Thirty-Six-Month Outcomes of a Generalist Paraprofessional Perinatal Home Visiting Intervention in South Africa on Maternal Health and Child Health and Development

• Type of Material: Article
• Authors: Mark Tomlinson, Stellenbosch University; Mary Jane Rotheram-Borus, University of California at Los Angeles; Ingrid M. le Roux, Child Health and Nutrition Trust; Maryann Youssef, University of California at Los Angeles; Sandahl H. Nelson, University of California at Los Angeles; Aaron Scheffler, University of California at Los Angeles; Robert E. Weiss, University of California at Los Angeles; Mary O’Connor, University of California at Los Angeles; Carol Worthman, Emory University
• Language: English
• Date: 2016-11
• Publisher: Springer Verlag (Germany)
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © Society for Prevention Research 2016
• Final Published Version (URL): http://dx.doi.org/10.1007/s11121-016-0676-x
• Title of Journal or Parent Work: Prevention Science
• ISSN: 1389-4986
• Volume: 17
• Issue: 8
• Start Page: 937
• End Page: 948
• Grant/Funding Information: This work was supported by the National Institute on Alcohol Abuse and Alcoholism (R01AA017104, R24AA022919), National Institute of Mental Health (P30MH058107), Ilifa Labantwana, National Institute of Allergy and Infectious Diseases (AI028697), and the National Center for Advancing Translational Science (UL1TR000124).
• Keywords: Community health workers (CHW); Perinatal home visiting; Maternal depression
• Research Categories: Health Sciences, Obstetrics and Gynecology; Psychology, Behavioral; Anthropology, Medical and Forensic

Abstract

Almost all pregnant women (98%) in 24 Cape Town neighborhoods were randomized by neighborhood to: 1) the standard care (SC) condition (n=12 neighborhoods; n=594 pregnant women), or 2) the Philani Intervention Program (PIP) in which home visits by Community Health Workers (CHW) were conducted (n=12 neighborhoods; n=644 pregnant women). At 36 months post-birth (84.6% follow-up) PIP mothers were significantly less depressed at compared to the SC mothers. Children in PIP are significantly less likely to be stunted (24.3% vs 18.1%, p=0.013), to have better vocabularies and are less likely to be hospitalized than children in the SC condition. These data suggest home visits may need to continue for several years post-birth. Sustainable, scalable perinatal intervention models are needed in LMIC.