Enable is a community-based home visiting programme that connects nearly 1500 pregnant women and their infants to health education, social support, and onwards referrals through a locally recruited “Mentor Mother” workforce. A process evaluation aims to identify how implementation and contextual factors influence programme outcomes. 

 

In Phase 1, key project activities included monitoring & evaluation support, interviews with Mentor Mothers, clients, and supervisors, and home visit audio recordings, to add context to Enable’s program progress. The Institute team also engaged with 17 Mentor Mothers to provide continuous opportunities to participate in training sessions related to data quality, team dynamics, and self-care. In 2021 we continued to engage with the Mentor Mother workforce. In addition, an exciting shift in Enable Project was the proposed integration of the Nyamakela4Care model, devised by collaborators at UCT’s Perinatal Mental Health Project (PMHP). We arranged to partner with PMHP and One to One to integrate the Nyamakela4Care model into how Enable operate their monthly meetings and provide support. We are interested in assessing how closely the principles covered in this model, which is now forming part of the Enable training curricula, are being adhered to.

The Zithulele Births Follow Up Study (ZIBFUS) is a cohort study of 470 mothers and their infants from birth through the first years of life. To date, ZiBFUS has built a comprehensive picture of healthcare, feeding practices, HIV, social support, mental health, food security and infant disease and mortality in this rural South African community.

 

In 2021, the team had planned a new follow-up wave when the children turn 8 years old. However, due to COVID-19 related delays, progression on the follow up study has been pushed to 2022. The Zithulele research team participated in the Ukwanda 9th Annual Rural Health Research Day in May 2019.

The Eastern Cape Supervision Study is a cluster randomised controlled trial, evaluating the impact of increased supervision and support for government community health workers on maternal and child health outcomes. In total, 873 participating women and their children were recruited during pregnancy and up to two years post-birth.

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The 3, 6, 15 and 24 month assessments of mothers and infants took place between 2019 and 2020. During the COVID- 19 lockdowns, the 24 month assessments were paused and later resumed through telephonic interviews with participants. In October 2020 the team returne to the field and conducted follow up visits for the phone interviews as well as the remaining 24 months’ assessments. Data is being analysed currently and a main outcome paper is being drafted.

The Evidence for Better Lives Study (EBLS) is an epidemiological study of exposure to violence and adversity during pregnancy in eight low- and middle-income countries (Jamaica, Ghana, Pakistan, the Philippines, Romania, South Africa, Sri Lanka and Vietnam), led by Cambridge University (United Kingdom). A total of 1200 pregnant women were assessed during the last trimester of pregnancy and 2-6 months after birth to gather information about experiences of violence, nutrition and food security, and child and maternal wellbeing.

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Data collection for the South African cohort took place in Worcester, with 150 women assessed during pregnancy and an 85% follow-up rate for the post-birth assessment. A policy impact workshop with local government staff and policy makers, health care professionals and interested researchers took place at the Ukwanda Rural Clinical School in Worcester to present the study findings and discuss implications for practice.