With maternal health being one of the priority areas for health improvement, it’s important for primary health care facilities to improve care for pregnant mothers. The Witkoppen Health and Welfare Centre in Fourways, north of Johannesburg, says it’s trying to improve on these health indicators.
HIV counselling is one of the first services that pregnant women have to receive at the clinic. The main reason is to encourage the new mothers to test for HIV. Those that are found to be HIV-positive will then be given the necessary treatment to stay healthy and to protect their unborn babies from HIV infection. Executive Director at Witkoppen Health and Welfare Centre, Dr Jean Bassett, says they try to intervene as early as possible in the health of the unborn child by testing the mothers.
“In 2011 we had 3 400 first visit ante-natal patients and 99% of them chose to be tested for HIV. And of those, 24% were HIV-positive. We always retest the moms at about 32 weeks of pregnancy to see if they have converted because that would mean high risk for the baby. So, we ensure that they go on appropriate treatment as soon as possible”, says Dr Basset.
She says HIV is an issue in the communities which they serve. Many of the women come from the neighbouring informal settlements of Diepsloot where unemployment is high. But Dr Bassett says in the past eight years the clinic has made in-roads in addressing the challenge and as a result they have seen a reduction in the HIV infection rate in pregnant women using their facility.
“We have been tracking the HIV ante-natal percentage and it has been sitting at 33%. So, in eight years it’s gone down to 24%. I think that is really enormous in-roads that we have made in ensuring that the HIV infection rate in our community does come down - and it has come down”.
But Dr Basset says the challenge is that some of the women get lost to follow up once they discover that they have HIV. This is exacerbated by social issues, such as poverty.
“The moms who are HIV-infected... we assess their home environments very carefully to see what the situation is... are these children vulnerable? Are they at risk and what additional help do they require? And that is done through our Social Services Department”.
It is this type of care that draws patients to the clinic. Sister Eudore Radebe is a mid-wife and she is in charge of the ante-natal clinic at Witkoppen. She says they see about 70 expectant women a day. This includes old and new cases. She says they are encouraging women to bring their male partners to also test for HIV and be part of the antenatal experience.
“If they come with the husband, we test the husband too. Today we had two couples and they both tested. So, we empower the women, we advise them to bring their husbands along and get tested together, even though we have already tested the women. But, the men wouldn’t know. We need men to support their women during this time”, says Radebe.
The clinic has now started what it calls a ‘dude’s support group’. This is where men are encouraged to be part of the whole antenatal care programme, including HIV testing.
Twenty-three year-old Naomi Ndlovu has been using the ante-natal clinic for a month. Ndlovu says she enjoys the service as she is now equipped to prepare for her unborn child.
“There is hospitality in this clinic. There is no discrimination and they make you feel comfortable to talk to them”, she says.
Another expectant mom, Thandi Ncube, shares Ndlovu’s sentiments.
“I like this place. They don’t discriminate you for HIV status or wherever you come from. They also do a lot of counselling. So, when you have something that is bothering you, they are open with you and they relieve you of that burden”.