Building Ukrainian systems, capacity, and commitment to prevent abandonment of children born to HIV-positive mothers

PURPOSE: In Ukraine, a country with one of the fastest growing HIV infection rates in Europe, 11 percent of HIV-positive children have been abandoned by their mothers to date. To address this issue, in July 2005, Doctors of the World (DOW) launched its psychosocial and medical support model (called MAMA+) to prevent abandonment of children born to HIV-positive mothers in three regions of Ukraine.

METHODS: MAMA+ uses the following methods to prevent abandonment of children born to HIV-positive mothers: 1. Networks of agencies and specialists for early identification of pregnant HIV-positive women; 2. Comprehensive system of family support through social, medical, and psychological support of mothers (including home visits) and families caring for children born to HIV-positive mothers; and 3. Peer support groups to empower HIV-positive women and their families. To develop local systems, capacity, and commitment, DOW implements the MAMA+ model with the All-Ukrainian Network of People Living with HIV/AIDS (the Network) in Kyiv, Donetsk, and Simferopol where three case management teams implement the model.

RESULTS: As of January 01, 2007, 99% of 153 MAMA+ clients retained their infants in their family homes; 458 HIV-positive women received HIV information and counseling; 120 representatives of partner organizations were trained. By November 2007, the three project sites will be transferred to the Network.

The group that has been most challenging to serve is women without stable housing and existing services must be adapted to serve this population.

POLICY IMPLICATIONS: Integration of the MAMA+ model into state policy and local NGO capacity is vital to make services accessible to prevent abandonment of children born to HIV-positive mothers in Ukraine.

To incorporate the MAMA+ model into public policy and practice and to meet the housing needs of HIV-positive women at-risk of abandoning their children, DOW is partnering with the Ukraine State Social Services to apply the MAMA+ model in their network of shelters for at-risk pregnant women and young mothers by: 1) enabling acceptance of HIV-positive young mothers in the shelters through policy change and 2) training senior staff to work with HIV-affected families with children through a specialized training curriculum and educational materials development.