Philani Plus (+) Intervention Program addresses maternal and child nutrition, HIV, alcohol use, and mental health

Philani is a non-government organization operating in 150 township neighborhoods in Cape Town, South Africa. The Philani child health and nutrition program was developed in the late 1970s to provide support to mothers of underweight and at-risk children. Philani incorporates elements used successfully in other child health and nutrition programs, including peer role models, peer educators and home visits during the early years of a child’s life.

Recently, this program has been expanded to address the intersecting issues of HIV, alcohol abuse and malnutrition. In 2008 a partnership was established between Philani, UCLA (University of California at Los Angeles, USA) and Stellenbosch University (Stellenbosch, South Africa), to evaluate the Philani Outreach and Mother-to-be Programmes.

A recent paper provides an overview of the Mentor Mothers program and the development of a community-randomized trial to evaluate the program.

Like many other home visiting and mentoring programs, Philani recruits and trains mothers from the neighborhoods in which they provide services. These “Mentor Mothers” are trained to address issues ranging from HIV and TB to malnutrition and alcohol use. In terms of alcohol use, they are taught to screen for alcohol use and to deliver a brief intervention.

Mentor mothers provide four prenatal and four postnatal home visits where they address HIV, alcohol, nutrition, depression, health care regimens for the family, caretaking and bonding, and securing government-provided child grants. Initially, mentor mothers visit all the mothers in the neighborhood to identify those most at risk for health problems and who might not present at health clinics (30% of pregnant women in South Africa do not access prenatal care).

The program evaluation has just started, but the researchers are able to provide a baseline profile of the women in the study. 1,239 pregnant at-risk mothers have been recruited from 24 neighborhoods.

  • 27% used alcohol during pregnancy;
  • 26% were HIV positive;
  • 17% previously had low-birthweight babies;
  • 23% had at least one chronic condition (10% hypertension, 5% asthma, 2% diabetes);
  • 17% had clinically significant prenatal depression and 42% had borderline depression

The Philani home visiting program has been successful in addressing malnutrition and we know that home visiting programs for at-risk women can be successful in preventing FASD (see, for example, earlier posts here and here and here and here). It’s great to see the program expand to address alcohol use in pregnancy and to provide care within the context of other intersecting health issues like HIV and TB.

You can visit the Philani web site to learn more about the range of programs they offer and to see some of the textiles they sell to support their programming (images from this post are from their web site). To learn more about FASD prevention in South Africa, see previous posts here and here.

 References

 Rotheram-Borus, M.J., le Roux, I.M., Tomlinson, M., Mbewu, N., Comulada, W.S. et al. (2011). Philani Plus (+): A Mentor Mother Community Health Worker Home Visiting Program to Improve Maternal and Infants’ Outcomes. Prevention Science, Epub ahead of print. DOI 10.1007/s11121-011-0238-1.

le Roux, I.M., le Roux, K., Comulada, W.S., Greco, E.M.,  Desmond, K.A., et al. (2010).  Home visits by neighborhood Mentor Mothers provide timely recovery from childhood malnutrition in South Africa: results from a randomized controlled trial.  Nutrition Journal, 9:56. http://www.nutritionj.com/content/9/1/56