Horizons Projects | Evaluation of Mothers2Mothers in KwaZulu-Natal, South Africa

HORIZONS PROJECT
Evaluation of mothers2mothers in KwaZulu-Natal, South Africa

In order to meet the information and emotional support needs of HIV-infected pregnant and postpartum women and improve utilization of prevention of mother-to-child transmission of HIV (PMTCT) services in South Africa, the mothers2mothers (m2m) program was introduced in the Western Cape in 2001 and is now being rolled out in KwaZulu-Natal. mothers2mothers is an innovative, community-based education, empowerment, and mentoring program for HIV-positive pregnant women and new mothers that aims to enhance public-sector PMTCT programs. The program trains and employs new mothers to become “mentor mothers” who offer psychological, emotional, and social support to other HIV-positive women through one-on-one and support group sessions in antenatal care and maternal and child health care clinical settings. The program focuses on women from pregnancy through the first year of their children’s lives.

While anecdotal evidence suggests that mothers2mothers provides many missing elements lacking from purely medical PMTCT programs, the program had yet to undergo an evaluation to assess its added value in increasing the uptake of PMTCT interventions. Horizons, in partnership with mothers2mothers, Health Systems Trust, and the Elizabeth Glaser Pediatric AIDS Foundation, conducted an evaluation of mothers2mothers activities as they were introduced and rolled out in KwaZulu-Natal.

To evaluate the program’s impact, researchers compared changes in pre- and post-intervention measures of service utilization. Baseline data were collected from a cross-section of women receiving PMTCT services prior to the introduction of mothers2mothers and from a second cross-section of women receiving PMTCT services after the program was in place for approximately one year in three sites in the Pietermaritzburg area of KwaZulu-Natal. The evaluation measured program impact by comparing the pre- and post-intervention groups as well as women who participated in mothers2mothers and women who did not participate.

Key findings include:

m2m achieved substantial coverage at the three evaluation sites with high rates of program participation by both pregnant and postpartum women.
m2m participants had greater knowledge about mother-to-child transmission than non-participants, but most differences were not significant.
Postpartum m2m participants were significantly more likely to have disclosed their status to someone than non-participants, and to have done so prior to delivery.
Postpartum program participants were more likely to report receipt and ingestion of nevirapine, as well as receipt of the infant dose.
Postpartum program participants were more likely to report practicing an exclusive method of feeding, with most feeding their child infant formula without giving breast milk.
Postpartum program participants reported substantially higher rates of having a CD4 test during their last pregnancy and knowing their CD4 count.
Program participants report significantly greater psychosocial well-being than their counterparts on several measures.

Location

Pietermaritzburg, KwaZulu-Natal, South Africa

Duration

July 2006–June 2007

Horizons and Population Council researchers

Carolyn Baek, Naomi Rutenberg

Non-Council collaborators

Irwin Friedman, Sibongile Mkhize (Health Systems Trust)

Mitchell Besser (mothers2mothers)

Elizabeth Glaser Pediatric AIDS Foundation

Donor

US Agency for International Development

Publications/Resources
Horizons and Population Council researchers' names appear in boldface type.

2007
Baek, Carolyn, Vuyiswa Mathambo, Sibongile Mkhize, Irwin Friedman, Louis Apicella, and Naomi Rutenberg. “Key findings from an evaluation of the mothers2mothers program in KwaZulu-Natal, South Africa,” Horizons Final Report. Washington, DC: Population Council. (PDF)

———. "mothers2mothers: Evaluation results show good coverage, and improved PMTCT outcomes of postpartum women who participated in program," poster presented at Scaling Up Through Partnerships: 2007 HIV/AIDS Implementers' Meeting, Kigali, Rwanda, 16–19 June. (PDF)

Khan, Hena. "From mother to mother," Horizons Report, June. Washington, DC: Population Council. (full text)