Mothers & Babies: Enable
Working in rural communities across OR Tambo District in the Eastern Cape, our Mentor Mothers have provided care, information and advice to over 1000 women and supported them to have healthy pregnancies.
Access to health care in rural settings in South Africa is difficult in the best of times. When heavily pregnant, a two-hour walk to a clinic in the searing heat or blinding rain is difficult and dangerous. Mentor Mothers are recruited directly from within the community they serve, and come to the programme with lived experience and coping mechanisms that books cannot teach. They undergo an intensive 6-week training course with our partners Philani, and are supported in the field by a dedicated team of supervisors, nurses and experienced Mentor Mothers.
Mentor Mothers visit women through the duration of their pregnancy, carefully explaining the importance of HIV-testing, what danger signs to look out for, and how to prepare for exclusive breastfeeding. They then continue to visit the women and their babies to ensure that they have the post-natal support they need.
Children in the community are weighed on an ongoing basis. If a child is underweight for their age, our Mentor Mothers work with the family to determine underlying causes (e.g. illness, poor nutritional practices, lack of access to social grants) and to help address those. They also support some home-based care cases of adults who have serious illnesses or disabilities.
Major Achievements To Date
Mothers-to-be, babies and children directly cared for by Mentor Mothers
Members of the community benefited from health and awareness raising sessions, of which 18,453 are children
Percentage of babies born in the programme who tested positive for HIV
The Enable solution is simple: integrated, door-to-door, health interventions by trained Mentor Mothers, providing access and referrals to clinics and hospitals.
In South Africa, half of child deaths occur within the first month of life and 24% of pregnant mothers are HIV positive.
The Enable project targets the most vulnerable – expectant mothers and children up to the age of five – through door to door visits. One to One Children’s Fund empowers local women, many of them HIV positive, equipping them with skills and knowledge to carry basic health checks.
They arrange regular visits to monitor their health, provide support and advice and, if further medical care or drugs are required, refer them on to a clinic. Where needed, they can help with transport.
To date, our Mentor Mothers have accumulated a caseload of over 2000 clients, and a further 36,905 members of the community receive health and awareness-raising sessions, addressing issues such as family planning, HIV and treatment adherence, and child and maternal health.
In addition, 3,340 children have been weighed and are monitored until the age of 6. The stand-out achievement of the project so far has been an almost 0% mother-to-child transmission of HIV rate after more than 500 births, despite the fact that nearly 24% of the mothers we work with are HIV+.
Case study by Miranda Prynne
MENTOR MOTHERS ZANELE AND VUYOKAZI
We joined Mentor Mothers Zanele and Vuyokazi on a visit.
The mother is nine-months pregnant, due any day, and is complaining of swelling in her legs and pain in her hips. She is 35 years old but looks a lot older. She is weighed, her blood pressure checked, she talks to Zanele and Vuyokazi as they update her files. She has their mobile numbers to ring if she needs any help. They advise her to ring the clinic if the pain in her hip gets worse and she must arrange to go to the clinic the moment she goes into labour. They hand her a sealed package containing antiseptic and wipes to clean the umbilical cord, just in case.
The advice from the Mentor Mothers is simple enough – breastfeed your babies, feed your children a varied diet with fruit and vegetables when possible, ensure your children are immunised, if you carry HIV, do not stop taking your antiretrovirals, ever.
Until meeting the Mentor Mothers, this expectant mother had no birth papers. As far as the South African government was concerned, she did not exist. This would have meant she could not register the birth of her new baby and apply for the child support grants she dearly needs.
The Mentor Mothers help with the paperwork. They help local women navigate the bureaucracy necessary to access government support. They provide the vital missing link between the government services and the Xhosa villagers.
Other members of our group met entire families whose livelihood had been saved from disaster by the early diagnosis and intervention of the Mentor Mothers. One party ended up making an emergency dash to the hospital after arriving to find a mother in labour.
The simplicity of the Enable model is its secret. This is no glamorous vanity project. It is a practical, low-cost solution to a problem. A solution that, with the right backing, could be applied on a much wider scale through government community health workers to improve the wellbeing of millions of young children and mothers.”
The simplicity of the Enable model is its secret. This is no glamorous vanity project. It is a practical, low-cost solution to a problem.
We are always looking for ways they can help mothers and children in the communities we work in to live their healthiest lives. Here are some exciting developments planned for the year ahead that will allow us to reach more people more effectively.
Innovation needs to be at the forefront our our work if we want to keep ahead of the curve. We are working with Dimagi to develop an mHealth app that will allow our Mentor Mothers to capture data in real time and have access to additional support and training materials.
WORKING WITH COMMUNITY HEALTH WORKERS
We have developed a partnership with the Department of Health to train Community Health Workers in 9 clinics across OR Tambo District. The CHWs will receive training, equipment, support and supervision from our experienced team. Partnering with government allows us to work within the health system, and not just alongside it.
We couldn’t do what we do without our incredible Mentor Mothers. In supporting their communities to live healthy lives, we also need to recognize that this can also take a toll on front-line health workers, who become sounding boards, shoulders to cry on, and people to confide in. We are partnering with Stellenbosch University and the Perinatal Mental Health Project to provide our Mentor Mothers with a validated self-care programme, tailored for the context that we are working in.