Philani Mentor Mothers Project

The implementation and evaluation of a community based home-visit intervention programme, whereby unemployed mothers are employed and trained as Mentor Mothers to deliver a series of home-visits to all pregnant and new mothers in their neighbourhoods.

Mentor Mothers provide support to pregnant mothers within their communities by rendering visits which take place from pregnancy until the infant is 6 months old. Mentor Mothers are selected based on the principle of positive peer deviants – they are mothers who themselves come from the same adverse circumstances as other mothers in their community, yet they have still managed to raise a healthy child despite their often impoverished circumstances.

Mentor Mother training is an intensive 3 to 4 week course which is composed of theory, group work, discussion, demonstration, counselling skills, and practical case work relating to a diverse range of topics, including but not limited to: the prevention and management of HIV, antenatal and neonatal care; maternal and infant nutrition and feeding; alcohol related behaviour; and child health.

"Mobenzi Researcher facilitates management of fieldworkers as well as high data quality."

The home visits are designed to be both supportive and educational in nature. They are intended to empower pregnant mothers to better protect the health of their families by accessing available clinic services, implementing preventive behaviours in daily life routines, and sustaining preventive behaviours over time.

The study takes place in 24 neighbourhood clusters which are located across two peri-urban settlements on the outskirts of Cape Town. Certain study areas are serviced with basic infrastructure, while in others there are no tarred roads or clinics, the dwellings consist only of corrugated iron and wooden waste materials, and the water and sewage systems are limited to public facilities which are scarce.

The 24 neighbourhoods are stratified into 12 matched pairs of neighbourhood clusters – each pair matched in size, infrastructure and government services. Each pair is randomly divided across intervention and control conditions, resulting in a control group of 12 neighbourhood clusters where pregnant mothers and children simply have access to the standard government clinic services which are available, and an intervention group of 12 neighbourhood clusters where mothers receive the community based home-visit intervention in addition to standard government services.

Mobenzi Researcher Implementation

To evaluate the effectiveness of the home-visit intervention, longitudinal health outcome data is collected by an independent team of researchers who conduct assessments and interviews with all mothers and infants from both intervention and control neighbourhoods.

A baseline assessment is taken of all pregnant mothers during pregnancy, and a follow up assessments made 6 days post birth, and again when the infants are 6 and 18 months old.

While the study invites all childbearing women from the intervention study neighbourhoods to join the intervention programme, the main outcomes of the research will be measured by the degree to which Mentor Mothers are able to improve the health of those mothers who are most at risk to begin with. These mothers are called ‘Mothers at Risk’ (MAR), and are women who are either HIV positive, have TB, use alcohol during pregnancy, or who have given birth to a low birth weight child/children previously or in this pregnancy.

Utilising the Mobenzi Researcher API, a dedicated web management console was developed to assist in the storage of research data, and detailed tracking of interactions of Mentor Mothers with pregnant mothers. Each Mentor Mother is equipped with an entry-level mobile phone. At each visit, a simple survey is completed, where the amount of contact time spent with the mother and topics discussed are captured.

This information is processed by the Philani console to provide real-time information on mothers requiring additional attention and to ensure an accurate assessment of whether the intervention programme is effective can be made once research outcomes are evaluated.

Impact

By allowing Mentor Mothers to capture data in the field and have activity logged, interpreted and graphically displayed, supervisors are able to assess progress at a glance. In addition to interaction tracking, visit schedules are automatically generated for Mentor Mothers and other data collectors.

Critically, the study demonstrates that - should the intervention programme prove to be effective in its objectives - it has the ability to scale. This would not be possible without the use of mobile technology to automate the logistical planning required to facilitate widespread roll-out.