The Community Health Worker
Care of the Non-Pregnant Woman of Child Bearing Potential (CBP) at Home Encourage Pregnant Women to Attend at the Antenatal Clinic Identify the Pregnant Woman Living with HIV Counsel all Pregnant Women on Good Nutrition and Following a Healthy Lifestyle Prevent Mother to Child Transmission of HIV, Syphilis and TB Promote Safety During Pregnancy and Delivery Postnatal Care for Mother and Baby Care
Care of the Non-Pregnant Woman of Child Bearing Potential (CBP) at Home
Encourage Pregnant Women to Attend at the Antenatal Clinic
Identify the Pregnant Woman Living with HIV
Counsel all Pregnant Women on Good Nutrition and Following a Healthy Lifestyle
Prevent Mother to Child Transmission of HIV, Syphilis and TB
Promote Safety During Pregnancy and Delivery
Postnatal Care for Mother and Baby
Care of the non-pregnant woman of child bearing potential (CBP) at home
- Ask if she is using reliable contraception, and if not, refer to the clinic.
Discuss the advantages of planned parenthood. - Screen all woman of childbearing potential (CBP) for pregnancy.
If she is not on reliable contraception or her period is late, provide/refer her for a pregnancy test. - Encourage all girls, boys, women, and men to test for HIV if they are sexually active.
Offer an HIV test to the woman and her partner if they have not tested in the last year. - Discuss healthy nutrition with the family
Early referral to community based services improves adherence to ART, exclusive breastfeeding and retention in care
Encourage pregnant women to attend at the antenatal clinic
- Identify pregnant woman early.
- Encourage booking at the antenatal clinic before 14 weeks.
- Encourage attendance of all 8 antenatal appointments.
- Track and trace any woman who missed their clinic appointments.
Identify the pregnant woman living with HIV
- Check that she has been offered an HIV test during this pregnancy.
- Encourage partner testing.
- Encourage testing of any other children living in the household if she tests positive for HIV.
Counsel all pregnant women on good nutrition and following a healthy lifestyle
- Discuss infant feeding.
- Follow a healthy diet.
- Avoid tobacco, alcohol, drugs and traditional remedies.
- Wash your hands after using the toilet, before and after preparing food, or after changing a baby’s diaper/nappy.
- Practice safe sex and continue to use condoms.
Prevent vertical transmission of HIV, syphilis and TB
- Provide education on STI’s, HIV, ART and the importance of viral load suppression.
- Encourage adherence to ART and all other treatment provided by the clinic.
- Counsel on the importance of exclusive breastfeeding.
- Screen all woman for TB and STI’s.
Promote safety during pregnancy and delivery
- Educate her and her family on danger signs in pregnancy.
- Educate her on the signs of labour.
- Encourage the mother to deliver in a clinic or hospital.
- Encourage her to plan her mode of transport to the delivery site.
Postnatal care for mother and baby
- Check mother for bleeding, infections, mastitis (see “Universal Measures to Prevent Infections during Pregnancy” ), and depression. Screen the mother for TB.
- Refer mother or baby at any stage if ill, including the jaundiced (yellow-skinned) baby.
- Educate mother on universal infection control practices if either mom or baby are ill (Go to “Universal Measures to Prevent Infections during Pregnancy” ).
- Provide support for exclusive breastfeeding and advise on latching and positioning of baby whilst feeding.
- Educate on hygienic cord care and keeping the baby warm (thermal care).
- Continue to support good adherence to ART, cotrimoxazole (if indicated), and other treatment.
- Make sure that the mother is giving infant NVP (and AZT) correctly (NVP once daily and AZT twice daily).
- Make sure mother and baby attend all postnatal check-ups and immunisation appointments.
- Check that baby is growing well. Refer for an assessment by a clinician if there are any growth concerns.
- Educate mother on contents of RTHB, including infant nutrition and danger signs in infants and children.
South African National Department of Health, Guideline for Vertical Transmission Prevention of Communicable Infections, Version 2_August 2023