The Philani Project aims to improve the health and wellbeing of vulnerable pregnant mothers and infants from low-income households, through a strategy of home visits by specially trained “mentor mothers”.
The model has been tested in a scientific study implemented in 20 neighbourhoods in Khayelitsha, Cape Town. It has shown that paraprofessional mentor mothers who have been trained to deliver a home-based maternal and child health intervention can improve both maternal and child outcomes over the first 18 months of life.
The intervention of mentor mothers into the lives of mothers-at-risk helps to ensure that they gain access to the most appropriate health services for themselves and their babies, that they reduce or eliminate alcohol consumption during pregnancy, improve nutrition for both themselves and their babies, and prepare more effectively for the baby’s arrival. They also learn about breastfeeding options and a range of effective parenting techniques. Related topics discussed with the mothers-at-risk by the mentor mothers include ensuring safer sexual activity and reproductive health (including HIV testing for themselves and their partners) and caring for their own physical and mental health. Where worrying mental health symptoms are encountered, the mentor mothers initiate the process of referral.
The Philani approach, which builds on the cultural values of the beneficiaries, is simple but effective. Mentor mothers, who are drawn from the neighbourhoods where the programme is implemented, go through a comprehensive training programme that prepares them to visit households where there are pregnant women or mothers of very young children. Once introduced to the household, they engage in conversation with these women and other household members in an informal, interactive and unthreatening way, providing the necessary advice and support in the process.
The Philani project is being conducted against a matrix of extremely serious social problems. These include widespread poverty, poor nutrition, HIV and TB infection, substance abuse, sexual abuse and violence in the home. Alongside the high number of South Africans living with HIV (roughly 30 percent of pregnant women are HIV+), our country also has the highest documented rate of children with foetal alcohol syndrome (in certain areas up to 6-7 percent of children in Grade 1). Many newborn babies and young children die as a result of HIV, TB, alcohol abuse and poor nutrition. Children who are born with a low birth weight are very vulnerable to becoming ill and not developing normally. Currently, as many as six percent of all South African children are likely to die before first grade.
A key impact of the intervention lies in the enhancement of readiness to learn, which is linked to a range of factors in the family and wider social context. Readiness to learn is now understood as an outcome of the child’s entire life course, rather than simply in terms of measurable cognitive functioning or reading potential at age five.
The outcomes of the study have been very positive. Mothers who have received the intervention are less likely to engage in hazardous drinking during pregnancy, and less likely to have a low birth weight infant. They are more likely to breastfeed longer and to breastfeed exclusively for six months. In the case of HIV-infection, they are more likely to adhere to the complete protocol for prevention of mother to child transmission of HIV, and more likely to take their ARV medication both antenatally and postnatally. Their infants are likely to experience fewer episodes of diarrhea and require fewer clinic visits. At 18 months, children whose mothers received the intervention were less likely to be malnourished than those who did not receive the mother mentor programme.
For a PDF of the full article, Click Here.