Key findings from an evaluation of the mothers2mothers program in KwaZulu-Natal, South Africa

Baek, Carolyn; Mathambo, Vuyiswa; Mkhize, Sibongile; Friedman, Irwin; Apicella, Louis; Rutenberg, Naomi

doi:10.31899/hiv2.1023

Cited by 30 publications

(36 citation statements)

References 5 publications

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“…Our findings are consistent with findings from a survey in South Africa which showed that patients who independently sought HIV testing were more likely to know someone on ARV therapy than those who did not (Mfundisi et al 2005), and are consistent with data from Botswana indicating a rapid increase in testing at VCT centers following the introduction of ARV therapy (Creek et al 2006). South Africa's ''Mothers to Mothers'' is a highly successful model of an approach that takes advantage of this tendency, and has reported high HIV test and PMTCT intervention acceptance in clinics where HIVpositive women teach clients, provide counseling, and dispense drugs for PMTCT (Baek et al 2007). Programs of this type are now beginning in Botswana.…”

Section: Discussionsupporting

confidence: 77%

Factors Associated with Low Early Uptake of a National Program to Prevent Mother to Child Transmission of HIV (PMTCT): Results of a Survey of Mothers and Providers, Botswana, 2003

et al. 2007

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In Francistown, Botswana, approximately 40% of pregnant women are HIV positive. PMTCT has been available since 1999, antiretroviral (ARV) therapy since 2001, and 95% of women have antenatal care (ANC) and deliver in hospital. However, in 2002, only 33% of ANC clients were tested for HIV, and not all women with HIV received services. In 2003, we conducted a survey of 504 pregnant and postpartum women to explore reasons for poor program uptake, and interviewed 82 health providers about PMTCT. Most women (95%) believed that all pregnant women should be tested for HIV. In multivariate analysis, factors associated with having an HIV test included being interviewed at an urban site, having a high PMTCT knowledge score, knowing someone receiving PMTCT or ARV therapy, and having a partner who had been tested for HIV. Neither fear of stigma nor resistance from partners were frequent reasons for refusing an HIV test. Providers of HIV services reported discomfort with their knowledge and skills, and 84% believed HIV testing should be routine. Ensuring adequate knowledge about HIV and PMTCT, creating systems whereby HIV-positive women receiving care can educate and support other women, and making HIV testing routine for pregnant women may improve the uptake of HIV testing.

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Section: Discussionsupporting

confidence: 77%

Factors Associated with Low Early Uptake of a National Program to Prevent Mother to Child Transmission of HIV (PMTCT): Results of a Survey of Mothers and Providers, Botswana, 2003

et al. 2007

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“…Social interventions were defined as any form of social support coming from the male partner, family, peers and community health workers (CHWs). Seven studies examined the effectiveness of peer mentoring interventions as compared to regular/routine PMTCT services [5,6,13,15,16,36,38]. Peer mentoring interventions involved mentor mothers who were also HIV-positive, had had a child recently, had used PMTCT services and were coping positively.…”

Section: Resultsmentioning

confidence: 99%

“…One did not report the timing of interventions [16]. Four of the peer mentoring interventions followed up mother-infant pairs at home and health facilities [13,16,36,38]; one of these studies made phone calls to mothers who had missed their EID appointments [16]. …”

Section: Resultsmentioning

confidence: 99%

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A systematic review of interventions to improve prevention of mother‐to‐child HIV transmission service delivery and promote retention

Ambia

Mandala

2016

Journal of the International AIDS Society

128

115

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IntroductionThe success of prevention of mother-to-child transmission of HIV (PMTCT) is dependent upon high retention of mother-infant pairs within these programmes. This is a systematic review to evaluate the effectiveness of interventions that aim to improve PMTCT service delivery and promote retention throughout the PMTCT steps.MethodsSelected databases were searched for studies published in English (up to September 2015). Outcomes of interest included antiretroviral (ARV) drugs or antiretroviral therapy (ART) initiation among HIV-positive pregnant and/or breastfeeding women and their infants, retention into PMTCT programs, the uptake of early infant diagnosis (EID) of HIV and infant HIV status. Risk ratios and random-effect meta-analysis were used in the analysis.ResultsInterventions assessed in the 34 identified studies included male partner involvement in PMTCT, peer mentoring, the use of community health workers (CHWs), mobile phone-based reminders, conditional cash transfer, training of midwives, integration of PMTCT services and enhanced referral. Five studies (two randomized) that evaluated mobile phone-based interventions showed a statistically significant increase (pooled RR 1.18; 95% CI 1.05 to 1.32, I2=83%) in uptake of EID of HIV at around six weeks postpartum. Male partner involvement in PMTCT was associated with reductions in infant HIV transmission (pooled RR 0.61; 95% CI 0.39 to 0.94, I2=0%) in four studies (one randomized). Four studies (three randomized) that were grounded on psychological interventions reported non-significant results (pooled RR 1.01; 95% CI 0.93 to 1.09, I2=69%) in increasing ARV/ART uptake among HIV-positive pregnant and/or breastfeeding women and infant HIV testing (pooled RR 1.00; 95% CI 0.94 to 1.07, I2=45%). The effect of the other interventions on the effectiveness of improving PMTCT uptake was unclear. Heterogeneity of interventions limits these findings.ConclusionsOur findings indicate that mobile phone-based reminders may increase the uptake of EID of HIV. Studies on male partner involvement in PMTCT reported reductions in infant HIV transmission. Stronger evidence is needed and future studies should determine the long-term effects of these interventions in improving retention throughout the PMTCT steps.

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“…Currently there are large mhealth initiatives focused on PMTCT in South Africa, including the Mobile Alliance for Maternal Action (www.mobilemamaalliance.org) and mothers2mothers (http://www.m2m.org), among others. The content of these initiatives range from mobile phone provision and SMS messages to peer support from ‘Mentor Mothers’ (22, 23). These initiatives have undergone rapid expansion reinforcing the acceptability of mobile-based initiatives, however rigorous evaluations to assess the effectiveness of interventions have been more limited.…”

Section: Discussionmentioning

confidence: 99%

Acceptability and Feasibility of a Mobile Phone-Based Case Management Intervention to Retain Mothers and Infants from an Option B+ Program in Postpartum HIV Care

Schwartz

Clouse

Yende³

et al. 2015

Matern Child Health J

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Objective To assess the acceptability and feasibility of a cell-phone based case manager intervention targeting HIV-infected pregnant women on highly-active antiretroviral therapy (HAART). Methods Pregnant women ≥36 weeks gestation attending antenatal care and receiving HAART through the Option B+ program at a primary care clinic in South Africa were enrolled into a prospective pilot intervention to receive text messages and telephone calls from a case manager through six weeks postpartum. Acceptability and feasibility of the intervention were assessed along with infant HIV testing rates and 10-week and 12-month postpartum maternal retention in care. Retention outcomes were compared to women of similar eligibility receiving care prior to the intervention. Results Fifty women were enrolled into the pilot from May-July 2013. Most (70%) were HAART-naive at time of conception and started HAART during antenatal care. During the intervention, the case manager sent 482 text messages and completed 202 telephone calls, for a median of 10 text messages and 4 calls/woman. Ninety-six percent completed the postpartum interview and 47/48 (98%) endorsed the utility of the intervention. Engagement in 10-week postpartum maternal HIV care was >90% in the pre-intervention (n=50) and intervention (n=50) periods; by 12-months retention fell to 72% and was the same across periods. More infants received HIV-testing by 10-weeks in the intervention period as compared to pre-intervention (90.0% vs. 63.3%, p<0.01). Conclusions Maternal support through a cell-phone based case manager approach was highly acceptable among South African HIV infected women on HAART and feasible, warranting further assessment of effectiveness.

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Key findings from an evaluation of the mothers2mothers program in KwaZulu-Natal, South Africa

Abstract: from the mothers2mothers program for their support on this evaluation, and all of the program staff at mothers2mothers for providing input into project activities. Thanks are also extended to the interviewers and to the many women who were willing to participate in the study.

Cited by 30 publications

References 5 publications

Factors Associated with Low Early Uptake of a National Program to Prevent Mother to Child Transmission of HIV (PMTCT): Results of a Survey of Mothers and Providers, Botswana, 2003

Factors Associated with Low Early Uptake of a National Program to Prevent Mother to Child Transmission of HIV (PMTCT): Results of a Survey of Mothers and Providers, Botswana, 2003

A systematic review of interventions to improve prevention of mother‐to‐child HIV transmission service delivery and promote retention

Acceptability and Feasibility of a Mobile Phone-Based Case Management Intervention to Retain Mothers and Infants from an Option B+ Program in Postpartum HIV Care

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