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.
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.
- Content Type Journal Article
- Pages 1-17
- DOI 10.1007/s11121-011-0238-1
- Authors
- Mary Jane Rotheram-Borus, University of California, Los Angeles, CA, USA
- Ingrid M. le Roux, Philani Nutrition and Development Project, Cape Town, South Africa
- Mark Tomlinson, Stellenbosch University, Stellenbosch, South Africa
- Nokwanele Mbewu, Philani Nutrition and Development Project, Cape Town, South Africa
- W. Scott Comulada, University of California, Los Angeles, CA, USA
- Karl le Roux, Philani Nutrition and Development Project, Cape Town, South Africa
- Jacqueline Stewart, Philani Nutrition and Development Project, Cape Town, South Africa
- Mary J. O’Connor, University of California, Los Angeles, CA, USA
- Mary Hartley, Philani Nutrition and Development Project, Cape Town, South Africa
- Kate Desmond, University of California, Los Angeles, CA, USA
- Erin Greco, University of California, Los Angeles, CA, USA
- Carol M. Worthman, Department of Anthropology, Emory University, Atlanta, GA, USA
- Faith Idemundia, University of California, Los Angeles, CA, USA
- Dallas Swendeman, University of California, Los Angeles, CA, USA
- Journal Prevention Science
- Online ISSN 1573-6695
- Print ISSN 1389-4986