Health and social outcomes of HIV‐vulnerable and HIV‐positive pregnant and post‐partum adolescents and infants enrolled in a home visiting team programme in Kenya

Abstract

objectives HIV-positive and HIV-vulnerable pregnant adolescent girls and adolescent mothers face significant barriers and vulnerabilities. Infants born to adolescent mothers are also more likely to die and be exposed to life-threatening conditions. This paper presents findings from an evaluation of a programme that used a home visitation model and offered a case-management, team-focused approach to increase family and community supportiveness to enhance health and social service uptake among pregnant adolescent girls and adolescent mothers in Kenya.methods The study used a quasi-experimental design with before and after comparisons among a non-randomised population to examine the effectiveness of bi-monthly household visits to 384 enrolled pregnant adolescent girls, adolescent mothers (ages 10-19) and their infants (0-24 months) between March 2018 and February 2019 in three counties in Kenya.results During the programme, household support increased from 57% to 85%, while 100% of eligible participants were on ART and virally suppressed (total of 20 adolescents). Nearly all pregnant adolescent girls (94%) delivered under skilled care vs. 78% of those who were post-partum at the time of enrolment (P < 0.001); 100% of infants (total of 17 infants) had an up-to-date PCR test with no seroconversions. Uptake of modern family planning increased from 39% at baseline to 64% at end line (P < 0.001). The referral rate declined from 84% to 78% from baseline to end line with low uptake of referrals for mental health services (17.3%).conclusions A team-focused approach of home visits to HIV-vulnerable and HIV-positive pregnant and post-partum adolescent girls and their infants combined with efforts to reduce stigma and increase supportiveness of households and the community can help address critical socio-cultural and behavioural barriers to accessing and using health and social services. keywords pregnancy, post-partum, HIV, adolescents, infants, home visiting Sustainable Development Goals (SDGs): good health and well-being; reduced inequalities; end preventable deaths of newborns and under-fives; gender equality *Contributed equally 640

Diverse policy maker perspectives on the mental health of pregnant and parenting adolescent girls in Kenya: Considerations for comprehensive, adolescent-centered policies and programs

“…Suggestions to enhance the wellbeing of pregnant women included income support, life skills training, maternal mental health care, treatment for harmful substance use, and home visits which were thought to have potential benefits for the children as well. While the study did not focus on pregnant and parenting adolescent girls, the findings align with the perspectives of policymaker informants from this study and with adolescents from our other study arm and other studies in Kenya [ 12 ].…”

Impact of sexual and reproductive health interventions among young people in sub-Saharan Africa: a scoping review

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“…As expected with non-RCTs, most studies 76.9% ( n = 20) included were labelled as moderate risk studies across all domains. Five studies were labelled as serious risk studies across all domains ( 30 , 38 – 41 ) and one study by Fikree and colleagues ( 42 ) was judged to be critical risk of bias study.…”

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