The following post is the first in a series of progress updates from MHTF-supported projects currently underway around the world.
mothers2mothers (m2m) strives to enhance the delivery and effectiveness of Prevention-of-Mother-to-Child-Transmission of HIV (PMTCT) services. m2m is currently working in nine countries across sub-Saharan Africa by training, employing and empowering HIV-positive mothers as Mentor Mothers who provide education and psychosocial support to similarly affected HIV-positive pregnant women and new mothers. Mentor Mothers work alongside doctors and nurses at public health facilities as integrated members of the health care team, providing critical and complementary support to clinical PMTCT services.
However, client drop-off throughout the PMTCT care cascade undermines effective uptake of and adherence to key PMTCT and maternal and infant follow-up services. With support from the MHTF, m2m is exploring the concept of Active Client Follow-Up (ACFU), an intervention designed to follow up m2m clients who have defaulted on key PMTCT services, encouraging them to return to, and remain in, care. In 2009, m2m carried out initial ACFU activities in South Africa and Kenya. The MHTF project intends to build on m2m’s early efforts, by implementing telephonic ACFU pilots in 2 additional countries in which m2m is currently operational. It is hoped that the results and learning from these activities will inform m2m’s potential to scale-up this promising intervention and integrate it into routine m2m programming.
The key objectives of the project include:
- consolidating ACFU knowledge and refining the telephonic approach;
- testing the feasibility of telephonic ACFU in targeted m2m locations (Malawi and Zambia); and
- introducing and integrating telephonic ACFU approaches in multiple m2m countries.
Here is a brief update from m2m on the progress of the project:
Initial findings from ACFU in East London, South Africa and Nairobi, Kenya suggest that the use of mobile phone text messages and calls is an effective, feasible, and acceptable intervention in influencing client retention and uptake of mother and infant health services. Desk research also suggests that ACFU is a practicable intervention for clients who have defaulted from PMTCT services. Based on these findings and to further test assumptions, m2m has been preparing for the implementation of 2 telephonic ACFU pilots in a selection of sites in Malawi and Zambia. This has involved the development of ACFU guidelines, tools, training approaches and materials. The pilots themselves will help m2m to refine these tools further, inform country-specific feasibility of ACFU, as well as inform future ACFU activity and potential integration into m2m programming – all with the aim of enhancing the effectiveness of PMTCT and m2m programme services in the future.