Kano State, Nigeria—While attending antenatal care (ANC) visits at Fagwalawa Cottage Hospital in Kano State, Nigeria, Aishat Yushehu received shocking news—she tested positive for HIV. When the mother of two approached her husband to attend couples counseling at the hospital, he refused. Unknown to Aishat, her husband had been diagnosed with HIV three years earlier and was on medication. This discovery drove a wedge between wife and husband and almost led to their separation.
But Joy Osumune, a Jhpiego-trained HIV counselor, intervened. As the head of the ANC unit at Fagwalawa Cottage Hospital and provider of services to prevent mother-to-child transmission of HIV, Joy was experienced in HIV testing and counseling and trained in couples counseling. She convinced Aishat and her husband to participate in a couples counseling session. “Thank God I had listened to my friend who said I should book for ANC in Fagwalawa Cottage Hospital,” says Aishat. “Joy and Jhpiego have been a God-send to my family.”
Fagwalawa Cottage Hospital serves an average of 7,106 pregnant women every month, according to the recent Kano State rapid health facility assessment survey. Fagwalawa is a commercial town, but despite its population, the nearest health center with HIV services is Danbatta General Hospital, about 80 kilometers away.
In August 2008, Jhpiego, an affiliate of Johns Hopkins University, launched a program to support the Government of Nigeria’s initiative and commitments to scale up the provision of HIV/AIDS services across the country. In 2010, with funding from the U.S. Centers for Disease Control and Prevention (CDC) and in conjunction with the Zamfara-Akwa Ibom HIV/AIDS Program (ZAIHAP), Jhpiego established an HIV testing and counseling program in the cottage hospital. Before this, many women in the area did not know their HIV status, except those who had the chance of being referred to hospitals over 90 minutes away. Between 2008 and today, across 31 public facilities, more than 200,000 women have received ANC and been counseled and tested for HIV using the opt-out approach – testing automatically occurs unless a client declines the service. More than 700 babies were born HIV-free. Of the 1,000 pregnant women who tested positive, 98 percent were provided with antiretroviral prophylaxis across ZAIHAP-supported sites.
Through her ANC visits, Aishat received medication to help prevent transmission of HIV to her unborn child. “I was faithful to my drug in pregnancy because Joy told me it is the only way my child can be healthy,” she recalled.
Aishat gave birth to a healthy baby girl. “I was very happy when the test that was done for my child at one-and-half years old was negative and that reinforced the earlier result done at six weeks that was also negative,” the mother said. “Today, my family and I are living positively and none of our children have been infected.”
As a health professional, Osumune has been adept at educating clients on critical health issues in a society skeptical about seeking institutional care. “For Joy to have been able to work and thrive in this environment and make such an impact over these years is an amazing success story for me,” says Dr. Oniyire Adetiloye, director of the ZAIHAP project.
Osumune measures her success by the health of her clients: “Today Aishat is very healthy, her baby is doing well and the family is united.”