Soon, pvt nursing homes may open doors to HIV positive pregnant women

Mumbai, June 11 – Doctors and nurses will be trained to adminster drug nevirapine to minimise chances of mother-to-child transmission

If everything goes according to plan, private nursing homes and maternity homes will soon open their doors to HIV-positive pregnant women.

The Mumbai District Aids Control Society (MDACS) and Brihanmumbai Municipal Corporation (BMC) are kickstarting efforts to identify and motivate private nursing homes to conduct such deliveries, in an attempt to prevent mother-to-child transmission wherever possible.

Jinal Shah, from Indian Express.

In a meeting conducted on Wednesday with BMC officials, MDACS asked the former to furnish a list of 50 top nursing homes in the city that conduct more than 50 deliveries each month.

“The National AIDS Control Organisation (NACO) has mandated that we identify 24 private maternity and nursing homes that conduct more than 50 deliveries per month. Doctors, nurses and technicians in these nursing homes will be motivated to conduct deliveries for the HIV-positive mothers,” said Dr Harish Pathak, additional project director at MDACS.

NACO has allotted funds for this Public Private Partnership (PPP) project, for blood testing kits and for training technicians to test mothers for HIV and also for protection kits for nurses and doctors conducting deliveries. The kits include several layers of protective clothing, gloves and head-to-toe overalls. “Doctors will also be taught how to administer the nevirapine drug to prevent mother-to-child transmission,” said Dr Pathak.

MDACS has made it clear that private hospitals can charge HIV-positive mothers the same fees for a delivery as they do for other women. However, they cannot claim money for protection or for the diagnostic kits.

“NACO has set a target that by end of this year, all 24 private centres should start taking in HIV-positive pregnant women,” said Dr Pathak. MDACS, however, is well aware of the refusals they may face from private nursing homes.

While some nursing homes welcomed the move, they too added that clinics should be permitted to choose whether to accept HIV-positive women or not.

“It is very important to segregate these patients for special care and to avoid cross-contamination,” said Dr Ketan Parekh who runs a nursing home in Ghatkopar, adding that the purpose of segregation is not to maintain a stigma. “To ensure that the protocols are followed, nursing homes should conduct deliveries on a regular basis. Continuous deliveries will mean good adherence to the protocol and hence low cross contamination,” added Dr Parekh.

According to MDACS officials, only four private hospitals in Mumbai conduct deliveries for HIV-positive pregnant women; the remaining are all performed in public set-ups. “Doctors from private hospitals simply refer such deliveries to state or civic-run hospitals,” said Dr Pathak.

“We are able to cover 90 per cent of HIV-positive pregnant women’s deliveries in public hospitals. Our aim is to strengthen it to cent per cent in public hospitals and to motivate private hospitals to start taking these women also. This will help us keep a tab on how many HIV-positive mothers go to private hospitals,” added Dr Pathak.

Currently, there is no data on how many HIV-positive mothers deliver in private hospitals or whether they are given nevirapine. Parent-to-child transmission accounts for 4 per cent of HIV infections in India.

• In 2006, of the 1,25,602 deliveries in Mumbai’s state and civic hospitals, in 638 cases mothers were HIV positive. Seventy-nine percent of children were saved by nevirapine.
• In 2007, of the 1,30,308 deliveries, in 659 cases, mothers were HIV positive. Eighty-three percent of children were saved by nevirapine.
• In 2008 from January to April, of the 39,303, in 180 cases, mothers were HIV positive. Eighty-nine percent of children were saved by nevirapine.

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