Smiling and singing, a group of mothers in the Oshana region are celebrating the graduation of their children. But this is no ordinary graduation. All the mothers are living with HIV, and the graduating children are just 18 months old. By taking their antiretroviral medicine consistently and correctly, the mothers have kept their infants HIV-free during pregnancy, birth, and breastfeeding for 18 months.
The graduation ceremony is organized by local civil society organization, Development Aid from People to People (DAPP), a partner organization funded by the United States President’s Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Centers for Disease Control and Prevention Namibia (CDC). DAPP works with communities across Namibia to support HIV positive pregnant and breastfeeding women to ensure that the virus is not passed from mother to child. DAPP holds ceremonies like this one with all the communities they support.
“Stopping the transmission of HIV from mother to child is critical; no infant or young child should acquire HIV when we have universally accessible medicines to prevent this from happening,” says CDC Namibia Country Director, Dr. Brian Baker. “Celebrating the fact that these children are HIV free at 18 months is something very special. Under the leadership of the Ministry of Health and Social Services, and through the support from PEPFAR, the children’s lives have been changed for the better. These ceremonies are powerful testimonials to the resiliency of these women and the support provided by the program to eliminate mother to child transmission of HIV.”
The journey of pregnancy and motherhood is often a complex mix of joys and challenges for any woman, but to live with HIV can make it harder. Even though good adherence to HIV treatment is effective in reducing the risk of mother to child transmission of HIV, the fear that your baby could become infected is still a heavy burden. Many people in Namibia face challenges such as poverty, unemployment, and food insecurity. These pressures are just some of the reasons mothers living with HIV stop taking their medication. Some may not have the money to travel to their clinic for a medication refill, while for others, lack of job flexibility forces them to skip clinic visits. Other challenges are domestic violence, long distances to the local clinic and fear of stigma.
The first critical step to the 18 month-milestone is ensuring that pregnant women know their HIV status. With support from CDC and other partners, the MoHSS has ensured that 99% of pregnant women in Namibia know their HIV status. This is where the pregnancy care and support package offered by DAPP starts as it involves regular follow-up visits by community health workers. If a pregnant woman misses an appointment at the clinic, the community health worker goes into the community to find her and help her return to care. The results of this personalized support are overwhelming.
“I am happy because DAPP are always reminding me of our appointment dates. Without them I could not be up to date with my clinic follow-up dates because I sometimes have so much work to do which can make me forget. The Field Officer visits my house to see how the baby is and they have a discussion with me. I am happy for the information I get. It is helping me to keep my child free from the virus,” says Konstasia, one of the mothers supported by the program.
Nine years ago, more than 13% of HIV positive mothers in Namibia passed HIV to their children during pregnancy, delivery, or breastfeeding. Today, less than 5% of HIV positive mothers pass HIV to their children. This reduction of nearly two-thirds has changed the lives of generations of Namibian children. It has been through the dedicated partnership between the governments of the United States and Namibia as well as organizations like DAPP, providing support to HIV positive mothers, that children are able to remain HIV free.
“Each time we have a graduation ceremony I am reminded of the journey we all walk together. From PEPFAR support through CDC, we can assist the Ministry of Health and Social Services to end HIV in Namibia. Today, children are growing up HIV-free. There is no better achievement than this,” concludes DAPP Director Kirsten Moller-Jensen.