Burnt Forest

Researchers are evaluating an enhanced Mentor Mother (MM) strategy designed to support pregnant and postpartum women living with HIV (WLHIV) by delivering risk-based, differentiated prevention of mother-to-child transmission of HIV (PMTCT) services. This hybrid implementation-effectiveness study takes place at Burnt Forest Sub-District Hospital (BFSDH) in Kenya and aims to assess whether the enhanced MM strategy can be successfully implemented and improve health outcomes for mothers and their infants. The study builds on existing MM programs by incorporating a patient-centered model that tailors support based on individual risk factors such as HIV viremia, stigma, non-disclosure, and socioeconomic challenges. The enhanced MM strategy involves trained peer counselors who perform structured risk stratification using standardized forms during clinical visits. Based on identified risks, Mentor Mothers provide tailored counseling, community outreach, and referrals. Women will meet with Mentor Mothers during routine antenatal and postnatal clinic visits and may choose between enhanced support or standard care. The study includes a 15-month implementation period with ongoing fidelity assessments, audits, and feedback to refine the strategy in line with national differentiated service delivery guidelines. During the study, participants will be evaluated through fidelity checklists, activity logs, chart audits, observations, and focus group discussions to assess how well the enhanced MM strategy is delivered and accepted. Clinical outcomes such as retention in PMTCT care, maternal HIV viral suppression, infant HIV testing uptake, and prevention of HIV transmission will be compared before and after implementation at BFSDH and across similar clinics using standard MM services. The study also collects participant satisfaction and feasibility ratings, with total participation lasting through the 15-month implementation period.