The Impact of Mentor Mother Programs on PMTCT Service Uptake and Retention-in-Care at Primary Health Care Facilities in Nigeria

Abstract

A prospective cohort study will compare rates of retention-in-care among PMTCT clients who are supported by formally-trained supervised Mentor Mothers versus clients who receive standard-of-care, informal peer support. Study sites are 20 primary health care centers (10 intervention, 10 control) in rural North-Central Nigeria. The study population is HIV-positive mothers and exposed infant pairs (MIPs) (N = 480; 240 MIPs per study arm). Primary outcome measures are the proportion of exposed infants receiving early HIV testing by age 2 months, and the proportion of MIPs retained in care at 6 months postpartum. Secondary outcome measures examine antiretroviral adherence, 12-month postpartum MIP retention, and MTCT rates. This article presents details of the study design, the structured Mentor Mother programs, and how their impact on PMTCT outcomes will be assessed.

ART attrition and risk factors among Option B+ patients in Haiti: A retrospective cohort study

“…Recently, the MSPP and its technical assistance partners have undertaken several promising initiatives to increase ART retention, including moves toward multi-month prescriptions and “rapid pathway” services for stable ART patients, community-based ART distribution, and active tracing of patients within 1–2 weeks of missed visits [34]. Several strategies for improving ART retention among pregnant women have shown promise in other countries, including promotion of couples testing [35,36], clinic- or community-based peer support [35,37,38,39], case management using community health workers [40], clinic level systems analysis and workflow re-design and other quality improvement approaches [35,41,42,43]. Targeted retention support initiatives for pregnant and post-partum women, especially younger women, need to be systematically tested in Haiti to reveal which innovations are most effective and cost-effective to optimize Option B+.…”

Correlates of facility delivery for rural HIV-positive pregnant women enrolled in the MoMent Nigeria prospective cohort study

“…The structured MM intervention consisted of intensive baseline training, a detailed scope of work, close mentoring and supervision by a designated Mentor Mother supervisor, a standardized logbook for documentation of field activities, and periodic performance evaluations [10]. Due to PMTCT programmatic requirements for trained peer counselors at some eligible sites, the study could not be randomized.…”

“…The MoMent ( Mo ther Ment or) Nigeria study evaluated the impact of structured peer support on EID uptake and maternal PMTCT retention [10]. Mentor Mothers (MMs) are HIV-positive, PMTCT-experienced women who counsel less-experienced peers for optimal PMTCT outcomes [11].…”

Active tracking of rejected dried blood samples in a large program in Nigeria

“…PMTCT programs can reduce the risk of MTCT to less than 2%, and is today the most efficacious tool for preventing pediatric HIV infection globally [2][3][4][5] . PMTCT programs have witnessed appreciable success in Nigeria with documented MTCT rates ranging from 1.3%-4.8% in mother-baby pairs who received antiretroviral therapy (ART), compared to MTCT rates ranging from 39.8%-68.0% where no intervention was administered [6][7][8][9] .…”