Watch above: How YMMs support young mothers living with HIV and their infants in Zimbabwe
Adolescent and young mothers (aged 10–24 years) have a higher risk of transmitting HIV to their infants than older mothers. The unique challenges faced by young mothers in adhering to treatment and accessing HIV testing and counselling require tailored programmatic approaches that are often missed by prevention of mother-to-child transmission (PMTCT) services designed for adults.
In Zimbabwe, a pilot project for young mothers is seeking to improve their PMTCT outcomes by building on the demonstrated success of a peer-support model in the Zvandiri programme. This model trained community adolescent treatment supporters (CATS) to support young people living with HIV to be linked to and retained in care.
The new pilot project trains Young Mentor Mothers (YMMs), who have received initial training as CATS, to support other young mothers living with HIV during the pregnancy and breastfeeding period to access testing, treatment and care services for themselves and their infants.
The NGO Africaid, in collaboration with the Ministry of Health and Child Care, implemented the YMM pilot project in five districts in Zimbabwe. The training and support provided to these peer mentors focused on specific topics for young mothers, including: early infant diagnosis, HIV treatment adherence for infants, partner testing, nutrition and parenting support. The YMMs support their peers through home visits and SMS reminders as well as through facility- and community-based groups.
To date, 48 young mothers living with HIV have been trained as YMMs and linked to 26 facilities within the national PMTCT programme. After 9 months of implementation, 645 (89 per cent) of young mothers received viral load test results and 603 (93 per cent) were virally suppressed. All HIV-exposed infants over six weeks old were tested and received results compared to a national average of 64 per cent. Elements of the pilot’s success included ongoing capacity-building and support to YMMs, incentives to build their motivation and a strong monitoring and evaluation system.
With technical leadership from UNICEF, support from the Ministry of Health and Child Care and funding from the Swedish International Development Cooperation Agency (SIDA), the YMM project is part of the joint UN 2gether-4-SRHR programme, which engages UNAIDS, UNFPA and WHO, to address HIV, gender-based violence and sexual reproductive health issues facing young mothers. The results and lessons learned from this pilot is informing a phased scale-up of the YMM project in Zimbabwe, beginning with 13 districts under 2gether 4 SRHR and seven districts with support from the Canadian Government's Grand Challenges Canada programme.