Mrs Lyn Haskins, Ms Ntokozo Mntambo, Dr
Christiane Horwood, Mrs Merridy Grant and Mr
UKZN’s Centre for Rural Health (CRH) recently presented preliminary findings on its on-going Nompilo Research Project being conducted in KwaZulu-Natal’s Ugu District.
Building on the existing Framework for Community-based Maternal, New-born, Child and Women’s Health (MNCWH) and neonatal interventions overseen by the National Department of Health, the CRH adapted the World Health Organization’s training materials for Community Case Management (CCM) and included an HIV component for the training of community caregivers (CCGs) to see whether they would reach the aims of the Nompilo Project.
Through this project, the Centre is investigating whether HIV-adapted CCM training for community care givers, supported with a Continuous Quality Improvement (CQI) methodology, could improve the uptake of maternal and new-born services at clinics and improve household practices. This includes the prevention of mother-to-child transmission (PMTCT) of HIV.
The project coincides with the sister 20,000+ Project which is named after the number of HIV infections from mother to infant that could be prevented each year in KwaZulu-Natal if every mother received care according to the national PMTCT guidelines. The plus of this project, also conducted in the Ugu District, signifies additional children who could be helped if recommended infant feeding practices could be optimised in the communities.
The 20,000+ Project aims to decrease mother-to-child- transmission of HIV to five percent in line with the National Strategic Plan target and according to the researchers, these efforts would avoid postnatal transmission of HIV through breastfeeding while still promoting child survival by avoiding deaths caused by diseases such as diarrhoea and malnutrition due to unsafe infant feeding practices.
In the Nompilo Project, care givers visit pregnant woman regularly to encourage early antenatal care attendance, advise them about infant feeding, encourage HIV testing and PMTCT, discuss home care during pregnancy, identify danger signs in pregnancy, and continue to visit the new mother and infant to monitor their health and well-being.
The CRH reported on a public health evaluation they conducted following a cluster randomised trial with 60 care givers and 15 supervisors per control and intervention group in the health district. In addition to the DoH’s C-Framework training received by the control group, the intervention group received further training to care for new-borns at home as well as sick children. Their supervisors and three back-up care givers were mentored and supervised for quality improvements in patient care
Findings reflected that although the care givers in both groups had similar knowledge and training at the baseline of the study, after the initial CRH training, the difference in the knowledge score of intervention and control care givers increased. The CRH team said that after four months, intervention care givers continued to have a higher knowledge score than control care givers, although both intervention and control care givers were still likely to visit pregnant women and households with sick children.
The final post-intervention survey will start in November 2013 and it is envisaged that the project will draw to an end in March 2014.