Acceptability of mentor mother peer support for women living with HIV in North-Central Nigeria: a qualitative study

Abstract

Background Mentor mothers provide psychosocial and other support to pregnant and post-partum women living with HIV (WLHIV), which has been shown to enhance maternal-infant outcomes in the prevention of mother-to-child transmission of HIV (PMTCT). Our objective was to assess the acceptability of mentor mothers as a PMTCT intervention, and to explore opinions on mentor mother program composition and delivery among stakeholders in North-Central Nigeria. Methods We conducted nine focus group discussions and 31 in-depth interviews with 118 participants, including WLHIV, pregnant women, male partners, health workers, traditional birth attendants, community leaders, PMTCT program implementers, and policymakers. Participants were purposively recruited from health facilities and surrounding communities in the Federal Capital Territory and Nasarawa State. Transcripts were manually analysed using a Grounded Theory approach, where theory was derived from the data collected. Results Most participants were female (n = 78, 67%), and married (n = 110, 94%). All participant groups found mentor mothers acceptable as women providing care to pregnant and postpartum women, and as WLHIV supporting other WLHIV. Mentor mothers were uniquely relatable as role models for WLHIV because they were women, living with HIV, and had achieved an HIV-negative status for their HIV-exposed infants. Mentor mothers were recognized as playing major roles in maternal health education, HIV treatment initiation, adherence, and retention, HIV prevention for male partners and infants, and couple HIV disclosure. Most WLHIV preferred to receive mentor mothers’ services at health facilities rather than at home, due to concerns about HIV-related stigma and discrimination through association with mentor mothers. Key mentor mother needs were identified as training, remuneration, and validation as lay health workers. Conclusions Mentor mothers are an acceptable PMTCT intervention among stakeholders in North-Central Nigeria. However, stigma and discrimination for both mentor mothers and their clients remain a critical challenge, and mentor mother needs such as training, pay, and a sustainably supported niche in health systems require focused attention. Trial registration Clinicaltrials.gov registration number (NCT 01936753), registered on September 3, 2013 (retrospectively registered).

Effect of peer-mother interactive programme on prevention of mother-to-child HIV transmission outcomes among pregnant women on anti-retroviral treatment in routine healthcare in Dar es Salaam, Tanzania

“…The motivation for peer support services has been partly driven by challenges of human resource shortages in understaffed overburdened health care systems, and also the demand for counselling, adherence and psychosocial support among women receiving PMTCT care [10,[13][14][15][16][17]. Although there is rich qualitative literature on the engagement of peer-mothers in PMTCT care [14,[18][19][20], the literature remains scarce on quantitative evaluation of the effect of peermothers on PMTCT outcomes, specifically ART adherence and retention, viral suppression and MTCT, in the era of lifelong ART for PMTCT [10][11][12]21]. Furthermore, few available studies indicate mixed results with some highlighting modest benefit and others reporting non-statistically significant effect of peer-mother engagement on PMTCT outcomes [22][23][24].…”

Determinant of service utilization for triple elimination of mother-to-child transmission of HIV, syphilis, and hepatitis B among women living with HIV during COVID-19 pandemic in Indonesia

“…27 Other studies also found that social support from peer support groups and health providers can reduce the impact of stigma and discrimination, which increases the confidence of women living with HIV in accessing PMTCT services. 28,29 Meanwhile, this study found that perceived severity increases the likelihood of women living with HIV accessing the PMTCT for HIV, Syphilis, and Hepatitis B. Women living with HIV will become more likely to access the health services because they are afraid of transmitting diseases to their babies, as well as afraid of the severe health.…”

The prevalence, incidence, and recurrence of intimate partner violence and its association with adverse childhood experiences among pregnant and breastfeeding women living with HIV in Malawi

“…Developing a tool (a short questionnaire) to screen pregnant women for IPV on each ANC visit that captures several forms of violence and creating effective referral structures at the various levels of care can help in this regard. Alongside this tool, should be strategies (for example, promoting inclusion of peer mentor mothers as part of the healthcare workforce 81 , 82 ) to help ensure that the tool is indeed administered among pregnant/breastfeeding women living with HIV given experiences of denial of care and discrimination based on HIV status when these women seek maternal health care. 83 Those reporting IPV can then receive additional care or support.…”