Enable – towards an AIDS-free generation

IMG_2207Enable aims to reduce mortality rates among children under 5 in the O R Tambo district in the Eastern Cape Province of South Africa, one of the poorest districts in one of the most under-served provinces in the country. 

We are delighted to share the latest update on the achievements of Enable with you. Over the last six months, we have seen our 30 trained Mentor Mothers go out into the community and deliver vital mother and child healthcare directly into homes: reaching 1,161 vulnerable pregnant women, mothers and children, and bringing benefits to 5,805 family members. Our Mentor Mothers provide interventions that have the highest impact on reducing under 5 mortality and morbidity.

On average, a Mentor Mother works with 43 clients. This represents a highly cost effective model: £223 is spent on each pregnant woman, baby delivered, new mother, and child under 5 to ensure they enjoy a healthier start to family life.

IMG_2124NOTABLE ACHIEVEMENTS

Less than 1% mother-to-child transmission of HIV continues in our target households despite 27% of pregnant women being HIV+.

30 trained Mentor Mothers delivering vital health care directly into the homes of 1,161 vulnerable pregnant women, mothers and children.

7 doctors active in the local hospital where previously only 1 doctor was trying to serve a population of 143,00.

91% of pregnant women know their HIV status, up from 76% at the start of the project.

95% of pregnant women in the area are now supported by our Mentor Mothers.

95% of babies are delivered in the hospital.

MENTOR MOTHERS HAVE ENSURED:

  • pregnant women receive the antenatal care needed for a healthy pregnancy and delivery.
  • babies are delivered in the safe environment of a hospital.
  • children receive the immunisations needed to protect them from serious or fatal childhood diseases.
  • underweight children are able to benefit from improved nutrition and vitamin supplements so they can reach a healthy weight.
  • mothers have the comfort of knowing there are support and advice at hand to keep their families healthy.
  • families are benefitting from improved availability of health services through the provision of a monthly mobile clinic and reduced stock-outs of medicines in clinics.
  • families are receiving the child support they are entitled to, enabling them to afford adequate food and vital supplies.
  • the community has increased awareness of their right to quality healthcare, which has increased demand and is pushing the government to be more accountable to its citizens.

INDEPENDENT EVALUATION

In this period, Enable had an independent evaluation of the impact of the project. In addition to providing crucial accountability to our funders, it was also an important opportunity for us to reflect on our project, review challenges, and build our learning to strengthen interventions going forward.

“We can be confident the community health model is having an impact on child survival in Nyandeni Municipality. One to One Children’s Fund has been able to make the model work even in the face of a weak public health system and high level of poverty.
Just a little over the half way mark, Enable is performing well and on track to meet almost all programme targets. Only the exclusive breastfeeding target will not be met.  One to One Children’s Fund is underestimating the impact it is having on child health outcomes.”

We greatly valued the recommendations in the evaluation to ensure maximum impact. These included improvements in methods to capture data, building the project to respond to sexual and reproductive health needs of young people, and bringing Community Health Workers into the project to strengthen sustainability.

We were delighted that the evaluation made a recommendation to scale up our Enable programme.

IMG_2227ENABLE ESCALATION PLAN

“Enable is doing an amazing job in a very difficult environment. We need Enable to expand services to more wards in the Eastern Cape.” Rural Health Advocacy Project

In line with One to One Children’s Fund’s methodology of innovate, escalate, graduate, we are looking to build on this successful innovate pilot and escalate it. We feel we are in a strong position to take this proven community health model to substantial scale in neighbouring areas, in a part of the country where the need is great. The expanded project area has some of the worst health outcomes in the country with entrenched poverty and under-developed infrastructure.

We plan to take our learning to bring in Community Health Workers as well as Mentor Mothers, broaden our intervention to include sexual reproductive health and mental health, and use mobile technology to improve effectiveness. If we are successful in securing funding, we will reach a further 2,400 families and bring benefits to 1000s more families through awareness-raising sessions and improved access to healthcare.

Download the complete report Enable Report 30_08_2018

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