Help create an HIV-free future in Malawi

by mothers2mothers
Help create an HIV-free future in Malawi
Help create an HIV-free future in Malawi
Help create an HIV-free future in Malawi
Help create an HIV-free future in Malawi

mothers2mothers (m2m) has just unveiled our official anniversary celebration—She’s Got The Power. Running from the 28th of September to the 15th of October, and encompassing m2m’s official 20th birthday on the 4th of October, She’s Got The Power will celebrate 20 years of remarkable impact and change that m2m Mentor Mothers—the incredible women living with HIV employed by m2m as frontline health workers—have delivered for themselves and their communities since our founding in 2001.

Every single m2m Mentor Mother is part of a new generation of African female leaders who are shattering norms and creating a ripple effect of health and change in their communities. Not only have they reached over 13.5M people with critical health services and education across a dozen African nations over the last 20 years—they are also paving a new path for a generation of women and girls by passing on health, agency, and power.

Indeed, She’s Got The Power to break barriers and transform a generation!

Health workers like m2m Mentor Mothers are pushing back these deeply rooted barriersand creating agencyfor women across sub-Saharan Africa.For the last 20 years, they have been making the impossible possible:

It was impossible for women living with HIV to be seen as community health leaders—She’s made that possible.

It was impossible to see an end to the spread of HIV infections—She’s made that happen.

It was impossible for women to imagine a healthy, more equal future—She’s made that a reality.

But we still have a long way to go to go to ensure that we end HIV/AIDS, guarantee health for all, and push for gender equality before 2030. That is why we need as many people as possible to join the movement, and take the first step in ensuring the power of women as community health leaders is recognised around the world. 

Be part of this change—visit She’s Got The Power to learn more.

Links:

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Dorothy Kachere, Mentor Mother in Mulanje, Malawi
Dorothy Kachere, Mentor Mother in Mulanje, Malawi

Focusing on the health of all family members—in particular women, children, and adolescents who are highly vulnerable to HIV and other health issues—is critical to reaching the global goals of achieving good health and well-being for all and an end of HIV/AIDS.

The 1,700 women employed by m2m as frontline health workers, called Mentor Mothers—like Dorothy Kachere in Mulanje, Malawi—not only focus on their client’s health, but also ensure that everyone in their client’s family is accessing the vital health services they need.

This was the case with Dorothy’s client, Mary (not her real name), who came to the health centre as a pregnant teenager. Mary was scared of being judged and reprimanded so she sought out an “approachable person’’ at the clinic to talk with, and along came Dorothy.

When Dorothy followed up with Mary at her home, she noticed a young boy of school age, who Dorothy identified as her seven-year-old brother, Dalitso, who was born disabled and couldn’t walk or talk.

Dorothy talked to the family about how they could provide more support to Dalitso. She introduced Dalitso and the family to play therapy and encouraged them to communicate with and sing for Dalitso consistently. She also organised play sessions with other mothers of disabled children at the health centre, and referred him for physiotherapy and early childhood development (ECD) services. Watching Dalitso’s improvement from the first time she met him to the lively 8-year-old boy he is today is one of Dorothy’s proudest moments.

“He can now communicate with some non-verbal cues and signs, he can express his emotions with smiles and little murmurs, and is even showing some independence with wanting to feed himself even though he can’t do that yet. Even though Mary was my reason for visiting the home, all the family members are now my clients. Mary has a healthy HIV-negative baby girl and Dalitso’s mom understands the importance of ECD and how to care for a disabled child,” Dorothy said.

It is success stories like Dalitso’s that highlight the importance of m2m’s work to improve the health and well-being of all members of a family. To that end, m2m has evolved our tried and tested peer-based model to encompass a family-centred approach that tackles a range of health-related challenges at all stages of life, from pregnancy, birth, childhood, adolescents, and beyond. We provide support and services to prevent new HIV infections and ensure people living with HIV access treatment and remain healthy. We also focus on related health challenges—including TB, maternal and child mortality, and early childhood development—while delivering women’s social and economic empowerment.  We want to make healthy, thriving families communities the new normal. In this way, we are creating an HIV-free generation.

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This time last year, few could have imagined the global disruption and challenges that lay ahead. Yet, amid the fear and hardship, there have been bright spots that have kept us going and given us hope for a healthier tomorrow.

At mothers2mothers (m2m), our commitment to the over one million women, children, and adolescents who depend on our services each year has not wavered. We are proud and grateful that we have been able to evolve and grow our program in significant ways to meet their needs while protecting the jobs of the 1,700 women living with HIV we employ as Mentor Mothers across ten countries. Today, let’s focus on the year’s good news even as we look forward to returning to a greater sense of normalcy once COVID-19 is contained.

Our top 10 highlights of 2020:

#1 An Effective Emergency Response: When COVID-19 began spreading across the African continent, we acted quickly to protect our frontline health workers—who were designated as essential workers throughout the pandemic—while making sure that our clients continue to receive support and services to stay healthy and safe. This included expanding our eServices support provided by phone, a WhatsApp-based platform, and text messages when it is impossible to meet our clients in person, and making sure Mentor Mothers are equipped with personal protective equipment (PPE). And, it’s working. Ninety-eight percent (98%) of the pregnant and breastfeeding women living with HIV we reached through eServices in Q3 adhered to their anti-retroviral treatment.

#2 Tech for Good: It was against this backdrop that m2m accelerated the development and launch of the Virtual Mentor Mother Platform (VMMP)—an interactive tool run on the WhatsApp messaging platform that enables users in nine countries to access vital health information and service referrals on COVID-19 and other important health topics in their preferred language.

#3 Now We Are 10: m2m launched our program in Angola and Tanzania in 2020, bringing the total number of our country operations to 10. Together with the start of operations in Ghana at the end of 2019, we surpassed our strategic goal of reaching two new countries between 2018 and 2021...almost two years early. m2m nurse and Mentor Mother in Lesotho A nurse & HIV Testing Services Mentor Mother crossing a river to get to a hard-to-reach community in Lesotho.

#4 Clinical Care Milestone: m2m officially began employing nurses to work alongside Mentor Mothers in Lesotho to help clients overcome barriers to accessing vital health services. Providing clinical services, aligned with global policy best practices, was one of the goals laid out in our Strategic Plan.

#5 Service Innovation: For the first time in our 19-year history, thanks to support from the Medtronic Foundation, Mentor Mothers began providing services to prevent and manage hypertension, diabetes, and other noncommunicable diseases (NCDs). This service innovation is critical—NCDs are a large and growing public health issue in sub-Saharan Africa, especially for individuals living with HIV, and they increase the risk of serious health challenges from COVID-19.

#6 A Year of Growth and Impact: m2m was excited to share the results of our 2019 Annual Programme Review, which showed continued growth and impact, and demonstrated how we are advancing the United Nations Global Goals of creating good health and wellbeing for all, and an HIV-free future. 2019 also marked the sixth year in a row that m2m achieved virtual elimination of mother-to-child transmission of HIV for our enrolled clients. WOW panel discussion m2m Mozambique Country Director Ilda Kuleba (upper right) joins panelists virtually at the WOW Global 24 Festival.

#7 Sharing Our Story on the World Stage: m2m participated virtually in a number of global events this year, including sharing our work and impact at the 23rd International AIDS Conference; and joining timely and important discussions at the WOW Global 24 Festival, the first-ever free 24-hour online festival uniting women and girls across the world. Our work was also featured in leading media outlets, including National Public Radio (United States); Marie Claire (United Kingdom); and BBC Africa.

#8 Cycle2Zero@Home: Supporters around the world biked, walked, ran, and rowed for our signature Cycle2Zero fundraising event in October, which pivoted from an in-person cycle through one of the countries we operate in, to a virtual challenge due to COVID-19. Fortunately, this did not put a damper on enthusiasm, with participants covering over four million kilometers and raising more vital funds than ever before.

#9 Progress throughout the Year: Even in the face of not one, but two pandemics—HIV and COVID-19—our work did not slow down. All of our country programs demonstrated continued development and impact, which is captured in our Quarterly Impact Reports.

#10 YOU: We are incredibly grateful for the flexible support of existing and new donors and partners who helped us meet critical emergency pandemic funding needs over the course of the year. Your partnership and unwavering support has been invaluable, and your generosity has been even more incredible given that you have faced challenges of your own. 

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Promise on her way to a parenting group.
Promise on her way to a parenting group.
While children may be less vulnerable than adults to the psychological effects of COVID-19, there is no doubt that the youngest generation will bear one of the biggest burdens of the pandemic. Widespread closures of schools and early childhood development programs; increased unemployment resulting in food insecurity and malnutrition; and greater difficulty accessing essential health services—combined with the emotional impact of the crisis—these COVID-19 effects are exposing children to health and developmental challenges that could last a lifetime, particularly in the world’s poorest countries.  
I am very concerned about the long-term impact that COVID-19 could have on the children in my community,” says Promise, a mothers2mothers (m2m) Community Mentor Mother in southern Malawi. Promise says the coronavirus is having a deep impact on her community. Many families are struggling for food. Schools and childcare centers are closed, depriving children of learning opportunities and interactions with their peers, and causing job losses among teaching and support staff. 
Challenges accessing health services 
Some mothers are not accessing health services for themselves or their children because they fear they will be infected with COVID-19. For those who do walk miles through this rural area to reach the nearest health center, they cannot always get the services their families need—services ranging from immunizations to the final test for the child for HIV to viral load monitoring—because medical staff are working in shifts to limit the number of people in the facility at any given time.
 
Furthermore, many people living with HIV in Malawi have received a six-month supply of their treatment, which is good practice. However, Promise says it also creates a disincentive to make the long trip to the health center. “Some clients have missed equally important appointments—such as antenatal care visits, infant HIV tests, childhood immunizations, to name a few—if they are scheduled before the date to refill their ARV prescription,” she says. 
Compounding the risks 
In sub-Saharan Africa, the risks to children of not accessing health services are compounded by the fact that millions of them are living with HIV or exposed to the virus. According to a UNAIDS report released earlier this month, 200 children (aged 0-14) contracted HIV each day in Eastern and Southern Africa in 2019. Just as worrisome, only 58% of children living with HIV in the region were on lifesaving treatment, compared to 73% of adults. Now, with UNAIDS warning that COVID-19 has “seriously impacted the AIDS response and could disrupt it more” by limiting HIV treatment and medical supplies, these children could face even greater health consequences.  
Furthermore, according to a study of low- and middle-income countries by the Johns Hopkins Bloomberg School of Public Health, 1.2 million more children under age five could die in six months due to challenges accessing routine health services and adequate nutrition.   
Unstoppable 
While COVID-19 restrictions prevent Promise and her fellow Mentor Mothers from going door-to-door and holding group support sessions in her community to provide m2m’s full range of family-centered services—which span pregnancy, childhood, and adolescence—this hasn’t stopped them from making sure parents are doing everything possible to keep their children healthy and safe.  
Promise now spends a considerable amount of time helping her clients navigate the health system, educating them on COVID-19, and supporting them to make it to their medical appointments and stay on HIV treatment. With only 60 percent of her clients in possession of a phone, Promise has become creative in her outreach—calling family members and working with government health workers still allowed to go door-to-door in the community to share messages to clients she has been unable to reach. 
To protect the health of her youngest clients, Promise checks they are tested for HIV, are receiving all of their childhood immunizations, and getting the nutrition they need. She also talks to parents and caregivers about activities to stimulate their child’s early development, especially during this unprecedented time and confirms children are meeting all of their developmental milestones. 
Remarkable women like Promise, one of more than 1,700 m2m Mentor Mothers across ten African nations, are working to protect Africa’s future, by ensuring children have the opportunity to stay healthy and thrive, even in the face of this global pandemic. We are inspired by their efforts and committed to making sure they have the tools and resources to do this work.  
Promise with clients before COVID-19.
Promise with clients before COVID-19.
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Mentor Mother, Teddy, in Uganda
Mentor Mother, Teddy, in Uganda

Since early March, mothers2mothers (m2m) has been rapidly adapting our programme to continue to provide services, while prioritising the health and safety of our frontline health workers and their clients .

The women m2m employs as Mentor Mothers were designated essential workers in countries under full, or partial, Covid-19 lockdown shortly after the WHO declared Covid-19 a pandemic. We've been working tirelessly ever since to make sure Mentor Mothers have access to the personal protective equipment (PPE) they need to effectively reach clients, while also staying safe. Read all about the challenges associated with procuring PPE on the African continent here.

Mentor Mothers have been playing an "essential" role at the understaffed health centres that they report to every day. Their presence bolsters the efforts of doctors and nurses, and enables them to to attend to more urgent medical needs. Mentor Mothers live and work in the same communities as those they serve, which makes them an especially trusted source in moments like this. They continue to deliver health services and education to women and families—not only about HIV/AIDS—but also other serious health issues including Covid-19. At this time, their support is more important than ever to make sure that families access vital health services, stay in care, and adhere to treatment regimens.

Read this blog post featuring the story of Irene, a Mentor Mother in South Africa, whose experience in combating the stigma and fear surrounding her HIV diagnosis, helped her to do the same when she began showing possible symptoms of Covid-19. The tactics she uses as a Mentor Mother to educate and inform her clients and fellow community members about HIV are the same tactics she uses to educate those around her about the facts and best practices to follow during the Covid-19 pandemic. Her role as a Mentor Mother enables her to share critical, lifesaving information and resources with her community.

In addition to the PPE-clad, physically distanced, direct service delivery that Mentor Mothers like Irene have provided since March, we have made significant investments in ramping up the eServices that we can deliver to clients. Mentor Mothers are staying connected with clients by phone, when in-person visits are impossible. These calls are essential for adherence counseling, appointment reminders, and general support for families in need. Since mid-April we have enrolled more than 50,000 clients in our eServices programme, and we continue to build out the infrastructure that will enable further expansion. We are also piloting a WhatsApp-based platform where new and existing clients can receive vital Covid-19 and general health and well-being information and support in 34 different languages. 

In short, the subject of this update says it all: our rapid response to the Covid-19 pandemic is rapidly evolving. Stay tuned to our GlobalGiving updates for more information, and visit our website for a deep-dive into all of the latest information about m2m. 

Linkage Officer, Nompumelelo, in Gauteng
Linkage Officer, Nompumelelo, in Gauteng
Mentor Mother, Zusiphe, in PPE
Mentor Mother, Zusiphe, in PPE
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mothers2mothers

Location: New York, NY - USA
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Project Leader:
Dave Brandwood
Los Angeles, CA United States
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