the volunteers are getting their jobs without having the right education.

• As a result, their service was interrupted by a nurse at the Maraki Health center for a month or two.

• Some volunteers stopped working due to low pay and for not getting paid.

• Not being able to have answers to questions they were asked by the community members during their outreach.

Positives of the project

• Their teaching focused on improving Antenatal care, knowing your HIV status, and saving your pregnant child from HIV/AIDS (PMTCT).

• The women were grouped with priests during community outreach.

• The volunteers association of the outreach as God’s calling to save their community from HIV/AIDS.

Continued

• Counseling of men and women in their own environment and by the people they respect in their community.

• The ease of building trust by community members with the volunteers.

• They receive free service at the health center compared to the hospital, like not paying for medication, gloves and some other supplies,

Areas of improvement

• To have a volunteers management team that has some power to make things happen when questions are raised during their monthly meeting.

• Try to make the health professionals at the chosen health centers be part of the team.

• Filling the gap of loss to follow up of HIV positive pregnant women when they deliver at the hospital.

Areas of improvement

• To support mother-to-mother coffee events to create experience sharing between HIV positive pregnant women and women who had already delivered HIV negative children.

• To have quarterly update of the volunteers skills and knowledge.

• To closely follow up on the interaction of health professionals at the health center and volunteers.

Mother-to-mother club at Azezo health Center.

• Psychosocial support group started by Intra-health.• Holds a coffee ceremony twice a week on Tuesdays and

Thursdays. • The new member s of PMTCT service at Azezo get

counseled by those that have already delivered HIV free children and show them there is hope out there.

• The group at the time of my visit had 66 members, 37 positive pregnant mothers

• The group so far has graduated 27 mothers• Graduation happens when a child is HIV free 18 months

after delivery.

Office of mother support group at Azezo.

Contacts

• City of Gondar Health Office Administrator: Mr Gedu Gebremariam (Understands some English)

• Intra-health International Amhara Regional Administrator: Mr Getaneh Derseh. (Speaks and writes English well). Phone number is 0582265345. Email; gderseh@intrahealth.org.

• Woleka Health Center Administrator: Mr. Dagnu(Understands some English). Phone number 0918 036147.

Woleka Health Center

Interview of the priests at the Diocese.