A dysfunctional tracking system impedes not only the ability to track clients and return them to the continuum of care, but also negatively affects retention strategies. This becomes critical when infants/ children are involved.

When ECEWS assessed Udi District Hospital in 2013 for activation of comprehensive HIV and AIDS response services, it was discovered that there was no functional tracking system. On roll out services, October 2013, the tracking unit was revamped and re-launched. While executing their new mandate, the Udi District Hospital client tracking team alerted the ECEWS LOCATE project team on the discovery of a known PMTCT enrollee, who had delivered a set of twins (Peter & Paul) at home 6 months prior to discovery. At the time of discovery, the client was no longer on ARVs, neither were the twins enrolled for any interventions. Their mother could no longer breastfeed them due to her condition and thus exposing them to whatever food sympathizers could offer. Their mother, Mrs Modesta Ekwe was found to be in a critical situation. She was found to be suffering from puerperal psychosis (after delivery madness). Her husband had abandoned her after the delivery, having witnessed two previous deliveries (twins) and her relapse in this health challenge.  Mrs. Ekwe could not access required medical attention for her condition due to low finances and the family had to resort to a traditional medicine practitioner. Some Igbo speaking Nigerians still hold the pre-colonial notion that giving birth to twins was a ‘bad omen’.

With the help of the community and relatives, the team identified a caregiver – Sister Grace Jesus – for the twins, and reintegrated them into the ART program where they continue to receive comprehensive ART services including:

  • Clinical evaluation: Paul recorded a WHO clinical stage 3 while Peter was stage 1;
  • ART laboratory investigations;
  • TB screening for twins and caregiver;
  • Nutritional assessment, immunization, growth monitoring: Paul weighed 5kg while Peter weighed 6kg and are presently on plumpy nuts (Ready to Use Therapeutic Food- RUTF);
  • Samples for dried blood spot (DBS) collected for twins and the team is currently awaiting the results (expected to be fast-tracked in the Polymerase Chain Reaction -PCR lab);
  • Infant feeding counselling given to the caregiver;
  • A presumptive diagnosis was made for Paul and has been initiated on ARVs pending when the PCR results are retrieved while peter was placed on Nevirapine daily for 6 weeks;
  • Monthly clinic visits prescribed for the twins and mobile alerts for clinic visits initiated for the caregiver.

This what Mrs. Grace Jesus had to say about the intervention:

“….I really thank God for using ECEWS to assist this family and all the other people… I honestly believe, that through ECEWS, the story of Mrs. Modesta will not end in tears, but in joy.”