Burundi adopts community based approach to prevent mother to child transmission of H...

21 August 2024

Bujumbura - "It's unacceptable that in 2024, children are still born with HIV," says Novela Irakoze, a person living who with HIV and works on preventing mother-to-child transmission. "I was born with HIV, and my goal is to protect children from experiencing what I did."

Novela is part of a group called "Mamans Mentor" (Mentor Moms), which supports HIV-positive pregnant women in receiving the right treatment to protect their babies from HIV.

By 2020, Burundi had made significant strides in combating HIV, nearing UNAIDS' 90-90-90 targets: 89% of HIV-positive individuals knew their status, 98% were on antiretroviral treatment, and 90% had achieved viral suppression.

Despite improvements, preventing mother-to-child HIV transmission remains a significant challenge. While 95.4% of all people living with HIV in Burundi receive ARV treatment, only 69% of HIV-positive pregnant women do. The mother-to-child transmission rate is still above 12%, despite the national goal of reducing it to below 2%.

"To prevent transmission, it's vital to keep both mother and child in care throughout the HIV exposure period," says Dr Denise Nkezimana, WHO Burundi's HIV, tuberculosis, and hepatitis programme manager. Yet, stigma and resource constraints often cause women to drop out of care.

In response to these challenges, the Burundian Government, in partnership with WHO, launched the Mamans Mentors pilot programme in 2019, which is a peer education initiative. So far, 135 women have been trained in three provinces, with plans to expand the initiative nationwide.

"Mamans Mentors are model mothers living with HIV who educate and support their peers through testing, treatment, and primary prevention," explains Dr Aimé Ndayizeye, Director of the National AIDS Control Programme (PNLS).

Mwanaidi Ndayishimiye, 30, discovered she was HIV positive during her first antenatal consultation. The news, while she was pregnant with her first child was devastating, and due to stress, she tragically lost her baby after a fall. "It felt like my world was falling apart," she recalls. With the help of Mamans Mentors, Mwanaidi successfully carried her second pregnancy to term, giving birth to a healthy, HIV-negative child.

"The Mamans Mentors supported me during my second pregnancy. They educate us and encourage us to talk. It was of great help", says Mwanaidi, now the mother of a 13-month-old HIV-negative child who is thriving.

With the involvement of mentor mothers, by 2023, all HIV-positive pregnant women will receive ARV treatment. The Mamans Mentors ensure that these women visit health centres regularly to monitor their HIV status and continue their treatment.

"We check the viral load at three months of pregnancy and again at six months to ensure that the woman gives birth with an undetectable viral load," explains Triphonie Yamuremye, Head of PMTCT Care at Buyenzi Community Medical Centre in Bujumbura.

To expand the success of the programme nationwide, WHO is supporting the development of a guide for Maman Mentors and assisting Burundi in targeting certification for the triple elimination of mother-to-child transmission of HIV, syphilis, and hepatitis B.

"During a community visit, we met a 24-year-old woman who was pregnant and in critical condition. We feared that her baby might already be infected," recounts Mentor Mum Novela. "Thanks to our intervention, she and her child, who was born HIV-negative, are thriving today. These are the victories we fight for, and we won't stop until Burundi is HIV-free."

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