SUAD0207 | REIMAGINING HEALTH WORKFORCE STRATEGIES: SHOULD WE INTEGRATE TRADITIONAL BIRTH ATTENDANTS TO BOOST PREVENTION OF MOTHER-TO-CHILD TRANSMISSION UPTAKE? WHAT WE LEARNT IN KANO, NIGERIA

Husna Baffa, Adakole Okoh, Micheal Sheshi, Usman Bashir, Bethtrand Odume, Mustapha Tukur | Kncv Nigeria, Kano, Nigeria

In Nigeria, the prevention of mother-to-child transmission (PMTCT) of HIV remains a public health priority, yet service uptake is limited, particularly in rural and underserved areas. Research indicates that traditional birth attendants (TBAs) facilitate more than 60% of deliveries in certain regions of Nigeria, establishing them as crucial community health influencers. However, their exclusion from formal health systems creates a gap in reaching HIV-positive pregnant women. Training and linkage systems that integrate TBAs into PMTCT strategies have demonstrated an improvement in early HIV testing and ART uptake. In Kano State, this approach is reimagining community-level health workforce engagement to improve PMTCT outcomes and bridge equity gaps. In August 2024, KNCV trained 168 traditional birth attendants across 44 LGAs in Kano to screen and test pregnant women not attending ANC. Each TBA’s home was mapped to a comprehensive site as a hub with the TBAs home serving as a spoke. Community volunteers were also trained to supervise and collate data from TBA homes and upload them on the National Data Reporting system (NDARS). Additionally, mentor mothers linked with these TBAs facilitate the referral of the positive pregnant women and enrollment in treatment, following them up to 18 months postpartum. We analyzed performance results prior to the training and after the training to assess the impact of training the TBAs. Between April and September 2024 only 1343 pregnant women were tested for HIV, with 3 positives identified and referred for care, 981 of the pregnant women were tested for syphilis, with 23 testing positive and referred for treatment. Following the training of the TBAs, we saw a significant increase between Oct. and March 2025 in the number of pregnant women tested, rising to 56,067, and the number of pregnant women testing positive rose to 99 with all referred for care. The results have shown that training and integrating TBAs into PMTCT strategies not only boosts uptake of services but completely changes the landscape, providing better access and bridging equity gaps among the pregnant women, we recommend further strengthening of the TBA referral and linkage mechanism to ensure further reach aimed at eliminating mother-to-child transmission of HIV.