Birth Attendants Trained in “Prevention of Mother-to-Child HIV Transmission” Provide Care in Rural Cameroon, Africa

Authors

  • Benjamin Wanyu BA,

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    • Benjamin Wanyu, BA, is the Program Manager of the Life Abundant Primary health care (LAP) PMTCT Program, Cameroon Baptist Convention Health Board.

  • Emmanuel Diom,

    Nurse AideSearch for more papers by this author
    • Emmanuel Diom, Nurse Aide, is the Coordinator of the Life Abundant Primary health care (LAP) PMTCT Program, Cameroon Baptist Convention Health Board.

  • Patricia Mitchell RGN, RMN,

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    • Patricia Mitchell, RGN, RMN, is the Director of the Life Abundant Primary health care program (LAP), Cameroon Baptist Convention Health Board.

  • Pius M. Tih MPH, PhD,

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    • Pius M. Tih, MPH, PhD, is the Director of the Cameroon Baptist Convention Health Board.

  • Dorothy J. Meyer CNM, MPH

    Corresponding authorSearch for more papers by this author
    • Dorothy J. Meyer, CNM, MPH, (Capt. USPHS, Ret.), provides volunteer services to the Cameroon Baptist Convention Health Board with emphasis on maternal child health.


Address correspondence to Dorothy J. Meyer, CNM, MPH, 3243 South Gila Drive, Flagstaff, AZ 86001. E-mail: DotJMeyer@aol.com

Abstract

Since 1984, Cameroon Baptist Convention Health Board's Life Abundant Primary health care program has established primary health centers in remote villages and trained literate women in these villages as birth attendants to offer antenatal care, low-risk delivery, and triage of high-risk mothers to larger health facilities. In 2002, the birth attendants were trained to provide Prevention of Maternal-to-Child HIV Transmission (PMTCT) services, including counseling, voluntary testing, performing oral rapid HIV tests (OraQuick; OraSure Technologies, Inc., Bethlehem, PA), posttest counseling, and administering single-dose nevirapine to HIV-positive women, to be taken in labor, and to their newborns. Ongoing supervision is provided by nurse supervisors. Between July 2002 and June 2005, 30 PMTCT-trained birth attendants in 20 villages counseled 2331 pregnant women and tested 2310 (99.1%) for HIV. Eighty-two women had a positive OraQuick HIV test (3.5%). Forty-two of these mothers were delivered by the trained birth attendants, with 88.1% of mothers and 85.7% of newborns receiving single-dose nevirapine prophylaxis. Nevirapine-treated babies were tested after 15 months of age, and two of 13 HIV-exposed infants had a positive rapid HIV antibody test (15.3% transmission rate with treatment). Program challenges include: maintaining adequate supplies of HIV tests kits and medications, supervising and supporting the PMCT-trained birth attendants on a regular basis, and achieving exclusive breastfeeding and early weaning.

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