Programs For Children
Power of Love's Pediatric HIV Care Program
Over 2 million infants and children are living with HIV globally, the vast majority infected at birth. These infants have at best a life-expectancy of 4-5 years without intervention. However, providing cost-effective care for HIV infected infants in resource-strapped sub-Saharan Africa has remained a significant challenge. Power of Love's pediatric HIV care program is our solution to prevent new HIV infections and to care for children infected with HIV. Our model of care is a unique community-based approach developed to take advantage of Africa's most valuable resource - its family network - to provide comprehensive care for HIV infected infants and children. Our program was developed in partnership with MIT's D-Lab, the Harvard School of Public Health, and the Waitt Family Foundation to bring for-profit best-practices and cost-management into a resource stressed environment.
POL's pediatric HIV care program provides food, medicines and a package of life saving health care servcies to 250 HIV positive children living in a poor community in Lusaka, Zambia. The package of life saving health care services includes weekly home visits from the health worker/Nurse, monitoring of adherance to HIV medication, adherance training for older children, psychosocial counseling, and education in HIV prevention. In addition, caregivers are trained in caring for an HIV positive child. This ensures that the child is under the care of a trained caregiver 24/7. At this time all 250 children, including the 50 new children that were enrolled last March are stable in health.
Using a tiered structure comprising of Family Care Givers, Community Care Assistants and a mobile Nurse, our pediatric HIV care program delivers a package of critical services to HIV+ children at a low cost per child per year. Survival rates for children in our progam are over 95%. In the last 10 years, we have lost 12 children out of approximately 562 enrolled since inception; statistically, we could have lost many more as life expectancy for an HIV positive child at birth is only 4-5 years.
A brief description of the various components of our program is given below.
PMTCT (Prevention of Mother-to-Child Transmission of HIV) Program: We strongly believe that with proper intervention we can eliminate new pediatric HIV infections. Our goal is zero new HIV infections in children born to HIV positive moms in our PMTCT program. We are happy to report that over the last four years (2011 to 2015), 100% of the children born to HIV positive moms were HIV free even though they have HIV+ siblings. In fact of the 31 children born since we launched the PMTCT program, only one child was born HIV positive. We hope to continue to achieve our goal of zero new HIV infections in 2015 and beyond.
Young Stars Program: In 2014, we extended our pediatric HIV care program by adding a new component, "Young Stars". The "Young Stars" component is designed to provide additional support to an HIV+ child who is growing up in an extremely stressed family background. The goal is for the child to continue to be in school, graduate out of high school and achieve his/her dream. The package includes funds for rent for the family, school expenses for the child, and weekly mentoring sessions with a trained community child care worker. Our first "Young Star", has shown a marked improvment in her attitude toward school, has gained confidence, and is looking forward to realizing her dream of becoming a Nurse. Our newest, "Young Star", an 11 year old boy was enrolled in October 2015. We are confident that our new "Young Star" will be able to realize his dream of joining medical school after graduating from middle and high school.
"Safe Park" - our Community Outreach Component
In June 2011, we added "Safe Parks" to address the emotional, mental, and spiritual health challenges faced by children living in the Matero compound in Lusaka, Zambia. This program is free of cost and open to all children in the community. "Safe Park", provides a safe environment for children to learn, play, interact, and complete school work. It has a huge impact on the health and wellbeing of the children in Matero. At present there are about 760 children enrolled and 80-90 children participate each week.
The Micro Loans Component
To strengthen families further, caregivers of children enrolled in our Pediatric HIV care program are encouraged to apply for a business loan that will help them take better care of their families and keep children in school.
The Malaria Prevention Component
We provide education on prevention of malaria and long lasting insecticide treated nets to children and families vulnerable to malaria.
The different components of our pediatric HIV care program have strengthened the community. This multi pronged approach has enabled us to reach and impact a family in several ways so that the quality of life and life-expectancy of the children has improved significantly and most children are back in school and learning. To date, this program has benefitted more than 600 HIV positive children directly and continues to benefit an additional 1200 children indirectly as families in our program share their learnings with others in the community.
Our pediatric HIV care program has been studied by local and international agencies and has been adpated and used by some. For example, we have provided training to over 450 caregivers of HIV positive children for CIDRZ (Center for Infectious Disease Research in Zambia) in 2007.
We can confidently state that our program is making a significant and sustained positive imapct in the community of Matero in Lusaka, Zambia.
A Brief Report on the Achievements of Power of Love’s Pediatric HIV Care Program in Lusaka, Zambia
As result of continued donor support, the children's program has been able to achieve the following milestones in the last 12 months:
1. Healthcare and Food
We continue to provide food, medicines, and weekly health visits to all the children enrolled in our pediatric HIV/AIDS care program in Lusaka, Zambia. The addition of a high protein soya supplement (particularly for very sick children), has accelerated their weight-gain process. The soya supplement is now a regular component of the food package.
2. Testing and Care
We have 200 HIV positive children enrolled and out of these about 64% of teh children are on ARV’s. This highlights the need to provide all the children with food, medicines and weekly visits by the health care worker/Nurse and to provide continuous monitoring of the health and medication regimen of the children on ARV’s.
3. School and Learning
All children eligible for school are attending school and learning.
4. Monitoring and Care
All children who are on ARV’s are being monitored to ensure adherence to medication regime. So far all patients are adhering fairly well to their regimens.
Most of the older children know their status and are able to adhere to the medications schedule on their own with minimal support from their care givers.
Older children are provided with pill boxes to help them adhere to their medication schedule and pediatric medicine spoons are provided to caregivers of younger children so that the child can be given the exact dosage.
5. Voluntary Counseling and Testing
As a result of an improvement in the health of the children, Family Care Givers (FCG’s) have been coming forward to VCT (Voluntary Counseling and Testing). This is a huge step towards prevention of HIV.
6. Counseling and Education
All children are being provided with psychosocial counseling. Older children who are aware of their status are also provided education on HIV prevention, and risky sexual behaviors. In addition, all of our health workers are trained in child counseling.
7. Continuous Training
The Community Care Assistants are given continuous practical training in care of HIV positive children.
8. Confidence and Ability
Family Care Givers are more confident about their child’s health and of their ability to care for all children in their home in addition to the patient in the program. As a result of the training provided to the FCG’s they are able to respond to infections in a timely fashion (before the infection escalates into something more serious).
Also, as a result of the training and weekly visits by the CCA/Nurse, the number of opportunistic infections has been reduced.
Finally, since inception of the ARC program, no death has been recorded at home.
9. Adherence Support
Chris Mulela has trained the Community Care Assistants (CCAs) to ask the right questions from the caregiver and get as much information from the patient/caregiver as needed. This approach has helped the CCAs in providing adherence-support/monitoring.
10. Healthcare Education and Testing for Family Care Givers
Family care givers are encouraged to go in for cervical cancer and breast cancer screening
Challenges Faced by the Children's Program:
1. Following Instructions
A few family care givers are not able to follow instructions regarding care for the HIV positive child. We need ongoing support and refresher training courses for them.
2. Ongoing Building for Peer Support
POL is still trying to build peer support groups for children who know their status. The support groups will discuss how to improve the quality of lives of children who are positive.
3. Increased Frequency of Visits
For some children, the Nurse/Community Care Assistant had to increase their frequency of visit from weekly to bi-weekly in order to ensure adherence to medications.
Our pediatric HIV care has increased survival rates of children in the Matero compound in Lusaka, Zambia and significantly improved the quality of life of their families. This program together with the micro loans, malaria prevention and Safe Park programs is comprehensive as it takes care of physical (food, medicines, schooling), social (environment, culture, religious issues), and psychological (counselling, peer groups) needs of the women and children. Second, the training in adherence to medication and monitoring has reduced the number of children who might have developed resistance to drugs at an early age, leading to an increase in their life span. Overall, the community of Matero has come to rely on our servcies and we have become an integral part of their lives. As always our focus is the provision of continuous quality health care to children, micro loans and business training to women, and malaria bed nets to the community so that families can become self-reliant.