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Author Notes:

Corresponding author: Mary Jane Rotheram-Borus; 10920 Wilshire Blvd., Suite 350, Los Angeles, California 90024, USA; rotheram@ucla.edu; CCHPublications@mednet.ucla.edu.

For author contributions, see the full article.

No authors have any competing interests.

The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Subjects:

Research Funding:

This study was funded by NIAAA Grant # 1R01AA017104 and supported by NIH grants MH58107, 5P30AI028697, and UL1TR000124. Mark Tomlinson is supported by the National Research Foundation (South Africa).

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Immunology
  • Infectious Diseases
  • Virology
  • HIV
  • maternal health
  • perinatal health
  • COMMUNITY-HEALTH WORKERS
  • SOUTH-AFRICA
  • CHILD-DEVELOPMENT
  • ALCOHOL-USE
  • PARAPROFESSIONALS
  • COUNTRIES
  • SERVICES
  • PROGRAM
  • NURSES
  • WOMEN

Outcomes of home visits for pregnant mothers and their infants: a cluster randomized controlled trial

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Journal Title:

AIDS

Volume:

Volume 27, Number 9

Publisher:

, Pages 1461-1471

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Objective: To evaluate the effect of home visits by community health workers (CHWs) on maternal and infant well being from pregnancy through the first 6 months of life for women living with HIV (WLH) and all neighborhood mothers. Design and methods: In a cluster randomized controlled trial in Cape Town townships, neighborhoods were randomized within matched pairs to either standard care, comprehensive healthcare at clinics (n = 12 neighborhoods; n = 169 WLH; n = 594 total mothers); or Philani Intervention Program, home visits by CHWs in addition to standard care (PIP; n = 12 neighborhoods; n = 185 WLH; n = 644 total mothers). Participants were assessed during pregnancy (2% refusal) and reassessed at 1 week (92%) and 6 months (88%) postbirth. We analyzed PIP's effect on 28 measures of maternal and infant well being among WLH and among all mothers using random effects regression models. For each group, PIP's overall effectiveness was evaluated using a binomial test for correlated outcomes. Results: Significant overall benefits were found in PIP compared to standard care among WLH and among all participants. Secondarily, compared to standard care, PIP WLH were more likely to complete tasks to prevent vertical transmission, use one feeding method for 6 months, avoid birth-related medical complications, and have infants with healthy height-for-age measurements. Among all mothers, compared to standard care, PIP mothers were more likely to use condoms consistently, breastfeed exclusively for 6 months, and have infants with healthy height-for-age measurements. Conclusion: PIP is a model for countries facing significant reductions in HIV funding whose families face multiple health risks.

Copyright information:

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.

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