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MAMA+ Comprehensive Support to HIV-positive Mothers with Young Children Roman Yorick, MD, MPH

MAMA+ Comprehensive Support to HIV-positive Mothers with Young Children Roman Yorick, MD, MPH HealthRight International. Street children and youth Children in institutions HIV-affected families Women and children victims of violence and abuse Women and children in conflict with the law

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MAMA+ Comprehensive Support to HIV-positive Mothers with Young Children Roman Yorick, MD, MPH

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  1. MAMA+ Comprehensive Support to HIV-positive Mothers with Young Children Roman Yorick, MD, MPH HealthRight International

  2. Street children and youth Children in institutions HIV-affected families Women and children victims of violence and abuse Women and children in conflict with the law Migrant families Service providers Target Groups

  3. Marina and Olya, Russia Marina, 24 Used drugs since she was 14, on drugs through pregnancy Partner also uses drugs and alcohol Never went to prenatal clinic Found she was HIV+ at the maternity hospital Intended to abandon the child, enrolled into MAMA+

  4. Marina and Olya, Russia • Home visiting to ensure child safety • Child day care • Support mother to abstain from drugs • Access to welfare and HIV care and treatment • Child HIV+, both mother and child on ARV

  5. Natalia and Igor, Ukraine Natalia, 26 Used drugs since she was 13 Diagnosed as HIV+ through a harm reduction program at 16 At 21 enrolled into treatment preparedness program Enrolled into MAMA+ during pregnancy On substitution therapy Three-stage ARV PMTCT

  6. Natalia and Igor, Ukraine Home visiting to ensure child safety Child day care Access to welfare Restore relationship with Natalia’s mother Relapsed to drug use Child HIV-negative Enrolled into university

  7. Psychosocial counseling Substitution therapy Treatment adherence Peer support Vocational counseling Home Visiting Early Identification MAMA+ Shelter MAMA+ Daycare Center MAMA+ model components

  8. Professional team Social workers Psychologists Medical providers Educators Lawyer Peer counselors

  9. Service form Database Service provision First contact Intake form Case management plan Case conference Progress assessment Intake Psychosocial assessment form Goal achieved? Psychosocial assessment Case plan development No Case open? Yes Yes Case closed No Case Management Methodology

  10. ARV Coverage for PMTCT, 2009

  11. MAMA+ Yekaterinburg 2010-2012 253 women served 90 abandoned children returned to families Rates of abandonment dropped from 6.3% in 2009 to 1.9% in 2011 (p=0.0037)

  12. Challenges Substitution therapy Harm reduction Drug rehab Milk formula as part of PMTCT Access to care for migrants Maintaining the methodology Funding for NGOs

  13. National Strategy in the Interests of Children “Positive Childhood” network of 31 NGOs Advocacy group since 2010, joint platform HIV-affected children in the national strategy Milk formula as part of PMTCT Reduction of time for diagnosis to 3-6 mos. Elimination of vertical transmission by 2015

  14. www.HealthRight.org www.HealthRight.org.ua www.doctors2children.ru Roman.Yorick@HealthRight.org

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