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Here It Was Called the Locations 4M+: PERINATAL PEER MENTORING PROGRAMME FOR WOMEN LIVING WITH HIV 4M STANDS FOR MY HEALTH, MY CHOICE, MY CHILD, MY LIFE Advocacy Brief about the 4M+ Programme Handmade book filled with personal advice and coping strategies BACKGROUND During 2017, Salamander Trust, in reproductive health and rights and, in so collaboration with PIPE Kenya and doing, to reduce chances of vertical UNYPA Uganda, implemented a Peri- transmission. The programme also Natal Peer Mentoring programme with focused on skilling the young mothers to young women living with HIV, with support their peers in similar ways funding from the MAC AIDS Foundation. through their pregnancy journeys. The programme provides safe spaces for The programme aimed to empower women to share, connect and support young women with knowledge on safe each other. motherhood and HIV, primarily to uphold the young women’s own sexual and 4M+ Page 2 The 4M+ programme was led by Twenty four of these mothers were Salamander Trust Associate Angelina below 24 years. The training built a Namiba, who has herself gone through team of ‘Mentor Mothers’ who the pregnancy journey whilst living voluntarily supported their peers in the with HIV. She originally created this community and health facilities. The programme in the UK with Positively training lasted 3 days in each of the 4 UK in London, where it was called the locations. It was highly interactive and “From Pregnancy to Baby and Beyond” covered several topics, including pre- programme. With Salamander Trust, conception planning, antenatal and the programme was then renamed 4M post-natal care, safe motherhood, and has spread to centres across the creative visioning, writing and drawing, UK. bookmaking and decision-making, amongst others. Each participant was The 4M+ programme, in Kenya and also trained to make her own book to Uganda, has grown out of these take home with her. This consisted of grassroots, peer-led experiences, the creative drawings, charts and based on existing community writing, full of emotions, ideas and knowledge and resilience. As such, it plans, which she produced throughout offers a peer-led grassroots model for the workshop stages. peer mentoring as an alternative to other, more top-down models. Input from in-country healthcare professionals throughout the different The training in Kenya and Uganda project planning, development and brought together 65 young mothers, delivery stages was also most valuable. aged between 17-49 years from National PMTCT Program Manager, Dr Nairobi and Nakuru in Kenya and Rose Wafula from Kenya, and Senior Kampala and Wakiso in Uganda. Paediatric and Adolescent Health Angelina (Salamander Trust), Brenda (PIPE), Ellen (Salamander Trust), Valerie (PIPE) and Nell (Salamander Trust ), Nairobi workshop 4M+ STANDS FOR MY HEALTH, MY CHOICE, MY CHILD, MY LIFE 4M+ Page 3 Specialist, Dr Sabrina Kitaka from SUCCESSES Uganda, were programme Steering Safe spaces: Throughout the training, Group members, and both provided the programme established safe technical advice to the programme, in spaces for participants to share their particular around country perinatal challenges and aspirations without care (‘PMTCT’) guidelines. We also fear of stigma and prejudice. This is a asked them to deliver the workshops’ critical need for young people living guidelines section. A representative with HIV in general and, more from the Kenyan clinician’s office came specifically, young women who are on the last Nairobi training day. Dr mothers, since stigma is still common Kitaka delivered the guidelines session in both countries. Consequently, some to one training session also. (1) of the participants who had earlier refused to disclose their status felt Twelve of the young women who comfortable to do so for the first attended were pregnant and others time. had babies. We invited women to come with their babies. This was very important. In one workshop, we had Realising rights: The programme was one toddler and six breastfeeding able to introduce unique and practical babies, all aged under 1 month. approaches. For instance, the creative visioning exercise for the pregnancy journey has enabled the participants to understand the kind of support that can, and should be offered to pregnant women at each stage of her journey, at community level or in the health facilities. Making connections: The programme has facilitated access by young mothers to information and other related health services, including Through the counselling sessions Mentor Mothers have contributed to the marked improvement in terms of mothers’ adherence to taking medications and also honoring the clinic appointments as scheduled. Health worker from a health facility in Nairobi Participants discuss and chart what happens during pregnancy (1) The workshops were facilitated by Angelina Namiba, together with Salamander Associates Ellen Bajenja and Nell Osborne, with valued support from Betty Ogolla, Valerie Musavi, Brenda Nyambura and Christine Omao of PIPE in Kenya and Resty Nawalga, Jacqueline Alesi and Sharifah Nalugo of UNYPA in Uganda. Advocacy brief: 4M+ Programme February 2018 4M+ Page 4 for partner testing at the health facilities, sensitizing men about the importance of their involvement in HIV prevention and encouraging male- friendly programmes. Linkages: The programme built links between the health facilities and the community. For instance, some of the trained ‘Mentor Mothers’ were posted to specific health facilities, where they provided voluntary counselling for young mothers who tested positive. They supported the young women by sharing their personal journeys. They referred women from the community Above and below: Creative visioning of the type to the health facilities, for services; and of support than can or should be available for vice versa, from facility to community, pregnant women living with HIV in the home, for support groups and to connect with community and health facility other women living with HIV. The health workers acknowledge the referrals and support groups for contribution the ‘Mentor Mothers’ are women who had not connected with making in supporting their work in the other women living with HIV. Most of health facilities. the young women supported were having their first baby. Building advocacy skills: The programme strengthened the ‘Mentor Engaging men: Participants were able Mothers’’ confidence to challenge to discuss, more broadly, some of the stigma and discrimination in their challenges associated with achieving community and within health facilities. safe motherhood. For instance, in all One testimony from Uganda revealed the workshops they discussed the involvement of men as a critical issue. Participants in Kenya described male involvement in safe motherhood as the need for men to support women through the pregnancy journey, to avoid vertical transmission and to support the wellbeing of the woman and her child. They noted that effective male involvement requires advocating 4M+ STANDS FOR MY HEALTH, MY CHOICE, MY CHILD, MY LIFE 4M+ Page 5 that a ‘Mentor Mother’ attached to one of the health facilities challenged nurses who were found to have I had a former school mate who was in form 2. neglected a young adolescent mother We were not very close since I was older than her and in form 4. I rarely interacted with her. during labour. Time came when I was conducting a mentor peer group meeting at school, when the Mutual support and growth: session ended she followed me to my class Additionally, the project facilitated and she said she had something important to linkages among the ‘Mentor Mothers’, discuss with me. I walked with her to the which has enabled them to continue school field and started the talk. She told me that she was raped by her uncle who infected linking and learning from one another, her with the HIV virus. Since then her parents share experiences and seek guidance treated her differently. When her siblings during their work. One example went to school she was forced to stay at home is a Mentor Mothers WhatsApp group, and asked to go look for a job to work. She which they created following the finally got a job as a house help, there she was training in Nairobi. This has provided a also abused by her employer's husband. The platform for sustaining communication day she was raped she lost her job and since then she had never had a place to call home. and interactions among the Mentor Her parents chased her saying she had failed Mothers about various updates and to maintain her job. She was forced to sleep opportunities, as well as sharing on the streets for some time and she had challenges and happy times. nothing to eat. It was a very tough time and she resolved to end her life. She started falling sick and a Good Samaritan saved her and Given that we are overwhelmed by the took her off the street. She took her to the number of mothers (we receive about 20 hospital where she was found pregnant and mothers on average every day of the week) having the HIV virus. She was devastated and the Mentor Mothers are playing a very vital she isolated herself. One day during this trying role in conducting the health education time she bumped into her Dad who called her sessions and guiding the mothers. They are a prostitute and a bastard. I took time to talk particularly helpful for young mothers who to her after her story, I introduced her to a look at them as their peers…..we are support group in our area where she received increasingly getting more young adolescent lots of support and she gained courage. She is mothers coming to the clinics and also the currently faring well and she delivered a baby support groups…..at least 30% are young boy who is one year old now. mothers below 25 years.….these Mentor Mentor Mother, Kenya follow-up Mothers have helped in keeping the mothers workshop in general busy as they wait for their turn to visit the doctor for examination.
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