Impact of AIDS on material and child health

ECONOMIC COMMISSION FOR AFRICA

Second meeting of the Preparatory Committee of the third African Population Conference

Dakar, Senegal 1-3 June 1992

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THE IMPACT OF'AIDS ON MATERNAL ANX> CHILD HEALTH "" :

In Africa, HIV infection is principally transmitted through heterosexual contact.

Transmission trough the other routes - blood, skin piercing instruments and from mother to child, accounts for less than 5 to 10 percent of all infection in sub-saharan Africa.

Epidemiological data shows an even distribution of HIV infections/AID among males and females, although in certain situations, higher prevalences have been observed in one sex more that the other. This may be an indication of the group through which the infection first entered the community. It may also be an indication of the recent entry of the infection into the community. (Figures 1 to 4).

The high HIV infection rates among women of childbearing age is responsible for the high prevalence rates of HIV infection in infants. The virus can be transmitted to the unborn child, during birth and postnatally, (Figures 5 and 6). About one-third of babies born worldwide to HIV infected mothers become infected themselves. WHO has recently confirmed that some of the mother-to-child transmission occurs through breast-feeding. Transmission of HIV through breast milk is more likely to occur in recently infected wome in whom there is a high concentration of virus in circulation. However, as breast-feeding is a crucial element of child survival, a baby's isk of dying of AIDS through breast-feeding must be balanced against its risk of dying of other causes if not breast-fed. At a recent WHO/UNICEF consultation meeting held in Geneva on HIV transmission and breast-feeding it was recommended that the breast-feeding of babies should be promoted and supported in all populations, irrespective of HIV infection

rates.

Mortality from AIDS, can occur at any time between fiv& to ten years or more from the time the HIV infection was acquired. Maternal mortality is on the average 100 times higher in developing countries than in the industrialized world. The impact of AIDS has resulted in the worsening of; the high maternal mortality. Similarly there has been a significant rise in infant mortality in areas with high prevalence of HIV infection. Figure 7 shows the projected child mortally rates in Africa with and without AIDS. High maternal mortality also results in higher

mortality among orphaned infants and young children due to the absence of maternal care.

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Orphanhood, in the African context, is often described as the loss of one's mother.

Projections indicate that the demographic impact of HIV infection and AIDS in sub- saharan Africa will result in the slowing down of the rate of population growth. It has also been estimated that the life expectancy at birth, which could have reached 62 years by the year 2010, will fall to 48 years as a result of the AIDS epidemic, (Figure 8). >

The adverse effects of HIV/AIDS on women and children, can be reduced by the prevention of transmission through education, the promotion of the use of condoms and the provision of alternative employment opportunities for women and girls, in order to wean them away from prostitution and commercial sex work. In the long term, governments will have to adopt policies that will enhance the status of women in the society, provide more opportunities for education, technical, vocational and professional training as well as create equal opportunities for men and women in all aspects of development.

Prominence should be given to AIDS prevention and control activities targeted to women in the overall AIDS prevention and control strategy adopted by governments. In addition efforts should be made to reduce the social and personal impact of HIV/AIDS on the individual and communities, and to mobilize communities, national and international support to combat the epidemic until it is brought under control.

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