Primary Care of the Pregnant Woman in High Burden Infectious Disease Settings: The Kenya Example

Session: Know your Epidemiology and Respond Accordingly: Addressing HIV, TB and Malaria to Ensure Healthy Pregnancy

Presenter: Mildred Mudany, Jhpiego
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Background: Jhpiego has been committed to assisting governments to meet Millennium Development Goals 4, 5, and 6 and believes they – and health goals beyond – will only be attained through decentralized primary health care approaches. The health care providers who predominantly care for women and their children in low and middle income countries are nurses and midwives. In Kenya, nurses and midwives prevent, detect and treat HIV, TB and malaria in the antenatal and postpartum care setting while providing routine pregnancy, postpartum and newborn care.

Methodology: This presentation will describe how Kenya has integrated prevention, diagnosis and treatment of all HIV, TB and malaria into the MNCH platform. National and county-level data will demonstrate how antenatal care is tailored to the local epidemiologic context and to the individual client’s needs.

Results: Kenya has effectively integrated HIV, TB and malaria prevention, diagnosis and treatment into the MNCH platform while improving pregnancy and newborn outcomes. Program activities that contribute to development of a confident and skilled health workforce that is able to respond to multiple health priorities include: development and dissemination of training materials and job aids, strengthening of the health system to deliver integrated services (with a particular focus on the supply chain), and engagement of community-based health workers.

Conclusion: It is possible to integrate high quality HIV, TB and malaria prevention, diagnosis and treatment into the MNCH platform, but it requires a governmental commitment to empowering frontline healthcare workers at the community and primary care levels, effective training, ongoing supportive supervision, useful job-aides, and a functional supply chain and in order to do so.