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Philani Plus (+): A Mentor Mother Community Health Worker Home Visiting Program to Improve Maternal and Infants’ Outcomes

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Abstract

Pregnant mothers in South African townships face multiple health risks for themselves and their babies. Existing clinic-based services face barriers to access, utilization, and human resource capacities. Home visiting by community health workers (CHW) can mitigate such barriers. The Philani Plus (+) Intervention Program builds upon the original Philani CHW home-visiting intervention program for maternal and child nutrition by integrating content and activities to address HIV, alcohol, and mental health. Pregnant Mothers at Risk (MAR) for HIV, alcohol, and/or nutrition problems in 24 neighborhoods in townships in Cape Town, South Africa (n = 1,239) were randomly assigned by neighborhood to an intervention (Philani Plus (+), N = 12 neighborhoods; n = 645 MAR) or a standard-care control condition of neighborhood clinic-based services (N = 12 neighborhoods; n = 594 MAR). Positive peer deviant “Mentor Mother” CHWs are recruited from the township neighborhoods and trained to deliver four antenatal and four postnatal home visits that address HIV, alcohol, nutrition, depression, health care regimens for the family, caretaking and bonding, and securing government-provided child grants. The MAR and their babies are being monitored during pregnancy, 1 week post-birth, and 6 and 18 months later. Among the 1,239 MAR recruited: 26% were HIV-positive; 27% used alcohol during pregnancy; 17% previously had low-birthweight babies; 23% had at least one chronic condition (10% hypertension, 5% asthma, 2% diabetes); 93% had recent sexual partners with 10% known to be HIV+; and 17% had clinically significant prenatal depression and 42% had borderline depression. This paper presents the intervention protocol and baseline sample characteristics for the “Philani Plus (+)” CHW home-visiting intervention trial.

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Notes

  1. The word “deviant” is in a positive direction from the norm of the township mothers. The theory utilized is labeled the “Theory of Positive Peer Deviants.”

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Authors and Affiliations

  1. University of California, Los Angeles, CA, USA

    Mary Jane Rotheram-Borus, W. Scott Comulada, Mary J. O’Connor, Kate Desmond, Erin Greco, Faith Idemundia & Dallas Swendeman

  2. Philani Nutrition and Development Project, Cape Town, South Africa

    Ingrid M. le Roux, Nokwanele Mbewu, Karl le Roux, Jacqueline Stewart & Mary Hartley

  3. Stellenbosch University, Stellenbosch, South Africa

    Mark Tomlinson

  4. Department of Anthropology, Emory University, Atlanta, GA, USA

    Carol M. Worthman

  5. Center for Community Health, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA, 90024-6521, USA

    Mary Jane Rotheram-Borus

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  1. Mary Jane Rotheram-Borus
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Correspondence to Mary Jane Rotheram-Borus.

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Thank you to the mothers and others who are participating in this work and make this research possible. This study was funded by the National Institute on Alcohol Abuse and Alcoholism (1R01AA017104). ClinicalTrials.gov registration # NCT00972699.

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Rotheram-Borus, M.J., le Roux, I.M., Tomlinson, M. et al. Philani Plus (+): A Mentor Mother Community Health Worker Home Visiting Program to Improve Maternal and Infants’ Outcomes. Prev Sci 12, 372–388 (2011). https://doi.org/10.1007/s11121-011-0238-1

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