The Impact of Mentor Mothers on PMTCT Service Outcomes in Nigeria
This trial is active, not recruiting.
|Treatment||trained mentor mother and supervisor|
|Sponsor||Institute of Human Virology, Nigeria|
|Collaborator||University of Maryland, Baltimore County|
|Start date||September 2012|
|End date||August 2016|
|Trial size||492 participants|
|Trial identifier||NCT01936753, IHVN_WHO_PMTCT_MoMent, RPC531|
Nigeria has significant challenges in the delivery and coverage of PMTCT (Prevention of mother-to-child transmission of HIV) services. Only 20 to 30% of pregnant women living with HIV are provided anti-retroviral drugs for PMTCT. Only 4% of HIV-exposed infants receive HIV testing for early diagnosis by age 2 months. Furthermore, an unacceptably high number of women with HIV who are enrolled in PMTCT programs do not complete them. In other words, uptake and retention in PMTCT programs in Nigeria is not adequate. Ultimately, mother-to-child transmission of HIV is high, almost 30%.
The investigators expect that Mentor Mothers (women living with HIV who serve as peer counselors) will help to improve uptake and successful completion of PMTCT services (eg testing and appointments), for reduced MTCT rates. The investigators also expect Mentor Mothers to have a positive effect on other outcomes for mothers and babies in PMTCT programs, for example, general health, breastfeeding rates, facility deliveries, and maternal-infant survival.
|Intervention model||parallel assignment|
Proportion of HIV-exposed infants receiving DNA PCR test by 2 months of age.
time frame: When HIV-exposed infant is between 6 weeks and 2 months old.
Proportion of mothers and exposed infants retained in PMTCT program at 6 months post-delivery.
time frame: From delivery date to 6 months post-delivery
Proportion of mothers ART-adherent pre- and post-delivery
time frame: From study enrollment at ANC clinic to delivery (predelivery) and from time of delivery to 6 months post-delivery
Proportion of infants HIV-positive at initial and 6 months post-delivery.
time frame: At first DNA-PCR by 6-8 weeks of age and at 6 months post-delivery.
Proportion of mothers and exposed infants retained in PMTCT program at 12 months post-delivery.
time frame: From time of delivery to 12 months post-partum.
Female participants at least 15 years old.
Study Participant Inclusion Criteria: - Pregnant and HIV-positive - 15 years of age and above Exclusion Criteria: - Working or ever worked as a Mentor Mother - Presenting in labor
|Official title||The Impact of Mentor Mother Programmes on PMTCT Service Uptake and Retention at Primary Healthcare Facilities in Nigeria|
|Principal investigator||Nadia A Sam-Agudu, MD, CTropMed|
|Description||Nigeria has had a national HIV/AIDS care and treatment program in place since 2003. Included in this national program are preventive sub-programs; the largest of which is the prevention-of-mother-to-child transmission (PMTCT) program. Despite more than 10 yrs of providing PMTCT, Nigeria still has significant problems with uptake of, and retention in these services. These problems translate into only 20 to 30% of HIV-positive pregnant women receiving Anti-Retroviral Drug (ARV) prophylaxis, and the highest number of new child HIV infections in any country in the world. Mentor Mothers (MM) are women living with HIV who are experienced users and navigators of HIV service delivery, particularly PMTCT. The idea to employ these women's experience in bringing other HIV-positive (especially pregnant) women into HIV care and PMTCT services has been tested in South Africa, and has been adopted and applied in several other African countries. MM programs have also been adopted and utilized in Nigeria, especially by the Institute of Human Virology Nigeria (IHVN); however, objective measurements of MM impact on PMTCT service uptake and retention have not been carried out in Nigeria. The investigators are conducting an impact evaluation study of MM in Nigeria, focusing on two North-Central states, the Federal Capital Territory and Nasarawa. This study is dubbed MoMent (Mother Mentor) study.The research team has specifically developed a rigorous, yet trainee-appropriate, standardized training curriculum for MoMent study MM. These trained MM, along with trained MM Supervisors, form the basis of our "Mentor Mother Intervention package". The choice of Primary Healthcare Facilities for this study are due to the fact that they are located in areas where PMTCT coverage and uptake is often lowest; they sites are located in hard-to-reach-areas where a significant number of PMTCT-eligible clientele live. The investigators expect the roll-out of the Mentor Mother Intervention package to improve visibility/acceptability of, access to, and retention in PMTCT services in rural areas.|
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