Kenya hopes free maternal care will save more children from HIV

by Katy Migiro | @katymigiro | Thomson Reuters Foundation
Tuesday, 10 September 2013 16:29 GMT

Children stand outside the home in Nairobi's Kangemi slum of a participant in the Jesuit-run Upendo programme which helps children at risk of abuse or neglect, many of whom have HIV-positive parents. Photo April 23, 2013 REUTERS/Darrin Zammit Lupi

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More than half Kenyan women give birth at home. If they had their babies at free government hospitals and clinics, they would get medicine preventing HIV transmission to their babies, cutting the large number of children with HIV

NAIROBI (Thomson Reuters Foundation) – Almost one percent of Kenyan children are HIV positive and the majority are not receiving treatment, the government said on Tuesday, highlighting the need to help and persuade more women to use maternal health services that are now free in public hospitals and clinics.

 Almost 60 percent of Kenya’s 104,000 HIV positive children are not receiving life-prolonging anti retroviral therapy (ART) because their parents do not know they are infected.

It is the first time the government has surveyed HIV prevalence among children.

“It’s an area that needs attention,” said Kevin De-Cocks, director of the Centers for Disease Control and Prevention’s Center for Global Health, speaking at the launch of the 2012 Kenya Aids Indicator Survey.

“The answer to the problem of HIV in children is the prevention of mother-to-child transmission.”

Virtually all children born to HIV positive mothers become infected with HIV at birth. They could be protected if their mothers gave birth in medical centres where they are tested for HIV and given medication to prevention transmission during delivery.

The rate of transmission of HIV from mother to child in Kenya fell from 28 percent in 2005 to 8.5 percent in 2012.

The main challenge is that 56 percent of Kenyan women give birth at home, mainly because they cannot reach a health facility, do not believe it is necessary or cannot afford to pay for services.


The government introduced free maternity services in public facilities on June 1 and since then there has been a rapid increase in the number of women delivering in hospital, a rise of between 10 and 50 percent across the country.

“This intervention, of making sure that our mothers can go to hospitals for delivery, is going to have a very big impact,” said James Macharia, the cabinet secretary for health. “We can make sure that… the babies born to them will be protected from HIV.”

Virtually all the pregnant women who visit antenatal clinics, rising from 65 to 92 percent of the total between 2007 and 2012, are tested for HIV.

Of those who tested positive, 90 percent received medication to prevent their children becoming infected, though this is not always effective. Some 16 percent of infants born to women who received medication to prevent HIV transmission tested positive at their first immunisation visit.

The survey underestimates the number of Kenyan children infected with HIV at birth as it includes only those aged between 18 months and 14 years, De-Cocks said. “We do not know how many children of zero to 18 months would have been infected, were infected and would have died,” he said.

One-third of HIV positive babies who do not receive treatment die before their first birthday and about half die before their second, he said.

“It emphasises again the importance of mother-to-child transmission services and of the scale-up and the importance of early infant diagnosis – making sure that children born to mothers with HIV have access to testing and then to treatment very early in life.”

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