Mentor Mothers: a Simple Solution to a Complex Problem

Nomvula dreamed of being a teacher.

She was once a good student who loved school. The grandmother who raised her, however, couldn't afford her school fees. So, at the age of 16, she was married off to an older man who agreed support her.

He moved Nomvula away from her family to his modest tin shack outside of Johannesburg, where she lived with him, his mother, his younger brother and sister. They didn't have plumbing or electricity, but Novula considered herself lucky. Her husband was kind to her and he had a job. It could have been much worse.

Nomvula was filled with joy when she discovered she was pregnant. Like many moms-to-be, she envisioned a future for her child that would be very different from her own. Her child (she secretly hoped for a daughter) would have a life of possibilities - a good education, a career, independence, security.

She went to a clinic, already making lists of baby names, already anticipating how excited her family would be about the news. She was not concerned about the results of her first HIV test because she had been a virgin when she married.

The test came back positive. Every dream, every hope Nomvula cherished came crashing down around her.

Shattered, Nomvula thought her life was over, and her baby's finished before it had even begun. Yet, in that same clinic, medical intervention - including free, lifesaving antiretroviral drugs - was readily available. But she didn't know that and no one was there to tell her on that fateful day. The doctor - who had responsibilities at other clinics - was elsewhere. The nurses simply had no time to help her, to address her fears, to explain her options.

She vowed to never tell her husband for fear he would blame her for the shame brought into the family. She could not tell her mother-in-law, who might beat her and throw her out. So Nomvula left the clinic, never to return.

Throughout sub-Saharan Africa, this story is all too familiar. While pediatric AIDS has been virtually eliminated in a number of countries, in Africa approximately 900 babies are newly infected with HIV every day. Nearly all of them acquire HIV from their mothers during pregnancy, childbirth or breastfeeding. Nearly all of these infections can be prevented.

This outcome is unnecessary and unacceptable. No baby should be born with HIV. Not in our lifetimes, not anywhere on earth.

Effective, inexpensive and safe medical interventions that prolong and improve the lives of mothers and prevent HIV transmission to infants are available, even in the world's poorest countries.

So why does this problem persist?

First of all, health systems in the poorest countries are often overburdened. Doctors and nurses often lack the time they need to educate and counsel a terrified new mother who has just found out she is HIV-positive. Medicine does not equal medical care, not by a long shot.

Second, stigma and shame still cause women like Nomvula to fear for their lives. That fear prevents them from seeking testing and proper treatment.

Finally, awareness is low. People everywhere - from the most vulnerable to the most removed - remain unaware of how easily we can prevent HIV transmission from a mother to her infant.

Mothers2mothers (m2m) was founded to close the gap and overcome these hurdles. m2m uses a simple and effective model to eliminate transmission of HIV from mothers to babies and sustain the health of women and children. We educate, employ and empower mothers living with HIV, who work as Mentor Mothers in health centers, bolstering their capacity and providing lifesaving information and one-on-one support to pregnant women living with HIV.

We put HIV-positive mothers at the heart of our efforts to eliminate pediatric AIDS and keep mothers alive. They become the frontline health workers that the region so desperately needs.

We employ our Mentor Mothers because it helps them gain economic security for themselves and their children. Thus, they also become respected role models in their community, defying HIV-related stigma and discrimination.

Mentor Mothers feel important and valuable - because they are. Indeed, the women Mentor Mothers serve are more likely to disclose their HIV status, to pursue HIV treatment and CD4 testing, and to deliver their babies in health care facilities than mothers who do not have a Mentor Mother.

Today, almost 1,500 Mentor Mothers are helping women in the 600 sites m2m operates in seven sub-Saharan countries - where nearly three million mentoring sessions took place in 2011.

We are collaborating with partners like Johnson & Johnson - a company that has provided valuable resources and enduring support for our mission - to bolster and expand our model.

We are now also working with governments and local implementing partners in countries with high rates of HIV to integrate the Mentor Mother model into their national health systems. We are also broadening the scope of what Mentor Mothers can do, such as providing information about reproductive health and family planning, nutrition assessment and counseling, tuberculosis screening, and other critical areas related to maternal, newborn and child health.

In fact, momentum is growing to use innovative strategies like the Mentor Mother model to finally end pediatric AIDS. The United Nations' Global Plan towards the Elimination of New HIV Infections among Children by 2015 and Keeping their Mothers Alive, launched at the United Nations in 2011, includes our model as an example of what works.

What works will be a prominent topic this week when the global health world is gathered in New York City to discuss our progress towards the Millennium Development Goals. The severe shortage of healthcare workers is a significant barrier to achieving them, and so I am looking forward to participating on panel with my colleagues from Johnson & Johnson, Save the Children and the African Medical and Research Foundation about the need for more frontline health workers, like Mentor Mothers.

Our goal could not be more urgent, and Nomvula's story makes that clear. She deserved a chance to defend her life and give birth to a healthy baby. She deserved a Mentor Mother.

Mentor Mothers are game-changers - frontline heroes in the quest for healthy motherhood and an HIV-free generation.

Learn more at www.m2m.org.