Introducing Nkoli Nwakego Ezumah: Strengthening male involvement in the prevention of mother-to-child transmission of HIV/AIDS (PMTCT) in Enugu State Nigeria

Nkoli Nwakego Ezumah is a recipient of a RinGs’ small research grant. She is a Sociologist with a PhD in Sociology from University of Ibadan, Nigeria, with a specialization in Gender and Development studies. She is currently a Professor in the Department of Sociology/Anthropology, University of Nigeria, Nsukka, and also serves as a researcher with the Health Policy Research Group, University of Nigeria, Enugu Campus. Her project is in the area of care seeking and service delivery and is titled: “Strengthening male involvement in the prevention of mother–to-child transmission of HIV/AIDS (PMTCT) in Enugu State Nigeria.”

Since the emergence of HIV/AIDS in Nigeria in 1986, mother to child transmission of HIV/AIDS still constitutes a serious health problem especially in the hard-to-reach or remote areas, where delivery practices in some of the facilities are suboptimal. In fact Nigeria is one of the 22 priority countries identified in the global report for eliminating mother-to-child HIV transmission (WHO 2011). Some of the key social factors that enhance the persistence of mother-to-child transmission of HIV/AIDS are issues related to primary prevention, lack of male involvement, and family planning among others. Specifically some of the factors contributing to low male involvement in PMTCT in sub-Saharan Africa (SSA) have been identified to be associated with the culture, health system, socio-economic factors, lack of information, poor communication, and lack of confidentiality (Kalembo et al 2012). This is why WHO in its strategic PMTCT Vision emphasized the need for male involvement as a strategy to scale up PMTCT programmes in Africa.

Some of the major advantages to justify the involvement of men in PMTCT include the following:

• It will increase men’s knowledge of HIV prevention, and therefore give rise to their cooperation with their partners in use of condoms and other measures to ensure safer sex and prevent HIV;
• HIV positive couples will be in a position to make informed decisions concerning how to live positively;
• Men will be able to assume responsibility to ensure that their unborn children will not be exposed to HIV;
• Men will be able to discuss practices;
• Men will be able to make informed decisions about access to care and treatment;
• Men will be able to assist pregnant women who are HIV positive to clinics or hospitals in order to have chances for safe delivery; and,
• Men will also be in a position to support HIV positive mothers to use infant feeding methods that will be safe.

Success stories about progress in improving male involvement in PMTCT been reported in Rwanda and Tanzania. These include:

• The modification of practices in facilities;
• Extending clinic hours to accommodate men who have tight schedules;
• Reduction of waiting time at maternal and child health clinics; and,
• Inviting male partners to participate in counselling.

In this project it is envisaged that some of the successful strategies that were used in Rwanda and Tanzania would be adapted in Enugu state, Nigeria to increase male involvement in PMTCT.

References

Kalembo, Fatch W., Yukai, Du, Zgambo, Maggie & Jun, Qiu. (2012). Male partner involvement in prevention of mother to child transmission of HIV in sub-Saharan Africa: Successes, challenges and way forward. Open Journal of Preventive Medicine. Vol.2, No.1, 35-42.

WHO (2015). Mother to child transformation of HIV.

WHO (2011). Global HIV/AIDS Response: Epidemic update and health sector progress towards Universal Access: progress report 2011. Geneva.