UNITE FOR CHILDREN UNITE AGAINST AIDS

May 1, 2008

Traditional beliefs pose challenges in the Prevention of Mother to Child Transmission of HIV

On April 29, 2008, I visited Shewula Clinic in Swaziland’s Lubombo region. I wanted to find out how they are rolling out the services of Prevention-of-Mother-to-Child-Transmission of HIV (PMTCT).

Shewula is a mission clinic supported by UNICEF to roll out PMTCT services. My recent visit followed a community mobilization conducted at Shewula last year whereby men were encouraged to go for HIV testing and to support their wives during pregnancy.

I went there specifically to have a discussion with the nurse to determine how the project is performing. I spoke to nurse Sani Sibandze who reported that there has been a considerable improvement in that pregnant women are coming for HIV testing services. As a result, from January to April 2008, a total of 65 mothers were tested for HIV and 18 tested positive. However, of these 18, only a very small number is accessing the PMTCT services.

Sibandze cited two major challenges that make the PMTCT services not accessible to some of the pregnant women. First, there is a misconception by the husbands who think that if their wives go for an HIV test, the result will determine their own HIV status which is not the case since a couple may have a different HIV status. Second, Shewula has deep rooted traditional practices which include the use of traditional medicine.

Many married men live within the same compound of their parental homes with their wives. This is a normal traditional practice in Swaziland. However, if the pregnant mother is staying at the husband’s parental home, the mother-in-law is still the overall decision-maker in the home. Sibandze observed that some women who were pregnant and had tested positive were not coming for follow up clinical services. When questioned, these women explained that the mother-in-laws did not allow them to use the clinics as they believed traditional medicine was best in ensuring a healthy pregnancy.

Also, their mothers-in-law discouraged them from delivering their babies at a health care facility seen as a waste of family resources and home deliveries are therefore encouraged. This prevents the mothers and their babies to access vital PMTCT services which ensure that HIV is not transmitted to the baby.

I came back to the office feeling very sad and disappointed that despite the community mobilization, men in that community were still not taking the lead and that some women were perpetuating violence against other women.

I spoke to my colleagues in the office who felt that another community mobilization was essential and more men and women need to be targeted in order to stop the transmission of the virus. Unfortunately, this is not the only community in Swaziland where men are not taking the lead. To this day, UNICEF continues to reach out to men and mobilize them in their own communities and in their own language in order to ensure a change in attitude and behaviour.