A non-governmental organisation, APIN Public Health Initiatives, has urged the Federal and state governments to eliminate user-fee for antenatal and delivery services in hospitals.
The associate director, prevention and community services, APIN, Dr. Ogunsola Okunlola, made this call while speaking to journalists today (November 29, 2022) in Abuja, saying the step would improve access to the prevention of mother-to-child transmission of HIV (PMTCT).
Okunlola said that the expansion of the insurance scheme to cover the very poor would be a step in the right direction.
According to him, there is a need for procurement and deployment of rapid test kits to all sites, to guarantee no missed opportunity for HIV testing services at all service delivery points.
He said the training and equitable distribution of healthcare workers across communities remain critical to the successful elimination of mother-to-child transmission of HIV (eMTCT).
“eMTCT is achievable with better resource allocation and utilisation, as well consistent deployment of innovative strategies.
“We must begin to think about how to better integrate HIV services into all our mainstream health services. This will facilitate and support sustainability,” he said.
Okunlola acknowledged that the country had made progress in closing the HIV treatment gap.
“Over the last two years, the country has treated over one million new cases.
“Currently, there are about 1.9 million Nigerians on sustained anti-retroviral therapy, which corresponds with about 99 per cent treatment coverage for the general population.
“Despite this progress, the paediatrics and pregnant women subpopulations continue to lag, with 34 per cent and 71 per cent treatment coverage, respectively,” he said.
The expert said that there were about 8.5 million annual pregnancies in the country, with only 5.7 million of them receiving antenatal care.
Okunlola said that out of the estimated 99,000 pregnant and breastfeeding women projected to need antiretroviral therapy annually, over 28,000 were still yet to be diagnosed and linked to treatment.
“According to UNAIDS, Nigeria contributes 15 per cent of the global new paediatric HIV infections and about 30 per cent of all cases of mother-to-child transmission (MTCT) of HIV.
“In Nigeria, an estimated 33 per cent of pregnant women receive antenatal care in non-conventional settings such as traditional birth attendant’s homes, mission homes, and maternity homes where HIV testing services are not available or optimised,” he said.
He added that only 2,618 health facilities of the 34,830 in the country are currently supported to offer PMTCT services.
“These missed opportunities contribute to the challenges of closing the PMTCT gap.
“Data has shown that vertical transmission of HIV is the primary route of infection among children and is almost completely preventable through PMTCT.
“eMTCT is one of the critical milestones to ending the HIV/AIDS epidemic as a public health threat by 2030,” he said.
He urged governments at all levels – in partnership with funding agencies such as PEPFAR and the Global Fund – to lead a PMTCT surge in the country.
“This is a step in the right direction to reach pregnant women wherever they may be.
“Currently, the country has mapped all sites providing any form of antenatal or delivery services, whether they are community sites, maternity homes, traditional birth homes, religious centres’ birth homes or facility sites private hospitals and government-owned health facilities,” he stated.
Okunlola also disclosed that there is an ongoing effort to deploy trained local government-level service providers who would provide PMTCT services and ensure documentation.
“This will address the missed opportunities in testing and linking HIV- positive pregnant women to treatment,” he added.