Tired of Running Around: Health Care Systems that Work for Women

VIENNA, Austria – “I am lucky to have found out about my HIV-positive status before I was pregnant,” said Vuyiseka Dubula, secretary-general of the Treatment Action Campaign (TAC) in South Africa, a well-known AIDS advocacy group.

Vuyiseka learned about her HIV status in 2001 when she was 22 years old. Her experience in navigating the health care system to get the medical care she needed was tough, and she knew it would only get worse when she sought antenatal services.

As a treatment literacy coordinator for TAC, she was well-informed about the need for HIV-positive women to take antiretroviral medication (ARVs) to avoid passing the virus onto their children. She also believed in getting women on treatment early, before they became pregnant, “because a healthy mother equals a healthy child”. Vuyiseka started taking ARVs in 2004 and got pregnant two years later.

Thanks to the treatment, she gave birth to a healthy baby girl who is HIV-negative. But as she visited various doctors during her pregnancy, she realized there was a real need to link HIV and maternal health services.

Vuyiseka experienced first-hand how often women are forced to see separate doctors — to get their medication, to follow-up on their ARV treatment, to monitor their pregnancy, to access maternal and newborn care. She saw how time-consuming and costly it was, particularly in settings where health clinics are scarce and people are forced to travel great distances to access care.

“We lose women in the process,” she explained. “They get tired of going from one doctor to another. Tired of speaking to people who don’t know their treatment regimen. We need to make the system more efficient for the user.”

Half of all adults living with HIV worldwide are women — over 60% in sub-Saharan Africa. The AIDS epidemic is integrally linked to maternal health since the majority of HIV infections are sexually transmitted or associated with pregnancy, childbirth and breastfeeding.

“Women and children stand at the end of the health-care queue,” said Purnima Mane, Deputy Executive Director of UNFPA, the United Nations Population Fund.  " Linking sexual and reproductive health and HIV " makes sense. It saves lives, delivers more health for the money – and it works for women.”

There are enormous benefits of having everything in one facility, she explained, some of which include better uptake of services, better quality of care and better overall utilization of limited health resources.

The Deputy Executive Director shared the podium with Vuyiseka during a press conference at the XVIII International AIDS Conference in Vienna. Also present were Paul De Lay, UNAIDS Deputy Executive Director, and Ann Starrs, President of Family Care International.

The speakers presented the United Nations Secretary-General’s global Joint Action Plan to integrate women’s and children’s health programmes and save the lives of more than 10 million women and children by 2015.

“We know that women want their total health care needs met in one place,” said Purnima Mane. “This is especially important in low income countries, where health facilities and health workers are in short supply.”