Programs For Children
Power of Love's Pediatric HIV/AIDS Care Program
Over 2 million infants and children are living with HIV, the vast majority infected at birth. These infants have at best a life-expectancy of 5 years.The problem of providing cost-effective care for HIV infected infants in resource-strapped sub-Saharan Africa has remained a significant challenge. Our pediatric HIV/AIDS care program or Arms Reach Care (ARC) is a unique community-based approach developed by the Power of Love Foundation to take advantage of Africa's most valuable resource - its family network, to provide comprehensive care for HIV infected infants and children.
ARC 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 stressed environment.
Using a tiered structure comprising of Family Care Givers, Community Care Assistants and a mobile Nurse, the ARC program delivers a package of critical services to HIV+ infants and children at a low cost per child per year. The validation of this model is that in the nine years, we have lost 11 children out of approximately 562 enrolled since inception. Statistically, we could have lost many more children as life expectancy for an HIV positive child at birth is only 4-5 years.
At present we have 200 HIV positive children in our pediatric HIV/AIDS care program. This program provides food, medicines, and a package of life saving health care services to all children. The package of life saving health care services includes weekly 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, we provide training in caring for an HIV positive child to caregivers of children. This ensures that the child is under the care of a trained caregiver 24/7. A brief description of the various components of our program is given below.
The PMTCT Component
In 2012, we had 11 children born in our Prevention from Mother to Child Transmission (PMTCT) Program. We are very excited as all 11 children were born HIV negative! This is remarkable as the new born babies have HIV positive mothers and siblings (who are enrolled in our pediatric HIV/AIDS care program). In fact of the 23 children born since we launched the PMTCT program, 22 have been born HIV free.
We strongly believe that with proper intervention of PMTCT we can reduce/eliminate new pediatric HIV infections. All women who have children in our program and are pregnant are enrolled in our PMTCT program.
The Safe Parks 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. At present there are about 700 children enrolled in this program and 80-90 children participate each week.
The Micro Loans Component
To strengthen families further, caregivers of children enrolled in our Pediatric HIV/AIDS 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.
This multi-pronged approach has strengthened the children's program 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 500 HIV positive children directly and continues to benefit an additional 1100 children indirectly.
Our pediatric HIV/AIDS care program has been studied by local and international agencies and has been adpated and used by some. For example, we provided training for 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/AIDS 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 POL’s Arms Reach Care (ARC) 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 all children have been tested for HIV. Out of this total of 200 children, about 64% 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.
4. Future Goals
In 2013, we would like to incorporate a psycho social counseling (PSS) tool for FCGs. At the moment there are support groups available for mothers at the government clinic.
The children’s program has increased the survival rates of the children in the Matero compound in Lusaka, Zambia and significantly improved the quality of life of their families.
The program together with the micro loans program is comprehensive. It takes care of physical (food, medicines, schooling), social (environment, culture, religious issues), and psychological (counselling, peer groups) needs of the women and children.
In addition, education on adherence 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.
The Power of Love program has matured and our focus through 2013 continues to be provision of continuous quality care to the children and micro loans to their caregivers so that they can take care of the whole family.
In the next few years we hope to extend the program to the entire community of Matero (population of 175,000) in Lusaka, Zambia