mothers2mothers Report: “Improving Client Retention in the PMTCT Cascade through Active Client Follow-Up (ACFU)”

Written by: Emily Puckart, Program Associate, MHTF

 

mothers2mothers (m2m) broadly works to enhance the delivery and success of prevention of mother to child transmission of HIV (PMTCT) services. By employing HIV-positive peer educators, m2m seeks to boost the effectiveness and uptake of PMTCT services by women. However, drop off in participation in PMTCT services prevents women from interacting with an m2m Mentor Mother who can deliver support on a variety of health topics and increase women’s usage of PMTCT services. Focused on reducing the number of women who do not participate in PMTCT services, m2m has explored the idea of Active Client Follow-Up (ACFU) in order to follow up with clients who have stopped participating in key services. During their pilot study, m2m considered a number of ACFU tactics including text messages, home visits, and phone calls to clients.

 

Supported by the Elton John AIDS Foundation and the MHTF, m2m conducted a four-country pilot program focused on exploring scale up and integration of ACFU into m2m settings and activities. Working on pilots in Lesotho, Malawi, Swaziland, and Zambia, m2m focused on determining the “acceptability, feasibility, and effectiveness of different ACFU tactics and approaches.”

 

Organizations interested in methods to integrate mHealth and HIV/AIDS activities into their broader maternal health programs, will likely find m2m’s pilot results useful in planning their own activities. For example, some interesting findings from the pilot project highlighted in m2m’s report include:

  • Cell phones and home visits to follow up clients are relatively inexpensive methodologies to improve client retention in PMTCT, at an average cost of US$0.27 per phone call and US$0.96 per hour spent on home visit. As per m2m’s ACFU guidelines, Mentor Mothers’ spent minimal time on the phone or in the home, focusing purely on the delivering the message that the client should return to the facility because of a missed appointment.
  • ACFU was found to be an effective approach across different types of settings (urban, rural, high volume, low volume), indicating its scalability and adaptability to the diverse settings in which m2m currently work.
  • Clients’ consent and preference for ACFU tactics varied across and within countries, indicating the need for m2m to employ a multi-tactic approach to implementing ACFU. Clients’ preference for different ACFU tactics reflected the varying levels of cell phone access, penetration and ownership3 in the different settings.

To read more about the findings from m2m’s four-country pilot please read their report “Improving Client Retention in the PMTCT Cascade through Active Client Follow-Up (ACFU)