Abstract:
Mentor Mother (MM) services are an evidenced-based peer support strategy
embedded within prevention of mother-to-child transmission of HIV (PMTCT)
programs. The current MM strategy in Kenya provides monthly, facility-based, one-
size-fits-all antiretroviral therapy adherence counselling and health education to
women living with HIV (WLHIV) who are navigating PMTCT services. MMs receive
a small monthly stipend as compensation for providing these services. We aimed
to gather formative information from MMs and their client WLHIV, with the goal of
developing an enhanced MM strategy that accounts for the unique needs of each
WLHIV. From April-July 2023, we conducted qualitative interviews with MMs (n = 16)
and WLHIV (n = 36) from three public health facilities supported by Academic Model
Providing Access to Healthcare (AMPATH) in western Kenya. Interviews and analysis
were guided by the Practical, Robust Implementation and Sustainability Model
(PRISM). Key findings included that both MMs and client WLHIV had favorable
opinions about the possibility of developing and implementing a risk-stratified MM
strategy wherein client WLHIV with identifiable risk factors receive intensified,
problem-focused services while low-risk WLHIV are eligible for less intensive
services. MMs and client WLHIV also agreed that empathetic MM-client relationships
that leverage shared lived experiences to build trust and address stigma should
remain central to the MM program. However, MMs were clear that a better-defined scope of work and capacity building through training and skills development
would be necessary for successful implementation of an enhanced MM strategy.
Additionally, motivating MMs with fair compensation and recognition for their work,
as well as providing more resources for client WLHIV with economic barriers to care,
could promote adoption and sustainability of an enhanced MM strategy. Additional
participatory research, as well as input from system-level stakeholders, is needed to
ensure feasible enhancements to MM services are contextualized within the real-
world constraints of PMTCT programs