Mother-Baby Pack brings hope in HIV prevention in Lesotho

Roderick Huntress, UNICEF

LESOTHO (July 23, 2010) — Malekena George lives in a rural area in the southern African kingdom of Lesotho. Four months ago, she set out on a trip to a distant clinic, determined to protect the health of her unborn child.

Malekena traveled for five hours across steep gravel roads and rocky mountain trails. She was eight months pregnant at the time, and had already seen her first baby die.

What she learned on that trip changed not only her own life, but the life of the baby she carried. And only now, long after her return home, are the rewards of her journey becoming clear for them both.

Two lives in danger

© UNICEF Lesotho/2010

Malekena George traveled to the Pilot Health Clinic in Lesotho's Berea District for antenatal care and received take-home treatment to prevent mother-to-child HIV transmission.

At the clinic, Malekena had her first antenatal examination, including a routine HIV test. The results showed that she was living with the virus. Her own health was at risk—and without intervention, she would transmit HIV to her child during pregnancy, delivery or breastfeeding.

The news was a shock. But there was also reason for hope, because the clinic offers a treatment that allows mothers living with HIV to protect their babies from the virus.

This medical intervention—prevention of mother-to-child transmission, or PMTCT—uses anti-retroviral drugs and an antibiotic to safeguard the health of both mother and child. But it usually requires a series of visits to a clinic over many months for new drugs and monitoring.

Malekena lived too far from the clinic to make the long, difficult journey over and over, and she couldn't afford the cost of repeated visits. Without preventive treatment, however, her baby's health and survival were in jeopardy.

A creative solution

The clinic's health workers used a technique pioneered in their own country to overcome the obstacles Malekena faced. They bundled pre-measured doses of PMTCT drugs together in a plain paper bag, and gave the young mother instructions in administering them to herself and the baby she was about to bear.

Malekena gave birth at home after a long and painful delivery. Her circumstances were not unusual; nearly half of pregnant women in Lesotho have their babies at home. Many live in rural areas far from a clinic, and reaching a health care facility in time for delivery is often not an option.

"When I saw my baby for the first time and held her in my arms," says Malekena, "I knew immediately that she would be fine. From that moment, I felt at peace."

Access to treatment

Malekena named her little girl Mankhube. Her confidence in Mankhube's good health was borne out when mother and daughter returned to the clinic for the infant's first HIV test. It showed that so far, she is free of the virus.

This mother and child were fortunate. Sub-Saharan Africa is the region hit hardest by the global HIV/AIDS epidemic, and many of its pregnant women have no access to PMTCT treatment.  

Lesotho offers services in nearly all of its clinics to prevent mother-to-child HIV transmission. In fact, a majority of the country's pregnant women living with the virus received treatment from the PMTCT program last year. But many still do not, often because they, like Malekena, live too far from a health facility—or because the costs of repeated travel are too great for them to bear.

Mother-Baby Pack introduced

© UNICEF/NYHQ2010-1057/Markisz

UNICEF's Mother-Baby Pack can make HIV-prevention treatment available to mothers and infants who might not otherwise have access to it.

To help these women gain access to preventive care, UNICEF and its partners have developed a product inspired by the very innovation that benefitted Malekena and Mankhube: the package of pre-measured PMTCT medicines pioneered by Lesotho's health workers.

UNICEF's recently introduced "Mother-Baby Pack" is a take-home box containing all the anti-retroviral drugs and antibiotics needed to protect the health of one mother and child. Color-coding and simple graphics help mothers identify which of the individually packaged medicines to administer during pregnancy, delivery and breastfeeding. 

UNICEF is rolling out the Mother-Baby Pack in four sub-Saharan African countries: Cameroon, Kenya, Zambia and Lesotho.

Today, Malekena looks back on her difficult trek and marvels at the outcome. "She is my miracle baby," she says of Mankhube. "I am so happy to have made the trip to the clinic. My first baby died when he was just over a year old, and it was terrible. Now I want to make sure my little girl grows up healthy."

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