CHAPTER ONE
INTRODUCTION
1.1 Background of the Study
The scourge of HIV/AIDS has, no doubt,
continued to ravage virtually all parts of the world. According to statistics,
34 million people are estimated to be living with HIV worldwide; 16.7 million
of these are women and 3.4 million are children younger than 15 years of age.
In 2011, a total of 2.5 million people were newly infected with HIV globally;
an estimation of 330 thousand of these new infections are children under 15
years of age. Also in 2011, the world recorded 1.7 million deaths orchestrated
by AIDS of which 230 thousand children under 15 years of age were involved
(UNAIDS, 2012).
Sub-Saharan Africa (including Nigeria),
with more than two-third of the world’s total number of HIV-infected people,
remains the region most affected by the HIV/AIDS pandemic. About 68% of all the
people living with HIV reside in sub-Saharan Africa, a region with only 12% of
the global population. The region also accounted for 70% of new HIV infections
in 2010 while in 2011, an estimate of 270,000 children in sub-Saharan Africa
were newly infected with HIV. AIDS has claimed at least, one thousand lives
annually in sub-Saharan Africa since 1998 (UNAIDS, 2012 and 2011).
According to the National Agency for the
control of AIDS (NACA), Nigeria has an estimated 3.1 million people living with
HIV/AIDS, with an annual HIV positive births of 56, 681, a cumulative AIDS
deaths of 2.1 million and an annual AIDS death of 215, 130 people (NACA, 2011).
Statistics from the agency further show that an estimated 281, 180 new HIV
infections have been recorded; 126, 260 are adults while 154, 920 children were
involved in the new infections. Women, however, constitute 57% of adults
infected with HIV in the country (NACA, 2011, FMOH and MASI, 2006). The
pandemic is, no doubt, having a serious effect on the reproductive health of
women (Adeleke, Mukhtar and Gwarzo, 2009, p.21).
HIV is the leading cause of mortality
among women of reproductive age worldwide and is a major contributor to
maternal, infant and child mortality. Without treatment, one third of children
living with HIV die before they reach one year of age and 50% die by the second
year of life (WHO and UNAIDS, 2009).
Globally, the number of women dying from
AIDS related cases during pregnancy or within 42 days after pregnancy was estimated
to be 37 million. Also, among the 21 high priority countries (including
Nigeria), 33,000 pregnancy – related deaths among women were recorded (UNAIDS,
2012 and 2011). Statistics also indicate that maternal mortality was still very
high in Nigeria (630/100,000 live births) (UNAIDS, 2011).
From the figures presented above, it is
very correct to aver that in all the HIV infections and deaths, children have
continued to be seriously victimized. One avenue that has fundamentally aided the infection
of children with this deadly disease (HIV) is Mother-to-Child Transmission
(MCT). This has, no doubt, served as a major pathway for the spread of the HIV
virus. For instance, in Nigeria alone, UNAIDS reported that an estimated 84,
200 children were newly infected with HIV through mother-to-child transmission
in 2009. To this end, the World Health Organisation (WHO) in 2010 reported that
the prevention of mother-to-child transmission of HIV (PMTCT) has been at the
forefront of global HIV prevention activities since 1998.
The transmission of HIV from an HIV
positive mother to her child during pregnancy, delivering or breast feeding is
called mother-to-child transmission (WHO, 2010). Children, no doubt, are mainly
infected with HIV through mother-to-child transmission at the time of
pregnancy, child labor and delivery or through breastfeeding. This has created
enormous social and economic problems. Aside the dominant hetero-sexual
transmission of HIV, vertical transmission from mother to child accounts for
more than 90% of pediatric AIDS. Particularly in developing countries, mother
to child transmission has become a critical child health problem (Goncho, 2009,
p.6).
The menace of mother to child
transmission has been very devastating. Many children have been infected which
has resulted to their early deaths. According to a progress report by UNAIDS
2012, an estimate of 3.4 million children younger than 15 years were living
with HIV globally in 2011, 919 of them in sub-Saharan Africa (where Nigeria is situated). An estimated 230 thousand
children died from AIDS-related illness in the same year.
In the absence of interventions, the
range of 20-45% of infants would be infected with the deadly HIV through mother
to child transmission during pregnancy. 10-20% of infants would be infected
during labour and delivery, while 5-20% will be infected through breast
feeding. With appropriate interventions, the overall risk can be reduced to
less than 2% (WHO, UNAIDS, UNICEF, 2008) cited in (Goncho, 2009, p.7).
To nip this deadly scourge in the bud,
renewed efforts were made to scale-up the prevention of mother-to-child
transmission (PMTCT) programmes globally. The Millennium Development Goals
(MDGs) adopted by the UN General Assembly in 2010 committed the international
community to reducing child mortality; improving maternal health, and combating
HIV/AIDS, Malaria and other diseases by 2015. At the UN General Assembly
Special Session (UNGASS) in 2001, governments, further committed to reduce by
50% the proportion of infants infected by HIV by 2010 by ensuring 80% of
pregnant women accessing antenatal care receive PMTCT services (WHO, 2010,
p.11). Also, in 2005, representatives of governments, multilateral agencies,
development partners, research institutions, civil societies and people living
with HIV assembled at the PMTCT High level global partners forum in Abuja,
Nigeria, which resulted in a “call for Action” for the elimination of HIV
infection in infants and children and an HIV-and AIDS free generation (WHO,
2007, p.4).
To effectively combat mother-to-child
transmission, the United Nations came up with four-pronged strategy for PMTCT
which addresses a broad range of HIV related prevention, care, treatment and
support needs of pregnant women, mother, their children and families. This
comprehensive approach includes four elements-the primary prevention of HIV
infection among women, especially young women, the prevention of unintended pregnancies
among HIV-infected women, provision of specific interventions to reduce HIV
transmission from HIV-infect women to their infants, and provision of
treatment, care and support for HIV-infected mothers, their infants and family
(FMOH, 2010, p.4-5).
The potential for PMTCT to reduce the
risk of HIV transmission to less than 2% of births to HIV-positive mothers
underscores the importance of a communication strategy that reaches all
relevant stakeholders (CADRE, 2009, p.12). This calls for the provision of
adequate information to the general population and relevant service providers
on the programme through well coordinated campaigns to create awareness and
positively influence attitudes, norms, values, and behaviours of the public
regarding PMTCT and to improve the capacity and skills of healthcare providers
for standard PMTCT services.
1.2 Statement of the Research Problem
Countless number of HIV prevention campaigns
have been going on globally, Nigeria not exempted. The campaigns sponsored by
various organizations and bodies such as the World Health Organization (WHO),
Society for Family Health...
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