Costs, Benefits and Potential Replicability/Transferability

Philani was designed with sustainable scaling-up as a central pillar. The Philani programme fits in with the new primary health care re-engineering programme currently being implemented by the South African Department of Health. Within this system, outreach teams will be composed of a professional nurse and an average of six CHWs per 250 families. Linked to this is the fact that the stipends paid to Philani MMs are in line with those recommended by the National Department of Health and would therefore not be an additional programmatic cost.

The Philani programme has been evaluated in a rigorous cluster randomised controlled trial. Women living with HIV were more likely to complete tasks to prevent vertical transmission, use one feeding method for six months, avoid birth-related medical complications and were less likely to have stunted infants. Mothers receiving the intervention were also more likely to use condoms consistently, breastfeed exclusively for six months and were also less likely to have stunted infants (le Roux et al. 2013).

The infants of depressed pregnant women in the intervention group were significantly taller and heavier at six months of age than the infants of pregnant depressed mothers in the control group. Compared to infants of depressed intervention mothers, depressed control group mothers were significantly more likely to have infants greater than two standard deviations below the World Health Organization weight and length norms by age over the first six months of life (Tomlinson et al. 2015)

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