Project for the Prevention of Mother-to-Child Transmission of HIV - Port-au-Prince, Haiti

PSI's central strategy is the creation of a franchised referral network of PMTCT services. The project began by PSI's partnering with the Ministry of Health and local public, private, and NGO collaborators to create a referral network of PMTCT services in metropolitan areas of Port-au-Prince. Pilot sites located at 7 hospitals and clinics are unified under the same communications plan and standard of care and linked for referrals. For instance, providers offering only prenatal care and VCT refer clients to another institution offering delivery services. The network model is based on a strategy that aims at increased access, high-quality services, effective referrals and follow up, and the capacity to rapidly add institutions. Services provided include prenatal care, VCT, ARV, counseling related to condom use and family planning, safe labour and delivery practices, infant feeding counseling and services, and psychosocial support for HIV-positive women. PMTCT services are integrated into existing antenatal care facilities to enhance project sustainability.

In order to create demand for services, PSI is promoting the PMTCT network using the branded logo Espwa Lavi ("hope for life"). A national behaviour change communication campaign entitled "Wi Pou Lavi San Jem SIDA" featuring this logo will take place in 2 phases. Phase I addresses knowledge of vertical transmission and reinforcement of primary prevention messages, while Phase II encourages testing for HIV among women of reproductive age and pregnant women in particular. Phase I (TV spot, radio spot, brochures, and posters) was launched in July of 2003 and will continue through December of 2003. Phase II will be launched when there is national consensus that there are enough functional VCT/PMTCT sites to respond to the demand that will be created. This campaign is designed to encourage VCT, reduce discrimination against people living with HIV and AIDS, and, in short, promote healthier attitudes and behaviour regarding HIV.

The campaign will be reinforced by interpersonal communication activities implemented by project sites and NGO partners, based on a "guide de sensibilisation" produced by PSI/Haiti. To prepare project sites for these activities, technical assistance was provided in the form of assessments of the institutions, planning sessions with site administrators, and training of staff. With regard to the latter, the Centres GHESKIO and Poz have conducted PMTCT training for providers. PSI/Haiti is also building the capacity of traditional birth attendants to educate their communities and refer clients to network sites for testing and delivery. This training also covers commodities and distribution, monitoring and evaluation, and communications.

HIV/AIDS, Women, Children.

According to organisers, approximately 12,000 HIV-positive women in Haiti give birth every year; approximately 30-35% of their babies become infected with the virus.

PSI began HIV prevention activities in Haiti in 1989 and has since that time continued to expand its social marketing of HIV/AIDS related products and services. Click here for a programme description of the AIDSMark Project, of which this initiative is a part.

With support from PSI/Haiti, Hôpital de la Communauté Haitienne and Hôpital Adventiste d'Haiti (in Diquini) began providing PMTCT services in April 2003. In May and June, the Network Clinics Centre de Gynécologie Préventive et d'Education Familial (CEGYPEF), Clinique d'Urgence, and Ministry of Education and Finance (MEF) Clinique began providing services. By the end of July 2003, almost 600 pregnant women at the 5 sites had been tested for HIV and 14 women were identified as HIV-positive and enrolled in the programme. The PMTCT pilot project tests a model for rapid scale-up: PSI is working with partners to integrate this project into Haiti's national PMTCT programme.