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Nigeria is home to 17.5 million orphans and vulnerable children (OVC) who struggle daily to access food, shelter, education, protection, and care.

In Nigeria, as in most countries, women and girls assume the bulk of the caregiving burden for those infected with HIV and children left vulnerable or orphaned by AIDS. These responsibilities often prevent girls and women from obtaining an education and developing income-generating skills.

In recent years, there has been a shift in how the international community is addressing the HIV epidemic. As more people are receiving antiretroviral therapy, we are seeing the benefits of reduced viral load on a population level. Fewer babies are being born HIV positive and prevalence rates are dropping in most countries with the highest HIV burdens.

Ethiopia’s Federal Ministry of Health (FMOH) began integrating mother mentors with a Mother Support Group (MSG) into national HIV programing in 2005 to address the special needs of HIV-positive pregnant and postpartum women and their children.

This report reviews the role of mother mentors and their Mother Support Groups (MSGs) in supporting HIV-positive mothers to live healthy lives and use appropriate health services.

Strengthening health systems is the core of management Sciences for Health’s response to the HIV epidemic. We build the capacity of the public and private sector in more than 35 countries to prevent, treat, and manage HIV & AIDS.

In response to the HIV and tuberculosis (TB) epidemics, we build the capacity of our public- and private-sector partners to prevent TB and HIV and improve diagnosis and management of co-infected patients.

Ten years ago, in 2004, testing positive for HIV in Ethiopia was a death sentence. It was the start of a painful decline, including illness and ostracism from society, ultimately leading to premature death.

The Ethiopia Network for HIV/AIDS Treatment, Care, & Support (ENHAT-CS) program, a USAID initiative funded by PEPFAR. was an MSH-led consortium of national and international partners.

Background In Ethiopia, over 60% of all people who are eligible for antiretroviral therapy (ART) receive it. However, coverage is only 12% among children under 15 years of age. Due to scarcity of data and limited awareness of possible HIV infection, especially in older children, the AIDS epidemic among Ethiopian children appears neglected in national programs. Methods

In Ethiopia, male-dominated gender dynamics and health care provider attitudes lead many women to avoid or not fully utilize antenatal care (ANC) and prevention of mother-to-child transmission (PMTCT) services, creating barriers to women’s access to care and to interrupting vertical transmission of HIV.

Following the World Health Organization’s 2013 guidelines endorsing antiretroviral therapy for all HIV-infected pregnant women, Ethiopia adopted Option B+ (initiation of triple regimen antiretroviral therapy (ART) for the duration of breastfeeding or for life regardless of a pregnant woman’s CD4 count) as the national standard for prevention of mother-to-child transmission (PMTCT

Ethiopia’s HIV prevalence rate is approximately 1.2 percent,2 equating to about 700,000 HIV-infected people. Since 2005, Ethiopia has been decentralizing free antiretroviral (ART) services from hospitals to health centers as a strategy to improve access to HIV care and treatment.

Mother-to-Child Transmission of HIV and Early Infant Diagnosis:The Global Situation

The Rwandan Ministry of Health partnered with the Integrated Health Systems Strengthening Project (IHSSP) to strengthen and coordinate its health information system. In 2009, when IHSSP was launched, the ministry had multiple systems to gather data from the country’s health services, but the systems used to aggregate and analyze the information were weak and were not interoperable.

Despite progress reducing maternal mortality, HIV-related maternal deaths remain high, accounting, for example, for up to 24 percent of all pregnancy-related deaths in sub-Saharan Africa. Antiretroviral therapy (ART) is effective in improving outcomes among HIV-infected pregnant and postpartum women, yet rates of initiation, adherence, and retention remain low. This systematic literature review synthesized evidence about individual and contextual factors affecting ART use among HIV-infected pregnant and postpartum women. Thirty-four studies were included in the review. Individual-level factors included both those within and outside a woman’s awareness and control (e.g., commitment to child’s health or age). Individual-level barriers included poor understanding of HIV, ART, and prevention of mother-to-child transmission; and difficulty managing practical demands of ART. At an interpersonal level, disclosure to a spouse and spousal involvement in treatment were associated with improved initiation, adherence, and retention. Fear of negative consequences was a barrier to disclosure. At a community level, stigma was a major barrier. Key structural barriers and enablers were related to health system use and engagement, including access to services and health worker attitudes. To be successful, programs seeking to expand access to and continued use of ART by integrating maternal health and HIV services must identify and address the relevant barriers and enablers in their own context that are described in this review. Further research on this population, including those who drop out of or never access health services, is needed to inform effective implementation.

Despite global progress in the fight to reduce maternal mortality, HIV-related maternal deaths remain persistently high, particularly in much of Africa. Lifelong antiretroviral therapy (ART) appears to be the most effective way to prevent these deaths, but the rates of three key outcomes—ART initiation, retention in care, and long-term ART adherence—remain low. This systematic review synthesized evidence on health systems factors affecting these outcomes in pregnant and postpartum women living with HIV. Low prioritization of maternal ART and persistent dropout along the maternal ART cascade were key findings. Service delivery barriers included poor communication and coordination among health system actors, poor clinical practices, and gaps in provider training. The few studies that assessed maternal ART interventions demonstrated the importance of multi-pronged, multi-leveled interventions. There has been a lack of emphasis on the experiences, needs, and vulnerabilities particular to HIV-infected pregnant and postpartum women. Supporting these women to successfully traverse the maternal ART cascade requires carefully designed and targeted interventions throughout the steps. Careful design of integrated service delivery models is of critical importance in this effort. Key knowledge gaps and research priorities were also identified, including definitions and indicators of adherence rates, and the importance of cumulative measures of dropout along the maternal ART cascade.

Best Practices for HIV Voluntary Testing and Counselling in Tanzania

The West African Abidjan to Lagos transport corridor crosses five countries through a densely populated and growing urban setting.

On the Road from Abidjan to Lagos, Urbanization Offers Risk and Opportunity, Hardship and Hope   A Corridor of Contrasts from Management Sciences for Health

Southern Africa has a long history of cross-border migration (movement of people across international borders) and internal migration (movement of people within a country). People migrate for political, social, and economic reasons.

BLC is responding to USAID Forward Agenda's Implementation and Procurement Reforms by providing capacity building support to local organizations, like North Star Alliance (NSA). The reforms emphasize long-term impact and sustainability as well as innovation and new partnerships.

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