The Mentor-Mothers program in the Nigeria Department of Defense: Processes and Implementation

Abstract Background : Nigeria has the second largest HIV epidemic in the world and one of the countries with the highest rates of new pediatric infections in sub-Saharan Africa. The country faces several challenges in the provision of healthcare services and coverage of Prevention of Mother to child transmission of HIV (PMTCT). Antiretroviral coverage is still low as research has shown that in 2019 only 32% of pregnant women living with HIV had access to antiretroviral drugs for PMTCT, with about 12% of HIV-exposed infants receiving testing for early diagnosis by age 2 months. To achieve optimal viral load suppression and reduce the risk of mother-to-child transmission (MTCT) of HIV, the World Health Organization in 2006 recommended “Task Shifting” as a means of initiating and managing more patients to meet the demand for antiretroviral therapy. In the Nigeria’s Department of Defense (DoD) this task redistribution necessitated utilizing Mentor Mothers to facilitate antiretroviral compliance and retention in care. This was to boost the health workforce and attain target achievement with PMTCT in the DoD. The aim of this study was explore those processes that guide implementation of the mentor mother program for PMTCT of HIV in some hospitals in the DoD in Nigeria as no research has been conducted in this area so far. Methods: The case study methodology, qualitative research approach was utilized and in-depth interviews were conducted with relevant stakeholders. Open coding for major themes and sub-themes was done and data analyzed using thematic analysis.Results: Foundational Factors; Leadership; Skill acquisition; and Service Characteristics emerged as processes guiding the implementation of the Mentor-Mothers program in the Nigeria DoD.Conclusion: The findings support the Mentor Mother (MM) Model, which empowers mothers living with HIV – through education and employment – to promote access to essential services and medical care to other women. Working with governments, local partners, and communities played a pivotal role in the formation, facilitation, and implementation of the MM model to effectively decrease HIV infections in children, reduce child and maternal mortality, and support the livelihood, development of women, families and communities.