Postnatal Clinic - A FRESH Start

With funding from the Gift of Hope, the Postnatal Clinic (PNC) at Witkoppen Health and Welfare Centre runs A FRESH Start Program, a fully comprehensive postnatal clinic service to all women and babies for 18 months after birth, maximizing identification and opportunity to treat HIV infection,  and improved long term health outcomes.

Mothers and babies come to the PNC within 7 days after delivery and receive a medical check-up for themselves and their babies. If a mother is HIV positive, the clinician ensures that she is following the protocol to Eliminate Mother-to-Child Transmission (EMTCT, previously known as PMTCT - Prevention of Mother-to-Child Transmission) and is up-to-date with the necessary treatment. After six weeks, the mother returns with her baby and receives follow-up services: a pap smear for the mother and a repeat HIV test if she was previously HIV negative, and immunisations for the baby. Again, EMTCT is provided for HIV positive mothers, and the baby is tested for HIV.  Follow up visits are scheduled at 10 weeks, 14 weeks, 6 months and 9 months.

At each visit the mother is provided with both emotional support and psycho-education. Referrals are routinely made to other services at Witkoppen, such as the Child and Family Mental Health Clinic, Social Services and HIV testing and counselling.

Health workers and counsellors provide health education, which includes information on caring for a baby, caring for oneself and recognising postpartum depression; and a message on EMTCT is given.

The FRESH Start  comprehensive model of the PNC considers both the physical and emotional needs of a mother and her baby.

Fresh Start Programme

Schedule of Services Offered at Post Natal Clinic to Mother and Baby

  • Mothers and babies come to the PNC 0-7 days after delivery and receive a medical check-up for themselves and their babies. If a mother is HIV positive, the clinician ensures that she is following the protocol to Prevent Mother to Child Transmission (PMTCT) and is up-to-date with the necessary treatment.
  • At six weeks postpartum, the mother returns with her baby and receives follow-up services: a pap smear for the mother and a repeat HIV test if she was previously HIV negative, and immunisations for the baby. Again, PMTCT is provided for HIV positive mothers, and the baby is tested for HIV.
  • The third postnatal visit around 10 weeks includes a check-up for the mother, Pap smear results, and immunisations for the baby. The HIV result for the baby is also ready at this time.
  • At around 14 weeks babies receive immunisations as applicable and mothers are retested for HIV.
  • At 6 months HIV-negative mothers and babies are retested for HIV. Babies are given vitamin A and their milestones are checked.
  • At 9 months, 14 months and 18 months, mothers and babies are provided with immunisations and other services as applicable.

VISIT

MOTHER

BABY

By age of baby

HIV TEST

PAP SMEAR

ROUTINE CHECK UP

BREAST FEEDING SUPPORT

PSYCHO-SOCIAL SUPPORT

PARENTING SKILLS

NUTRITION

HIV TEST

IMMUNIZATIONS

ROUTINE CHECK UP

DEVELOPMENTAL MILESTONES

4 – 7 DAYS

 

 

 

 

 

 

6 WEEKS

 

10 WEEKS

 

 

(a)

(b)

14 WEEKS

 

 

 

 

9 MONTHS

 

 

 

14 MONTHS

 

 

 

18 MONTHS

 

 

  • Pap Smear results delivered at the 10 week visit. Patients with abnormal results are referred to the Cervical Cancer Clinic for following up care including free colposcopies and Lletz procedure.
  • The 6 week HIV test result is delivered at the 10 week visit. If the child tests positive, they are referred to the Pediatric HIV Clinic for further care.