HIV, AIDS and sexually transmitted infections - care, support and prevention - AIDS action  

HIV, AIDS and sexually transmitted infections - care, support and prevention - AIDS action

  HIV / AIDS and sexually transmitted infections
  care, support and prevention

 

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 HIV, AIDS and sexually transmitted infections - care, support and prevention - AIDS action
 

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HIV and safe motherhood  >  Introduction 
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Introduction

HIV and Safe Motherhood

Acknowledgements
Definitions
Introduction
Before Parenthood
HIV in pregnancy
Voluntary counselling and testing for HIV
Care during labour and delivery
Infant feeding and HIV
What else can health workers do?
Resources




HIV and safe motherhood    4   Page 5   6  top of page

  Introduction

 

 
The health and wellbeing of women everywhere is of great importance in its own right


The health and wellbeing of women everywhere is of great importance in its own right. It is also key to the health and wellbeing of their families, communities and societies. But every year, over half a million women in developing countries die in pregnancy and childbirth. The Safe Motherhood Initiative was started in 1987 to improve maternity services and to protect the health of mothers and their infants. 

HIV presents an enormous challenge to safe motherhood. In 1998, it was estimated that approximately two million HIV-positive women worldwide would give birth. In several major towns in eastern and southern Africa, more than a quarter of pregnant women are now HIV positive. 

Women with HIV are more likely to have complications during pregnancy and delivery, or abortion. They are also more vulnerable to anaemia, malaria, pneumonia, urinary infections, and tuberculosis (TB). For women with symptomatic HIV, pregnancy can also speed up the progress of their illness to AIDS. In South Africa, about one in eight maternal deaths are directly due to HIV, and it is a factor in other maternal deaths, for instance from bleeding. 

It is estimated that in Africa and Asia, more than two million children each year will lose their mother or both parents to AIDS. These children can be at especially high risk of poverty, neglect and early death. When grandparents or older children are left to look after orphans, they often lack the support or resources to meet basic needs.

HIV can also pass from mother to child during pregnancy, labour and delivery, or through breastfeeding. It is not known exactly what proportion of babies born to HIV-positive mothers will be infected themselves, but without any kind of intervention, it is estimated that between 15 and 45 out of every 100 would be infected. Around 570,000 children aged 14 or younger (most of them in sub-Saharan Africa) became HIV positive in 1999, almost all from mother-to-child transmission. 

The prospects for infected children are not good. Children who are HIV positive are over 20 times more likely to die before the age of five than non-infected children. A study in Rwanda found that, even with frequent medical treatment, over a quarter of the children with HIV in the study died before they were two years old, and over half died before their fifth birthday. 

Good HIV prevention and care is an essential pan of safe motherhood. Maternity services could playa crucial role by improving care for pregnant women with HIV and AIDS, and helping to reduce the spread of HIV and AIDS before, during and after pregnancy. Fewer resources will be needed if programmes work together. 

This briefing paper is for health workers in sub-Saharan Africa who care for mothers during and after pregnancy and delivery. It will also be useful for health planners, and anyone working with young people and with women and men, providing information, advice or counselling on reproductive health and parenthood.

The paper provides information on the issues raised for Safe Motherhood by the high prevalence of HIV in the region. It suggests actions that can improve care and advice for all women, including those who are HIV positive, as well as ways to reduce the risk of mother-to-child transmission for those women who know they are HIV positive.



    

 

 

 
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