Enhanced Mentor Mother Strategy for Pregnant and Postpartum Women Living With HIV
Pilot Implementation-Effectiveness Study of an Enhanced Mentor Mother Strategy
Indiana University
200 participants
Jul 10, 2025
INTERVENTIONAL
Conditions
Summary
Mentor Mothers (MMs) are peer supporters who help pregnant and postpartum women living with HIV (WLHIV) as they receive prevention of mother-to-child transmission of HIV (PMTCT) services in resource-limited settings like Kenya. Differentiated service delivery (DSD) is a care model that tailors services based on clients' needs, helping to improve both the quality and efficiency of care. This hybrid implementation-effectiveness study will test whether an enhanced MM strategy that uses DSD can be successfully carried out and improve health outcomes for mothers and infants. The study will take place at Burnt Forest Sub-District Hospital (BFSDH) in Kenya. Researchers will ask: * Can the enhanced MM strategy be delivered as planned and accepted by patients and staff? * Does the strategy improve clinical outcomes like keeping mothers in PMTCT care, achieving HIV viral suppression, completing infant HIV testing, and preventing HIV transmission to infants? Researchers will compare health outcomes before and after the strategy is introduced at BFSDH, and also compare outcomes at other similar clinics that continue with standard MM services. Women who choose to participate will meet with a MM during their routine antenatal and postnatal clinic visits. They will be offered the enhanced MM support, but can choose to receive standard care if they prefer.
Eligibility
Inclusion Criteria4
- Pregnant and postpartum women living with HIV (and their infants born during the study)
- ≥18 years of age
- Enrolled in PMTCT services at BFSDH
- Able to understand and provide informed consent in English or Kiswahili
Exclusion Criteria5
- Women who are not pregnant or postpartum
- \<18 years of age
- Not enrolled in PMTCT services at BFSDH
- Unable to understand and provide informed consent in English or Kiswahili
- Cognitive impairment that would interfere with ability to participate in the study
Interventions
The enhanced Mentor Mother strategy introduces a structured approach to differentiated PMTCT support, led by trained peer counselors/Mentor Mothers (MM). Mentor Mothers will be trained on how to perform risk stratification, and they will use a standardized form to identify and document psychosocial and clinical risk factors. Based on these, MMs then deliver tailored interventions, including additional counseling, community outreach, and referrals. Fidelity assessments and a process of audit and feedback will be used to further refine the strategy, which builds on national differentiated service delivery guidelines and integrates into routine care without requiring added clinic staff.
Locations(1)
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NCT06999928