Pediatric HIV Care
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.
The goal of Power of Love's pediatric HIV care program is 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 350 HIV positive children living in an impoverished 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, adherence 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 350 children, including the 100 new children enrolled this year are stable in health. Here is a detailed report on the impact of program activities in 2016.
Using a tiered structure comprising of Family Care Givers, Community Care Assistants and a Project 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 12 years, we have lost 14 children out of approximately 662 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
At the heart of the Pediatric HIV Care program is the philosophy that everyone is a caregiver. We believe that an HIV+ child can be cared for at home by a trained family member under the supervision of a health care professional. Accordingly, family members of children in our pediatric care program are provided with training in caring for an HIV+ child. This ensures that the children are under the care of a trained caregiver 24/7. Trained family members can escalate care to a higher level as needed.
Power of Love's Pediatric HIV Care program was launched in 2004 in the Matero community of Lusaka, Zambia. Matero is one of the largest and poorest compounds in Lusaka with a population of at least 300,000. This community has a high incidence of HIV, malaria, and tuberculosis, and an unemployment rate upwards of 60%. Most residents are poor and live on less than $2 per day, defined as extreme poverty by the UN. It is estimated that in Matero alone there are 5,000 HIV+ children who could benefit from our services. Here are stories of two children who have benefitted from this program.
Direct beneficiaries of this program are 350 HIV+ children, and additional 1900 residents benefit indirectly as trained family members share their experiences with others in the community. To date we have trained over 700 women caregivers who share their knowledge about HIV prevention and care throughout the community. Here is a detailed report on the impact of program activities in 2016.
All children are regularly tested for CD4 counts, and caregivers of children requiring anti-retroviral therapy (ART) are guided in acquiring ARV medication from the Government clinic.
The Results of Pediatric HIV Care are Undeniable
- Children previously unable to attend school regularly because of poor health are able to resume their studies and lead close-to-normal lives. As the child’s health improves primary caregivers (most are grandmothers caring for multiple children) have more time available to work and provide better care for their families.
- Children are visited in their homes every week by a healthcare professional. The healthcare worker takes the child’s weight, checks for infections, discusses any issues of concern with the family members, and provides advice on how best to take care of the child.
- Older children are provided with education on HIV prevention.
- Of the total 662 children enrolled in our program since inception, we have lost 14. With life expectancy at birth for HIV positive infants at only 5 years, a survival rate of over 95% demonstrates the efficacy of the program.
- As caregivers (grandmothers/great aunts/mothers) see for themselves the positive effects that quality care has on their child's health, they come forward for voluntary HIV testing, which is critical in preventing the disease's spread. To date, more than 300 caregivers have come forward for voluntary testing.
- Caregivers of children are encouraged to apply for a microloan to start a small business. Earnings from these businesses go a long way in helping to pay for food, housing improvements, and school expenses.
All children in our program receive food, medicines, and a package of lifesaving healthcare services. In addition, children who are malnourished or undernourished are provided with a high protein soya supplement. As a result of this continuous quality care, most children improve in health (have fewer opportunistic infections, start gaining weight, have higher CD4 counts) after a few months on the program. Better health enables the children to attend school regularly and school performance improves. Finally, there is a reduction in stigma associated with HIV as result of better knowledge about HIV care and prevention.
Power of Love's pediatric HIV care model was developed, with the help of the Harvard School of Public Health in 2004. This model of care consists of a network of community health workers and medical professionals who provide HIV+ children with high quality healthcare services as close to home as possible.
Pediatric HIV Care offers a solution to both the shortage of trained health care professionals and the over-burdening of government clinics. While there exist home-based care programs, our Pediatric HIV Care program is unique because it puts the onus of care back into the home. Not only does our model of care equip family members of HIV+ children with the skills they need to provide care, it also significantly reduces the cost of operations.
Our pediatric HIV care is a multi-tiered model of care, starting in the home with the caregivers themselves and leading up to medical professionals. Health professionals at each level are trained to provide medical care and to quickly escalate care to the next higher level.
Level 1 - Family Caregivers (FCGs)
Family care givers are the primary caregivers (a majority are grandmothers caring for multiple children) of children in our program. Before the child is enrolled, the FCG takes part in a five-day workshop that provides training in basic hygiene, HIV care and prevention. This training program was developed with the help of the Harvard School of Public Health and is especially designed for women caregivers in Zambia. The goal of this training is equip the women to take better care of their HIV+ children and other family members.
Continued education is provided to FCG’s via bi-monthly refresher sessions. In addition to HIV, AIDS and malaria education, FCGs are taught simple yet effective responses to common opportunistic infections, such as chronic diarrhea, fever, and cough. They are trained in the maintenance of good hygiene and nutrition to prevent infections and strengthen the immune system. Monthly support meetings are also available to FCGs, giving us an opportunity to increase their knowledge about HIV, and to encourage the caregivers to get tested for HIV.
Level 2 - Community Care Assistants (CCAs)
At this level, trained health care workers provide medical care specific to HIV, particularly in the identification and treatment of opportunistic infections.
Community care workers (CCA’s) are trained in an intensive 8-week workshop, followed by monthly daylong refresher sessions. The refresher sessions allow the CCA’s to reinforce their existing skills, reflect on and address challenges encountered in the community, and acquire knowledge on new areas relevant to their practice.
CCA’s supervise up to 65 patients each. They visit each child in his/her home every week, during which they supervise the care provided by FCGs, oversee treatment adherence, and counsel the patient and the family member. Since our CCA’s are from the community and have been working with the child for a long period of time, there exists a friendly bond between them. During these visits the, CCA’s watch out for early symptoms of problems that may require further medical attention, and refer the child to the Nurse as needed.
Level 3 - Project Nurses
Our fully trained and certified nurse meets regularly with the CCAs to review patient records and visits each patient at least once a month.
As per Zambian regulations for community-based healthcare, Project Nurses make final diagnoses and referrals and prescribe treatment courses. Each nurse can dispense medication for common opportunistic infections and provide professional care that cannot be provided by community health workers. If the child’s case is serious, our Project Nurse takes the child to a doctor/hospital for further treatment.
Our goal is to enroll an additional 100 HIV+ children in 2017. Your generous donations will help us provide the much needed healthcare services to all 350 HIV+ children currently in our program. Please donate generously. Every little bit counts.
Thanks for your care and support.