Nsirim Reward O, Iyongo Joseph A, Adekugbe Olayinka, Ugochuku Maureen
Catholic Relief Services , Abuja, Nigeria.
J Public Health Afr. 2015 May 13;6(1):455. doi: 10.4081/jphia.2015.455. eCollection 2015 Mar 31.
One of the fundamental challenges to implementing successful prevention of mother-to-child transmission (PMTCT) programs in Nigeria is the uptake of PMTCT services at health facilities. Several issues usually discourage many pregnant women from receiving antenatal care services at designated health facilities within their communities. The CRS Nigeria PMTCT Project funded by the Global Fund in its Round 9 Phase 1 in Nigeria, sought to increase demand for HIV counseling and testing services for pregnant women at 25 supported primary health centers (PHCs) in Kaduna State, North-West Nigeria by integrating traditional birth attendants (TBAs) across the communities where the PHCs were located into the project. Community dialogues were held with the TBAs, community leaders and women groups. These dialogues focused on modes of mother to child transmission of HIV and the need for TBAs to refer their clients to PHCs for testing. Subsequently, data on number of pregnant women who were counseled, tested and received results was collected on a monthly basis from the 25 facilities using the national HIV/AIDS tools. Prior to this integration, the average number of pregnant women that were counseled, tested and received results was 200 pregnant women across all the 25 health facilities monthly. After the integration of TBAs into the program, the number of pregnant women that were counseled, tested and received results kept increasing month after month up to an average of 1500 pregnant women per month across the 25 health facilities. TBAs can thus play a key role in improving service uptake and utilization for pregnant women at primary health centers in the community - especially in the context of HIV/AIDS. They thus need to be integrated, rather than alienated, from primary healthcare service delivery.
在尼日利亚实施成功的预防母婴传播（PMTCT）项目面临的一项基本挑战是医疗机构对PMTCT服务的接受程度。一些问题通常会阻碍许多孕妇在其社区内指定的医疗机构接受产前护理服务。由全球基金资助的尼日利亚天主教救济服务社PMTCT项目在其尼日利亚第9轮第1阶段，试图通过将位于初级卫生中心（PHC）所在社区的传统助产士（TBA）纳入项目，来增加尼日利亚西北部卡杜纳州25个受支持的初级卫生中心对孕妇的艾滋病毒咨询和检测服务需求。与传统助产士、社区领袖和妇女团体进行了社区对话。这些对话聚焦于艾滋病毒母婴传播方式以及传统助产士将其服务对象转介到初级卫生中心进行检测的必要性。随后，使用国家艾滋病毒/艾滋病工具，每月从这25个机构收集接受咨询、检测并收到结果的孕妇数量数据。在这种整合之前，所有25个卫生机构每月接受咨询、检测并收到结果的孕妇平均数量为200人。将传统助产士纳入项目后，接受咨询、检测并收到结果的孕妇数量逐月持续增加，在这25个卫生机构中平均每月达到1500名孕妇。因此，传统助产士在提高社区初级卫生中心孕妇的服务接受度和利用率方面可以发挥关键作用——尤其是在艾滋病毒/艾滋病背景下。因此，需要将她们纳入而不是排斥在初级医疗服务提供体系之外。
