This program earned a Platinum award in 2010 and 2006.
Although mother-to-child transmission of HIV/AIDS is almost entirely preventable, it remains a huge problem in South Africa, with overburdened healthcare systems, social stigma, and lack of access to healthcare being the main culprits. In order to create more effective prevention of mother-to-child transmission (PMTCT), Mothers2Mothers (m2m) was established in 2001, with the focus of empowering HIV+ mothers to be involved in the healthcare process, improving the levels of service deliveries to mothers in the future. Women attend healthcare centres where m2m operates and, if they are diagnosed as HIV+, they can join in a training programme to become Mentor Mothers. An intensive two-week training programme follows; and the Mentor Mother is then employed as a full-time staff member of the healthcare team at the healthcare centre that they originally visited. They then serve as peer mentors and educators to HIV+ pregnant women and new mothers for a period of 13 months, allowing a new intake of mothers each year. Each women visiting participating healthcare centres will be paired with a Mentor Mother when she arrives at the centre. Mentor Mothers also facilitate support groups and group meetings for mothers. Community outreach and education programmes are also conducted by Mentor Mothers and Site Coordinators, including home visits where necessary. In areas where women do not have the resources to travel to healthcare centres, Mentor Mothers will travel to them. The m2m progamme is intended to be easily replicable in any healthcare site already providing PMTCT services in South Africa and other African countries. It is therefore easy to implement, as the process includes intensive consultation and coordination with national, provincial and local government health departments, local communities, healthcare centres etc.
Innovation: The programme aims to include HIV+ mothers in the PMTCT programme process, helping them to reduce the stigma they face, and support other mothers in the future.
Effectiveness: There are currently 310 programme sites in seven provinces in South Africa; with a further 227 programmes in six other African countries (Zambia, Malawi, Kenya, Rwanda, Swaziland, Lestho). It is estimated that more than 2m client encounters will take place in 2009, with 300 000 HIV+ pregnant women and new mothers enrolled every month.
Poverty Impact: Almost 1500 HIV+ women are employed by m2m as Site Coordinators and Mentor Mothers. The Mentor Mothers are each employed for 13 months, meaning that new mothers are taken in each year. This means that the spread of information is much more widespread, and has an impact on many more women. By involving the HIV+ women in the process, it also helps to reduce the stigma attached to those with HIV, and allows them to play an active and useful role in healthcare systems.
Sustainability: The programme has received substantial funding from a wide range of international and local funders. Over half is received from the US government (through PEPFAR; USAID; NPI and CDC). A large amount of the remaining half is provided by other private and public NGOs and companies. The current annual budget is roughly $5m; but this is expected to double annually for the next two years, with a further 50% increase in year 3. This is to facilitate the continued expansion of the programme to other areas and countries. Thus far, it does not seem that the funding is likely to lapse anytime in the future. Also, the m2m process has become institutionalized in a number of health departments; and in KwaZulu-Natal, every HIV+ mother attending antenatal care must see an m2m Mentor Mother; and every HIV+ mother delivering in the hospital must see a Mentor Mother before she is discharged. Thus, the progamme is becoming increasingly formalized in government policies, and this improves its chances of sustainability.
Replication: As already noted, the project is intended to be replicable in any healthcare centre currently providing PMTCT services. It has already been replicated to sites across the country, and into other African countries. It is therefore an easily replicable process. However, it is unlikely that a different NGO would be able to implement a similar project, as m2m has become so well established in so many areas. Despite this, training mothers as HIV/AIDS peer educators and mentors is a good way to involve them, and to reduce the incidence of mother-to-child-transmission, and it would therefore be useful for similar projects to be implemented in other areas too.