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The MoMent (Mentor Mother) Study


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Background

The MoMent Study has the official title, "The Impact of Mentor Mother Programs on PMTCT Service Uptake and Retention at Primary Health Care Facilities in Nigeria." It is a four year study (2012-2016).

Mentor Mothers (MM) are HIV positive women who have given birth to children without HIV due to access to Prevention of Mother-to-child transmission of HIV (PMTCT) services. They are trained to provide psychosocial and other support to women and mothers living with HIV.

This study is funded by the Canadian International Development Agency (CIDA) and the World Health Organization (WHO) through the INSPIRE grant MoMent evaluates the impact of mentor mother son access to and retention of PMTCT services in Primary Health Care Centers (PHCs). The study is being conducted at PHCs in North Central Nigeria (Federal Capital Territory and Nasarawa State). IHVN has partnered with the Clinton Health Access Initiative (CHAI) in Nigeria to implement the study.

Nigeria contributes a significant percentage to the global PMTCT gap. Of the estimated 220 to 250,000 HIV+ pregnant Nigerian women delivering every year, only 10-20% receive appropriate PMTCT services. The small numbers of womenthat access PMTCT services also have challenges in staying in the PMTCT program (poor retention). Nigeria therefore needs efficient, cost-effective and sustainable interventions with which to scale up her PMTCT service access and delivery.

According to the World Health Organization (WHO), comprehensive PMTCT services should include the following:

  • Primary prevention of HIV infection in women of reproductive age, and their partners;
  • Prevention of unintended pregnancies among HIV positive women
  • Prevention of HIV transmission from infected women to their infants
  • Provision of treatment, care and support to infected women, their infants and families

It is to this end that IHVN has engaged and trained mentor mothers (MM) since 2009; basing its program on the South African M2M model. As at September 2013, IHVN has almost 400 MM working with HIV+ mothers and their children at primary, secondary and tertiary-level healthcare facilities across Nigeria.

The objectives are:

  1. Optimize, implement, and evaluate a training curriculum for Mentor Mothers
  2. Assess MM service acceptability among PMTCT stakeholders from hard-to-reach communities, and
  3. Measure the impact of MM onprevention of mother to child transmission outcomes for the HIV+ mother-exposed infant pair (MIP). Specifically, we will evaluate the impact of MM on early infant diagnosis uptake, drug adherence, and PMTCT service retention for the MIP.

MoMent MM Training Curriculum and Program

The MoMent team, including our CHAI partners, developed an Mentor Mother training curriculum and program, in order to standardize and optimize the services provided by MMs to their clients. The MM curriculum is an updated, yet simplified combination of both IHVN and CHAI training slides. The program is a rigorous one, highly structured and supervised by IHVN and site staff.

MoMent Formative/Qualitative Studies

Focus Group Discussions (FGDs) and Key Informant Interviews (KIIs) were conducted among PMTCT users and providers, including pregnant and non-pregnant HIV+ women, government officials, and personnel working for implementing partner NGOs.

MoMent Prospective Cohort Study

The second aspect of the study is a prospective cohort design. This aspect compares PMTCT outcomes for study mother-exposed infant pair according to Objective 3 above, at intervention (MM) sites versus control sites (providing standard of care PMTCT support services without trained MM).

imagesIn brief,, the study seeks to evaluate the impact, if any, of mentor mothers on access, drug adherence, timeliness of testing, and retention in the PMTCT service cascade as well as to quantify where in the cascade mentor mothers have the greatest and least impact. Study findings can drive PMTCT policy changes regarding nation-wide engagement of MMs and exactly where to engage them within the PMTCT service cascade.

For further detailed study updates, check http://clinicaltrials.gov/ and search for "MoMent Nigeria."

- Principal Investigator: Dr. Nadia Sam-Agudu
- IHVN/UMB Co-Investigators: Dr. HarounIsah, Dr. Manhattan Charurat, Prof. Llewellyn Cornelius, Dr. Joshua Okundaye
- Project Coordinator: Dr. Olusegun Adeyemi

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:: Support and Funding

The Institute of Human Virology, Nigeria AITRP Training Programmes are supported and funded by the Fogarty International Center.
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