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Lack Of Antenatal Screening Scandalous

9 November 2007

Lack Of Antenatal Screening Scandalous

Antenatal screening for HIV for pregnant women to save their babies and extend maternal life expectancy should be available from every district health board in New Zealand as a matter of course says New Zealand First’s health spokesperson Barbara Stewart.

“In 2004 Waikato Hospital infectious diseases physician Graham Mills called on the then Minister of Health to fast-track a policy offering pregnant women an HIV test. This was after five children were infected with HIV at birth in 2003 and three more had been diagnosed by October 2004.

“Four babies were born in 2005 with the HIV virus because their mothers did not know they were HIV positive. In March 2006 the Waikato DHB became the first district health board to routinely offer HIV screening.

“A year long pilot study in the Waikato screened about 9000 pregnant women for HIV and found two. The test for HIV is estimated to cost $9 and the direct medical cost of caring for an HIV infected child is around $250,000.

“Nine district health boards will be offering antenatal HIV screening by next June. Several more are considering it. All well and good if you happen to be pregnant in the area of one of the more enlightened DHBs but what about the rest of the country?

“The attached answer to a written question from 2006 demonstrates the delays caused by our ponderous health system but it is still unbelievable that a first world country with a relatively small population cannot routinely screen pregnant women for diseases such as HIV, syphilis and chlamydia which put them and their babies at avoidable risk,” said Mrs Stewart.


Question: Does he consider it satisfactory that it will take three years for HIV screening to become available for pregnant women throughout the country; if so, why?

Portfolio: Health

Minister: Hon Pete Hodgson

Date Lodged:24/03/2006

Answer Text: Antenatal HIV screening is already available in New Zealand. Current antenatal HIV screening policy in New Zealand, developed in 1997, recommends the assessment of all pregnant women for their risks of HIV. The policy stipulates that where risk factors are identified, or are not clear, counselling and voluntary testing should be offered.

While the Ministry of Health has announced the staged implementation of a programme requiring the universal offer of antenatal HIV screening, the risk assessment approach to antenatal HIV screening remains the policy in district health board (DHB) areas that have not yet implemented the universal offer programme.

The Ministry’s National Screening Unit (NSU) is working with DHBs to
implement the universal offer antenatal screening programme nationally.
The NSU is managing the national aspects of the programme, including the development a national monitoring and evaluation plan, national guidelines for health professionals, and national consumer information resources. The NSU’s work is supported by the National Antenatal HIV Screening Implementation Advisory Group (NAHSIAG).

The NAHSIAG developed preliminary criteria it recommended DHBs should meet before commencing screening. These include the ability to:

- implement standardised laboratory testing forms
- meet national requirements for information provision to women and for obtaining informed consent
- collect, monitor and provide required data for local and national
programme monitoring, implementation of agreed national testing and result confirmation algorithms
- ensure appropriate management, follow-up and support for positive women and babies, including support by local practitioners and stakeholders, and consideration of privacy, immigration, insurance and other key issues.

The programme may be implemented nationally in a shorter timeframe if DHBs meet these criteria earlier.

Attachment: None

Date Received:02/04/2006


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