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A nurse checks the baby’s heartbeat. Photo: Richard Hanson/Tearfund

From: Maternal health – Footsteps 91

How to help families and communities provide crucial support for women before and during childbirth

Memory with two-week-old Patience, other family members and Mother Buddies Evelyn and Snarlet. Photo: David Deakin/Tearfund

Memory with two-week-old Patience, other family members and Mother Buddies Evelyn and Snarlet. Photo: David Deakin/Tearfund

HIV and maternal mortality have been called ‘the two intersecting epidemics’ (The Lancet). A pregnant woman who is living with HIV is six times more likely to die in pregnancy or childbirth than a woman who is not living with HIV. 

IMPACT (Improving Parent and Child Outcomes) is a Tearfund partner programme that uses the concept of ‘Mother Buddies’. These are trained church volunteers, mainly mothers living with HIV, who want to pass on their learning and experience to other expectant mothers in their community. They visit vulnerable pregnant women about eight times over a 12–15 month period, covering 6–9 months of pregnancy and 6 months after birth. They support the family through encouragement and friendship, and by providing information and helping women to attend antenatal appointments. 

MiHope screenshot illustrating Mother Buddy visit schedule with clients.

MiHope screenshot illustrating Mother Buddy visit schedule with clients.

They are assisted by a mobile phone system called MiHope (Mobile interactions bringing Hope) which provides communications, information and data collection capabilities (in this way it is different from the Safe Pregnancy and Birth app on the page 11, which is purely information). 

The communication system uses mobile instant messaging, which enables 1000 chat messages to be sent for the price of a single text message (SMS). It provides information in national languages on all aspects of IMPACT – from prevention of unintended pregnancies and recognising pregnancy complications through to birth and infant care. The data collection tool guides the Mother Buddy on what questions to ask through each of the eight visits. Information is collected on the phone, which links into the Ministry of Health. There is also a facility to remind mothers of their next clinic appointment automatically. All data collected is then not just available on the phone but in a securely accessed web portal – enhancing monitoring, analysis and evaluation.

The IMPACT programme is already running in Malawi and is about to start in Nigeria. Some names have been changed. David Deakin is Tearfund’s Head of HIV – 

IMPACT in action  

Joseph and Memory are a married couple who are both living with HIV and recently had their child Patience. They were supported by Evelyn, a Mother Buddy from the Evangelical Association of Malawi. ‘We are so grateful to Evelyn for all of the advice and support that she has given us during the pregnancy and birth – mother and baby are doing just fine!’

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