Voices from the Capacity Project

At Modjo Health Center in Oromia, Ethiopia, a young woman is distraught. She recently learned that she is HIV positive, and she is deeply worried about her future. “If my husband knows my status he would send me away from home,” she insists.

A friendly woman named Asegedech approaches and engages her in conversation. Gradually the young woman understands that she is talking with someone just like herself. Asegedech brings up the Mothers’ Support Groups (MSG) program based at the health center. Sharing her own experience as a member, she helps soothe the young woman’s concerns. “You have a nice opportunity to prevent mother-to-child transmission now,” Asegedech emphasizes. “There were no such opportunities a couple of years ago. You can also come every week on Monday and benefit from our MSG counseling service. Feel free. We all live with HIV like you.”

The MSG program supports HIV-positive women’s health needs. Initiated by IntraHealth International and continued under the Capacity Project since 2007, MSG has expanded to 78 sites and enrolled over 2,600 women. The program empowers mothers and mothers-to-be to access peer-based support and make linkages to services such as family planning, infant-feeding counseling, nutritional guidance, antiretroviral therapy, prevention of mother-to-child transmission (PMTCT) and health institutional delivery.

The Capacity Project’s Melaku Gabissa emphasizes the severe distress many women experience when they learn their status. “The mental problems they are facing outweigh the problems the disease could cause to them. When they organize in groups and learn from each other, they begin to recognize that this problem is not only that of one mother but other women as well. They begin to say, ‘Oh, I could also address my problem in such a fashion’.”

Last October the Capacity Project and BBC World Service Trust produced a 25-minute radio show on the MSG program for Ethiopia National Radio. Interviews from Modjo Health Center helped listeners understand what women go through and how the program helps. When journalist Girma Mulugeta expresses surprise at seeing a traditional coffee frying ceremony, a member of MSG informs him: “We are doing this here to treat ladies who were screened and found to be HIV positive. These ladies feel worried and depressed. As I am living with the virus, I would share my experience on how I felt when I was told about my own status. The coffee ceremony would help us as a mainstay to discuss the feeling, and in doing so a newly tested positive lady would begin to learn how to live with it and swallow her worries.”

Gabissa notes that “mothers who tested positive would be more likely to share their problem with a mother living with HIV, like Asegedech, than a counseling health professional. Such mothers would also relish visiting each other at home. When it comes to treating health problems, women in the group begin taking life-prolonging drugs before the disease actually attacks them much.” MSG promotes taking the necessary drugs for PMTCT as well as follow-up medical care for infants.

At Modjo Health Center, Asegedech continues her conversation with the nervous young woman. “I am taking life-prolonging drugs for two years now,” she offers. “Do I look like someone who lives with HIV as you look at me now? Here you get many benefits,” she continues. “You will get antiretroviral drugs. You would get CD4 count service to begin taking the drugs. You will be the beneficiary because your health status would be checked regularly.”

Reaching out to communities, the Capacity Project joined a day-long regional health education event in Teji on January 11. More than 2,000 people attended and heard a broadcast of the BBC’s radio show on MSG. The Project provided additional information from a tent, while actors performed short dramas on the importance of PMTCT, the involvement of health workers and the value of engaging men in family health.

MSG has become one of the most accepted Ministry of Health initiatives to support PMTCT. The Ethiopian HIV/AIDS Prevention and Control Office included MSG in its HIV/AIDS response strategy and PMTCT guidelines. The MSG training manual, endorsed by the Ministry of Health and launched nationwide, includes documentation of experiences and lessons learned. “All women participating in MSG services are leading their families quite well,” Gabissa adds. “They begin developing hope in life.”

[March 2009. Print a PDF version.]

The Capacity Project, funded by the United States Agency for International Development (USAID) and implemented by IntraHealth International and partners (IMA, Jhpiego, LATH, MSH, PATH, TRG), helps developing countries strengthen human resources for health to better respond to the challenges of implementing and sustaining quality health programs.

The Voices from the Capacity Project series is made possible by the support of the American people through USAID. The contents are the responsibility of IntraHealth International and do not necessarily reflect the views of USAID or the United States Government.