Hello Dear Indira Narayanan, I am a Rwandan Neonatal Nurse and below are our practices, statistics and plan in regard to breastfeeding/ EBM to admitted exposed children, HIV statistics,National agenda, …
In our country we do apply protected breastfeeding guideline. Jumping directly to the issue of breastfeeding, we do for all babies including those HIV exposed babies with ARVs protection, meaning mother on Tri-therapy (Those are initiated any time the person is tested HIV positive; being pregnant or not) and baby on Nevirapine and zidovudine syrup initiated at birth. For Neonatal units/ NICU admitted babies they are fed directly on breast; if the condition does not allow direct feeding, we do use expressed human milk from the mother.
Beyond breastfeeding and EBM: HIV positive women are encouraged to have planned pregnancies and discuss with their partners and Health care provider about safer pregnancies (clinical and immunological findings) and have free access to family planning methods. Through the extension and improvement of prevention initiatives, treatment protocols and guidelines, and attention to equity, the 2018 MTCT rate was at 1.5% with some best performing districts that already achieved zero transmissions of HIV from mothers to their children for the last 7 years. other districts are striving to achieve it.
The National plan is to eliminate the maternal to child HIV transmission. The campaign to end paediatric AIDS by 2030 was launched in 2018; the “Free to shine Campaign”. The campaign key messages are “start free, stay free, AIDS free” emphasizing that every child deserves the chance to start an HIV free life. Community involvement, access to HIV testing,access to early and quality antenatal care services for all pregnant women thatinclude PMTCT, parents’ adherence to treatment, protected breastfeeding toensure health mothers and HIV negative babies.
Ensuring that those districts who made zero transmission sustain it; and those who are looking to achieve EMCT are supported accordingly. In Rwanda, HIV prevalence has been stable since 2005 and remains at 3% among adults age 15–49 (4% among women and 2%among men). The prevalence of HIV is higher in urban areas (6%) than ruralareas (2%); HIV prevalence is 6% in the capital city of Kigali and 2–3% in eachof the other provinces.
Fauste Uwingabire is academic staff at the University of Rwanda. Professional interests: Nursing care.