By Laide Akinboade

The United Nations Children’s Fund, UNICEF, has decried the non availability of good data of prenatal and postnatal women, thereby impeding treatment and prevention of mother to child infections of Hiv/Aids in Nigeria. 

According to the most recent data, “over a quarter (26.

For instance, in 2016, just 32% of pregnant women living with HIV received antiretroviral treatment to prevent mother-to-child transmission and only 34.

In the last decade, UNICEF has been working with relevant agencies and government at all levels in Nigeria, specifically with a view to reducing the prevalence of mother to child transmission.

 Towards this end, Nigeria was selected as one of UNAIDS’ 23 priority countries for PMTCT – being one of the nations with the highest HIV burden yet low levels of treatment coverage during pregnancy. Unfortunately though, of these 23 countries, Nigeria has the second lowest level of ART coverage in pregnant women.

The number of pregnant women visiting health facilities remains low, as does the number of health facilities providing PMTCT services, with only 7,265 health facilities providing PMTCT in 2015. (current datas are not available)

Though the Nigerian government has made a commitment to improve and create more PMTCT facilities in hospitals and general health clinics, it is doubtful that the target of  95% of health facilities providing PMTCT services by the end 2021 in Nigeria is achievable. 

Speaking at a UNICEF funded workshop recently, Dr. Gbenga Ijaodola, of the Federal Ministry of Health lamented the fact that Nigeria has not been able to adequately collate data on pregnant women for many reasons. He stated that agencies have resorted to working with estimates, because in most cases, pregnant women no longer attend ante natal clinics. 

“So many pregnant women especially those in the rural areas hardly go to the hospital for ANC, they patronize traditional birth attendants, because the health facilities are too far from them or they cannot afford to pay for the services of these facilities so much eSign themselves to TBAs”

“Three out of four pregnant women in Nigeria attend ANC, this  means over 40% of pregnant women don’t go for ANC at all. So the question is where do they give birth,  then how can the nation have a proper data of pregnant women, prevent HIV transmission of mother to child, when the pregnant women don’t even go for HIV testing?”, he asked. 

Dr Atana Ewa, from University of Calabar, Teaching hospital at the media dialogue lamented that HIV is a major cause of infant and childhood mortality and morbidity in Africa. Over 1.9 million Nigerians is estimated to be living with HIV. In 2018 the incidence of HIV was estimated at 8per 10,000 persons.

She stressed that, in order to prevent mother to child transmission, a mother cannot breast feed the child more than 12 months,  “A breast feeding mother who is HIV positive must know her viral load and must be taking her anti retroviral drugs. 

“And no matter how much she loves breast feeding and the baby, she must stop at 12 months,  exclusive breast feeding for 6months and she continues but not beyond 12 months. 

“The longer you breastfeed , the more you are increasing the chance of passing the virus. Even though she is on ART, let not do it too long, nobody knows the level of which infection can or can’t occur”, she said.
Even the pregnant women who attend ANC, over 63% of them don’t even have access to the much needed PMTCT. 

In order to increase the number of pregnant women coming for ANC and PMTCT, it is imperative for the government to make ANC free and if possible give incentives to every  pregnant woman that comes for   ANC. When these women attend ANC, there will be proper documentation of these women and necessary tests would be carried out.  

Sadly, Nigeria contributes 22,000 new HIV infections in children globally and a mere  28 per cent HIV exposed infants had access to early infant diagnosis in 2020.

For the Nigerian government to address data lapses in the country, there is need for the federal, state and local governments to create ante natal care and delivery services in every ward. It goes without saying that once a well equipped health facility is close enough and available, pregnant women will not have an excuse not to go for their ANC regularly. 

In addition, government  must look into exorbitant health facilities fees, which has often discouraged most pregnant women in the country from attending ANC, hence the inability to collect and/or gather good data. 

Prevention of mother-to-child transmission (PMTCT) programmes offer a range of services for women of reproductive age living with or at risk of HIV to maintain their health and stop their infants from acquiring HIV.

Prevention of Mother To Child Transmission, PMTCT, improves maternal and child health through preventing the spread of HIV infection. 

My name is Tessy,  am 37 years old, I am a community health worker, I am a mother of two beautiful children . In 2013, while on my Industrial Training, IT,  in one of the communities in Cross River State, a needle pricked  me  and I got infected. Unknown to me, the person I treated was an  Human Immunodeficiency Virus, HIV, positive person. 

Six months after I finished my IT, and came back to Calabar, I fell seriously sick. My dad rushed me to the hospital, that was where I did a HIV test and it was discovered I was positive. So they refered me to the General Hospital, I felt like my world had crumpled and for two weeks I refused to take my medications. I developed tuberculosis, you know HIV and TB work together. I was treated for TB, started my antiretroviral drugs after three months. I haven’t been seriously sick since then. Once a while, I do take anti malaria drugs. 

I am a HIV positive person and my two children and husband are negative. For you not to infect your children you must be committed to your medications and also check your viral load regularly so that your children won’t be infected. 

As far as your viral load is suppressed, your husband and children will not be positive. They placed my husband on drugs which they call PrEP (pre-exposure prophylaxis) and my husband is not positive since he has been taking the drugs. My children were also placed on Nevirapine. And I will be able to breast feed them exclusively for 6 months.

Then at 18 weeks old , then you will go and do your Dried Blood Spot (DBS)test, DBS testing for the. baby, which allows for diagnosis of HIV as early as six weeks of age. After the test and the children comes out negative.

One thing I am very happy about , is the fact that my husband who is a military officer  and my kids are negative. 

Then i am happy that  I went to the hospital early and was able to get antiretroviral drugs on time especially when I got pregnant with my babies, there are lot of women that are HIV positive but do not attend antenatal clinic, some are not even captured at all. 
“That is why government must take Prevention of Mother To Child Transmission, PMTCT, very seriously, ensuring that all pregnant women attends  antenatal care regularly. Regular attendance of antenatal is a sure way to prevent transmission of mother to child and increase in the number of people infected with HIV’.”

According to the Joint United Nations Programme on HIV/AIDS (UNAIDS)  85% of pregnant women living with HIV had access to antiretroviral medicines to prevent transmission of HIV to their child in 2020.

The implementation of effective PMTCT programs would require innovative strategies that leverage improvement of Antenatal care (ANC) uptake as an entry point for PMTCT..

Nigeria need to urgently link all its data sources to National Data  Repository, NDR, and incorporate PMTCT data to NDR.