(HHV-8/KSHV) in South Africa

January 6, 2018 | Author: Anonymous | Category: Science, Health Science, Obstetrics
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Nompilo Study: Results of Evaluation

Lisa M. Butler, PhD, MPH Division of General Pediatrics, Boston Children’s Hospital Department of Pediatrics, Harvard Medical School Presenting on behalf of the Nompilo Study Team: C. Horwood, W. Ngidi, M. Grant, J. Reddy, P. Barker, and N. Rollins

Research Questions Implementing integrated community case management training & QI support to CHWs: •

Is it feasible?

• Does it lead to gains in CHW knowledge, selfefficacy and practice? •

What is the effect on infant feeding practices, and uptake of PMTCT and MCH services?

Setting and Design Setting:

• Ugu District, KwaZulu Natal, South Africa

Design: • Cluster randomized controlled trial • CHW supervisors (N=30), CHWs (N=120) • Mothers: ~8 mothers per CHW pre & post intervention

3

Participants and Timelines • CHW: • > 18 years old • Grade 9 education or greater • Employed by Department of Health to provide home support to pregnant women, mothers and children in Ugu District, SA • Mothers • > 18 years old • Delivered live-born infant in past 12 months • Reside in household assigned to participating CHW

CHW:

Baseline

Mothers:

PreIntervention

6 Months

12 Months PostIntervention

Analytic Approach •

Mixed-effects models



Interaction of treatment group with visit month tested for differences in rate of change between groups

Results

Participant Characteristics: CHW Characteristics

Intervention CHW N=60

Control CHW N=60

P-value

39.3 (34.7-44.6)

38.5 (34.1-44.5)

0.91

Female

98.3%

100%

0.91

Education – completed secondary school

31.67%

31.66%

0.92

Experience as CHW: 4+ years

63.3%

61.7%

0.88

Age (years), Median (IQR)

Self Efficacy •

Significantly improved self efficacy at 6 and 12 months

(intervention vs control CHWs): • Talking to a pregnant woman about HIV • Advising a pregnant woman about her own nutrition • Assisting a mother with breastfeeding • Explaining services available for PMTCT • Doing a postnatal visit to check the mother’s health & newborn baby • Recognizing danger signs in pregnancy, newborn or postpartum mother

CHW Knowledge 80

P=0.28

P
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