Description: Established in September 2001, Mother2mothers (M2M) (NPO) operates from the Khayelitsha health clinic and is an innovative health care facility-based education and support programme for pregnant women and new mothers living with HIV. The programme exists in partnership with provincial, district and municipal initiatives to support the delivery of antenatal care, HIV testing and ARV treatment in the Western Cape and Mpumalanga. Developed in recognition of the special educational, emotional and economic needs of women recently diagnosed with HIV, M2M addresses the importance of peer-to-peer education and psychosocial support as a key supplement to medical services for the prevention of mother-to-child transmission of HIV (PMTCT). M2M has become an integral part of the comprehensive management of HIV care during and after pregnancy in both health care facilities and communities across the country. M2M does this by training and employing new mothers who themselves benefited from services to become "Mentor Mothers". They provide education and support to other pregnant women and new mothers living with HIV and become an integral element of clinical prevention of PMTCT care, focusing attention towards a mother's broad spectrum of needs - physiological, psychological, emotional, social and spiritual. This is achieved via four sub-programmes; Mother-to-Mothers-to-Be (M2M2B), the core project, is a peer education & empowerment initiative that focuses on preventing mother-to-child transmission of HIV during pregnancy & delivery; M2M extends this concept into the first year after delivery; Mother-to-Community (M2C), takes M2M out of the health care facility into the community where Mentor Mothers can combat stigma, educate families etc; finally, Mothers' Creations (MC) supports the prevention & treatment adherence programmes through economic empowerment & views it as a path to social empowerment. New mothers are trained in producing high quality beadwork and sell its beadwork in the USA.
Innovation: M2M presents an innovative solution to the challenges faced by traditional PMTCT services. First, M2M develops a team of emphatic mentors to advocate for & listen to newly diagnosed women the mentor mothers are consistently available to help navigate complex drug regimens, infant feeding decisions & limited health care infrastructure; all of which they have come tom understand through personal experiences. M2M also takes advantage of PMTCT enrolment as a unique opportunity to involve entire families in long-term health care. The sense of community engendered by M2M groups encourages mothers to return to the clinic, particularly in cases where they have come to distrust the public health infrastructure.
Effectiveness: M2M monitors & keeps records of the number of clients at the 65 sites nationwide. M2M employs 68 full-time staff as administrators and site co-ordinators who earn an estimated R3500 per month. 152 part-time memtor mothers earn R80 per day and are employed on 13 month contracts at the end of the contract they are rotated into other fields of HIV/AIDS care.
Poverty Impact: At its core M2M is about female empowerment, demystifying HIV and employing women. To date, R3 million has been paid to 450 participating beaders. Currently 250 women are employed by MC. Women have purchased their own homes, while one mother has purchased a car to start her own taxi business.
Sustainability: M2M operates an annual budget of R8 million and complies with South African accepted accounting practices. The programme is managed jointly by the Medical, Managing, & International Directors, with a Board of Directors in SA & USA. The provincial programme managers oversee the clusters of sites and manage the activities of facility-based site co-ordinators. Funding is secured for the next three years, with commitments from donors as indicated in the partnership cluster.
Replication: The programme is ongoing and has been replicated in the Eastern Cape, Kwa-Zulu Natal, Northern Cape and Mpumalanga and can be operated wherever there are PMTCT programmes. The model as practised should be replicated across the country.