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Peer mentors: Frontline heroes during COVID-19

3 August 2020 – It’s a brisk autumn morning in Ga-Rankuwa, about 50km west of Pretoria, South Africa’s administrative capital. Clients gather outside Phedisong 4 Clinic, all wearing masks, but not everyone maintains social distancing in this era of COVID-19. This changes as soon as they enter the clinic, where they sit apart in rows or on benches.

For adolescent girls and young women (AGYW), this clinic visit may be routine, or may change their lives. For those coming in for the first time, they are often fearful, expecting judgement for possibly being pregnant or HIV-positive.

Recognising fear as a barrier to health-seeking behavior, UNICEF South Africa established this innovative peer mentor project with Mothers2Mothers two years ago. This project targets adolescent young mothers who are HIV-positive, who receive training to mentor other young mothers who are pregnant and breastfeeding. There are currently 106 peer mentors across Gauteng and KwaZulu-Natal.

At the clinic, the peer mentors are the ‘welcoming committee’, taking all mothers and pregnant women aside for health screening. They test for HIV, TB and sexually transmitted diseases, take vital signs, and provide counselling services for HIV, mental health, family planning, and gender-based violence (GBV). They provide life-saving services to AGYW, and are an invaluable support to the health system, relieving the workload of professional nurses and reducing waiting times.

“The peer mentors encourage young pregnant mothers to test for HIV at every visit. We monitor the data of those facilities that have peer mentors as opposed to those that don’t. Phedisong 4 is consistently at 100% of antenatal client-initiated antiretroviral therapy (ART). This means the peer mentors’ counselling is very good; they have no mothers declining to start on ART”, says Mrs Rebecca Makau, programme manager of Maternal, Women’s Health and Genetics for Tshwane District Health Services.

“They also assist with MomConnect registrations of all pregnant mothers. We created a Whatsapp group for peer mentors to share statistics and encourage them to do registrations daily. That has sparked a healthy competition among them where they look forward to the monthly data and all strive to be best performers.”

During COVID-19, post-natal clubs have been suspended, but the peer mentors connect with clients through Whatsapp and text messaging to encourage those who typically would withdraw from the services and to provide psychosocial support at a time that is unnerving for most. At the clinic, they use a simple screening tool to introduce GBV and mental health into conversations with mothers to identify and refer those who have been exposed to GBV and who are suffering from depression.

Temperature screening: As a precaution against COVID-19, temperatures are screened at KT Motubatse Clinic in Soshanguve, Tshwane, before clients are permitted inside where social distancing is required.

Advice for new mothers: Mentor mother Yvonne Lesoalu counsels Francina Mautla (20) with her newborn baby, Sam, on the importance of breastfeeding at KT Motubatse Clinic in Soshanguve, Tshwane.

Couples testing: Mentor mother Lucy Makhubela at KT Motubatse Clinic counsels/prepares to counsel a couple.

Peer mentors advise clients to bring their partners along for counselling, ‘because for us to test the mother not the father, that’s not working for us.’ An HIV-positive pregnant client (24) was struggling to accept her HIV status, blaming her partner for infecting her with HIV. The peer mentor educated her about HIV transmission and the importance of accepting her status so she could live positively with HIV. The partner apologized to her, and the mentor counselled the couple on adherence and the importance of taking treatment. The client’s viral load has since reduced to undetectable levels, minimizing the chance of transmitting HIV to her baby. She is thankful to the mentor for the support and education and is adhering to her treatment. Her partner is very supportive.

Through a donation of R913,000 from Pampers South Africa and Procter & Gamble SA, UNICEF SA was able to distribute nappies to our partners, Mothers2Mothers and the Limpopo Trust. Here Mrs Rebecca Makau, Programme Manager for Maternal, Child and Women’s Health, Tshwane district, hands over nappies to new mum, Yvonnia Shadung, at Phedisong 4 Clinic in Ga-Rankuwa.

Observing social distancing: Programme Manager, Rebecca Makau, with mother mentors Yvonne Letsoalu (L) and Lucy Makhubela (R) at KT Motubatse Clinic in Soshanguve, Tshwane at the handover of nappies from Pampers South Africa and Procter & Gamble SA.