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close this bookNational Guidelines for the Clinical Management of HIV/AIDS - Tanzania (NACP; 2005; 131 pages)
View the documentLIST OF ABBREVIATIONS
View the documentACKNOWLEDGEMENTS
View the documentFOREWORD
Open this folder and view contentsCHAPTER 1: INTRODUCTION
Open this folder and view contentsCHAPTER 2: ORGANIZATION OF HIV/AIDS CARE AND TREATMENT
Open this folder and view contentsCHAPTER 3: HIV/AIDS PREVENTION
Open this folder and view contentsCHAPTER 4: PROTECTIVE MEASURES AGAINST HIV TRANSMISSION
Open this folder and view contentsCHAPTER 5: LABORATORY TESTS IN HIV/AIDS
close this folderCHAPTER 6: HIV/AIDS AND PREGNANCY
View the document6.1 Introduction
View the document6.2 Mother to Child Transmission of HIV (MTCT)
View the document6.3 Prevention of Mother to Child Transmission of HIV (PMTCT)
close this folder6.4 Antenatal care of women with HIV/AIDS
View the document6.4.1 Care during labour and delivery
View the document6.4.2 Postnatal care of a woman with HIV/AIDS
View the document6.4.3 Follow up for the HIV Exposed Child
View the document6.4.4 Use of prophylactic antiretroviral (ARV) drugs during pregnancy
Open this folder and view contentsCHAPTER 7: PEDIATRIC HIV/AIDS AND RELATED CONDITIONS
Open this folder and view contentsCHAPTER 8: COMMUNITY AND HOME BASED CARE FOR PEOPLE LIVING WITH HIV/AIDS (PLHA)
Open this folder and view contentsCHAPTER 9: COUNSELLING RELATED TO HIV-TESTING AND TREATMENT ADHERENCE
Open this folder and view contentsCHAPTER 10: MANAGEMENT OF COMMON SYMPTOMS AND OPPORTUNISTIC INFECTIONS IN HIV/AIDS
Open this folder and view contentsCHAPTER 11: MANAGEMENT OF MENTAL HEALTH PROBLEMS IN HIV/AIDS
Open this folder and view contentsCHAPTER 12: MANAGEMENT OF HIV INFECTED PATIENTS USING ANTIRETROVIRAL DRUGS
Open this folder and view contentsCHAPTER 13: ARV THERAPY IN INFANTS AND CHILDREN
Open this folder and view contentsCHAPTER 14: USE OF ARVS IN SPECIAL CIRCUMSTANCES
Open this folder and view contentsCHAPTER 15: HIV/AIDS AND NUTRITION
Open this folder and view contentsCHAPTER 16: MANAGEMENT OF ANTIRETROVIRAL MEDICINES
Open this folder and view contentsCHAPTER 17: CERTIFICATION OF HEALTHCARE FACILITIES AS CARE AND TREATMENT SITES
 

6.4.2 Postnatal care of a woman with HIV/AIDS

Stress and adjustment of the postnatal period is likely to be intensified for the woman who is HIV positive, complicated by anxiety about her baby’s health and her own, uncertain about the future and long term well-being and care of her baby.

Elements to be addressed in postnatal care include the following:

Continued care at the MCH clinic for post-partum follow up and close coordination with the CTC staff to address HIV related emotional and clinical issues.

The health worker should be alert of the woman’s sense of isolation, loneliness and guilt and should support or make a referral to a counsellor, social worker or contact with self help group as appropriate

Postnatal examination should specifically be directed towards eliciting signs or symptoms suggestive of physical illness and emotional stress

Gloves should be worn when examining the perineum, caesarean wound, carrying out cord care, changing the babies diaper, or when carrying out invasive procedures such as collection of blood sample

The mother should be encouraged to take care of her baby if the condition allows

Plan for follow up care of mother and baby should be discussed prior to discharge, and the woman should be encouraged to consider the role that might be played by the community health workers for her ongoing care

Decision to inform other care givers of her HIV status should be left to the woman herself and arrangements for information should be discussed with the woman

Information on contraception should be offered before discharge. Some women will not have confided their HIV status to their partners, and this discussion might offer an opportunity to explore this difficult problem. Further formal counselling may assist a woman to find a way of discussing her infection with her partner

Information on any special requirements on child care including early signs of infections in infants

Women need to be fully educated about the symptoms of HIV infection, and encouraged to report to the clinic if she develops fever or any other symptoms/signs

The health worker should encourage the woman to talk about her feeding options and discuss the additional risk of breastfeeding. The decision not to breastfeed may be an additional source of disappointment, which she may want to talk about, along with it being a marker of her infection. For more information on infant feeding counselling, refer to infant feeding counselling section of the MTCT Guidelines, March, 2004.

Access to family planning should be promoted at every clinic visit

Health care workers have an essential contribution to make in coordinating appropriate care and providing accessible source of information and support after delivery. The health worker should plan with the woman for early and regular follow up of at the nearest Care and Treatment Clinic (CTC)

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