The Impact of Mentor Mothers on PMTCT Service Outcomes in Nigeria
NCT ID: NCT01936753
Last Updated: 2018-09-18
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
NA
497 participants
INTERVENTIONAL
2014-04-24
2017-11-01
Brief Summary
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Mentor Mothers (MMs) are women living with HIV who provide peer support to other HIV-positive women. MM programs have been incorporated into PMTCT programs in several African countries with some success, but with varying levels of MM training and program structure. The MoMent (MOther MENTor) study investigates whether highly-structured MM programs will further improve uptake and successful completion of PMTCT services (eg testing and appointments) in Nigeria. The study also evaluates the impact of structured MM programs on other outcomes, including facility deliveries, new infant HIV infections, infant survival and maternal viral suppression. Rural areas are the focus of this study because of their particularly poor performance in PMTCT coverage and outcomes.
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Detailed Description
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Mentor Mothers (MM) are women living with HIV who are experienced users and navigators of HIV services, particularly PMTCT. Public health interventions engaging MM to support other HIV-positive women for linkage and retention in PMTCT and treatment services has been tested in South Africa, and has been adopted and applied in several other African countries. Similar MM programs have also been adopted and implemented in Nigeria since 2007; however, objective evaluations of MM impact on PMTCT service uptake and retention have not been performed to date.
While MM and similar peer support interventions have shown some success in other African countries, their implementation between and within countries has not been standardized. Incremental impact may be gained with more structured, objective-specific MM programming and service delivery.
The MoMent (MOther MENTor) is an implementation research study that is evaluating the impact of structured vs routine peer support on PMTCT outcomes in Nigeria, focusing on two North-Central states, the Federal Capital Territory and Nasarawa. The intervention consists of a simple but detailed standardized training curriculum for MMs coupled with daily MM supervision by dedicated personnel as well as standardized, user-friendly tools for both MMs and their supervisors to use for service delivery. These trained MM, along with trained MM Supervisors, form the basis of the Mentor Mother Intervention package. The choice of rural areas served by Primary Healthcare Centers is due to the fact that PMTCT coverage and uptake is lowest in these areas; the study sites are located in hard-to-reach-areas where a significant number of PMTCT-eligible clientele live.
Conditions
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Study Design
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NON_RANDOMIZED
PARALLEL
PREVENTION
NONE
Study Groups
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Mentor Mother Peer Support
This is an enhanced behavioral intervention. Mentor Mothers trained with a standard study curriculum are assigned to pregnant HIV-positive women accessing care at Primary Healthcare Centers in study communities. Under close daily supervision, Mentor Mothers provide support and counseling for the mother-infant pairs until the exposed infant is 12 months old. Study participants in this arm also receive standard of care PMTCT services.
Trained Mentor Mother and Supervisor
Trained, closely supervised Mentor Mothers guide and support the mother-infant pair to achieve timely and complete access to, and retention in PMTCT services along the entire cascade.
Routine Peer Support
Pregnant HIV-positive women receive standard-of-care PMTCT services (drugs, appointments, tests). These women are, per routine, assigned peer counselors who are also HIV-positive women with PMTCT experience but who do receive little or no standardized formal training, and are not closely supervised.
No interventions assigned to this group
Interventions
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Trained Mentor Mother and Supervisor
Trained, closely supervised Mentor Mothers guide and support the mother-infant pair to achieve timely and complete access to, and retention in PMTCT services along the entire cascade.
Eligibility Criteria
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Inclusion Criteria
* 15 years of age and above
Exclusion Criteria
* Presenting in labor
* Does not plan to continue receiving services at study site
15 Years
FEMALE
No
Sponsors
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University of Maryland
OTHER
Federal Ministry of Health, Nigeria
OTHER_GOV
Institute of Human Virology, Nigeria
OTHER
Responsible Party
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Dr. Nadia Sam-Agudu
Senior Techical Advisor, Pediatric and Adolescent HIV
Principal Investigators
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Nadia A Sam-Agudu, MD, CTropMed
Role: PRINCIPAL_INVESTIGATOR
Institute of Human Virology, Nigeria; University of Maryland School of Medicine
Locations
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Nadia Sam-Agudu
Abuja, Federal Capital Territory, Nigeria
Countries
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References
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Sam-Agudu NA, Cornelius LJ, Okundaye JN, Adeyemi OA, Isah HO, Wiwa OM, Adejuyigbe E, Galadanci H, Afe AJ, Jolaoso I, Bassey E, Charurat ME. The impact of mentor mother programs on PMTCT service uptake and retention-in-care at primary health care facilities in Nigeria: a prospective cohort study (MoMent Nigeria). J Acquir Immune Defic Syndr. 2014 Nov 1;67 Suppl 2:S132-8. doi: 10.1097/QAI.0000000000000331.
Cataldo F, Sam-Agudu NA, Phiri S, Shumba B, Cornelius LJ, Foster G. The Roles of Expert Mothers Engaged in Prevention of Mother-to-Child Transmission (PMTCT) Programs: A Commentary on the INSPIRE Studies in Malawi, Nigeria, and Zimbabwe. J Acquir Immune Defic Syndr. 2017 Jun 1;75 Suppl 2:S224-S232. doi: 10.1097/QAI.0000000000001375.
Sam-Agudu NA, Aliyu MH, Adeyemi OA, Oronsaye F, Oyeledun B, Ogidi AG, Ezeanolue EE. Generating evidence for health policy in challenging settings: lessons learned from four prevention of mother-to-child transmission of HIV implementation research studies in Nigeria. Health Res Policy Syst. 2018 Apr 17;16(1):32. doi: 10.1186/s12961-018-0309-x.
Al-Mujtaba M, Cornelius LJ, Galadanci H, Erekaha S, Okundaye JN, Adeyemi OA, Sam-Agudu NA. Evaluating Religious Influences on the Utilization of Maternal Health Services among Muslim and Christian Women in North-Central Nigeria. Biomed Res Int. 2016;2016:3645415. doi: 10.1155/2016/3645415. Epub 2016 Feb 24.
McCarthy E, Joseph J, Foster G, Mangwiro AZ, Mwapasa V, Oyeledun B, Phiri S, Sam-Agudu NA, Essajee S. Modeling the Impact of Retention Interventions on Mother-to-Child Transmission of HIV: Results From INSPIRE Studies in Malawi, Nigeria, and Zimbabwe. J Acquir Immune Defic Syndr. 2017 Jun 1;75 Suppl 2(2):S233-S239. doi: 10.1097/QAI.0000000000001364.
Sam-Agudu NA, Ramadhani HO, Isah C, Erekaha S, Fan-Osuala C, Anaba U, Adejuyigbe EA, Charurat M. The Impact of Structured Mentor Mother Programs on Presentation for Early Infant Diagnosis Testing in Rural North-Central Nigeria: A Prospective Paired Cohort Study. J Acquir Immune Defic Syndr. 2017 Jun 1;75 Suppl 2:S182-S189. doi: 10.1097/QAI.0000000000001345.
Sam-Agudu NA, Ramadhani HO, Isah C, Anaba U, Erekaha S, Fan-Osuala C, Galadanci H, Charurat M. The Impact of Structured Mentor Mother Programs on 6-Month Postpartum Retention and Viral Suppression among HIV-Positive Women in Rural Nigeria: A Prospective Paired Cohort Study. J Acquir Immune Defic Syndr. 2017 Jun 1;75 Suppl 2:S173-S181. doi: 10.1097/QAI.0000000000001346.
Odiachi A, Erekaha S, Cornelius LJ, Isah C, Ramadhani HO, Rapoport L, Sam-Agudu NA. HIV status disclosure to male partners among rural Nigerian women along the prevention of mother-to-child transmission of HIV cascade: a mixed methods study. Reprod Health. 2018 Mar 2;15(1):36. doi: 10.1186/s12978-018-0474-y.
Cornelius LJ, Erekaha SC, Okundaye JN, Sam-Agudu NA. A Socio-Ecological Examination of Treatment Access, Uptake and Adherence Issues Encountered By HIV-Positive Women in Rural North-Central Nigeria. J Evid Inf Soc Work. 2018 Jan-Feb;15(1):38-51. doi: 10.1080/23761407.2017.1397580. Epub 2017 Dec 13.
Sam-Agudu NA, Isah C, Fan-Osuala C, Erekaha S, Ramadhani HO, Anaba U, Adeyemi OA, Manji-Obadiah G, Lee D, Cornelius LJ, Charurat M. Correlates of facility delivery for rural HIV-positive pregnant women enrolled in the MoMent Nigeria prospective cohort study. BMC Pregnancy Childbirth. 2017 Jul 14;17(1):227. doi: 10.1186/s12884-017-1417-2.
Sam-Agudu NA, Odiachi A, Bathnna MJ, Ekwueme CN, Nwanne G, Iwu EN, Cornelius LJ. "They do not see us as one of them": a qualitative exploration of mentor mothers' working relationships with healthcare workers in rural North-Central Nigeria. Hum Resour Health. 2018 Sep 10;16(1):47. doi: 10.1186/s12960-018-0313-9.
Odiachi A, Al-Mujtaba M, Torbunde N, Erekaha S, Afe AJ, Adejuyigbe E, Galadanci HS, Jasper TL, Cornelius LJ, Sam-Agudu NA. Acceptability of mentor mother peer support for women living with HIV in North-Central Nigeria: a qualitative study. BMC Pregnancy Childbirth. 2021 Aug 7;21(1):545. doi: 10.1186/s12884-021-04002-1.
Odiachi A, Sam-Agudu NA, Erekaha S, Isah C, Ramadhani HO, Swomen HE, Charurat M, Cornelius LJ. A mixed-methods assessment of disclosure of HIV status among expert mothers living with HIV in rural Nigeria. PLoS One. 2020 Apr 30;15(4):e0232423. doi: 10.1371/journal.pone.0232423. eCollection 2020.
Other Identifiers
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RPC531
Identifier Type: OTHER_GRANT
Identifier Source: secondary_id
IHVN_WHO_PMTCT_MoMent
Identifier Type: -
Identifier Source: org_study_id
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