title: Outcomes of home visits for pregnant mothers and their infants: a cluster randomized controlled trial.
abstract: OBJECTIVE
  To evaluate the effect of home visits by community health workers (CHWs) on maternal and infant well being from pregnancy through the first 6 months of life for women living with HIV (WLH) and all neighborhood mothers.
  
  
  METHODS
  In a cluster randomized controlled trial in Cape Town townships, neighborhoods were randomized within matched pairs to either standard care, comprehensive healthcare at clinics (n=12 neighborhoods; n=169 WLH; n=594 total mothers); or Philani Intervention Program, home visits by CHWs in addition to standard care (PIP; n=12 neighborhoods; n=185 WLH; n=644 total mothers). Participants were assessed during pregnancy (2% refusal) and reassessed at 1 week (92%) and 6 months (88%) postbirth. We analyzed PIP's effect on 28 measures of maternal and infant well being among WLH and among all mothers using random effects regression models. For each group, PIP's overall effectiveness was evaluated using a binomial test for correlated outcomes.
  
  
  RESULTS
  Significant overall benefits were found in PIP compared to standard care among WLH and among all participants. Secondarily, compared to standard care, PIP WLH were more likely to complete tasks to prevent vertical transmission, use one feeding method for 6 months, avoid birth-related medical complications, and have infants with healthy height-for-age measurements. Among all mothers, compared to standard care, PIP mothers were more likely to use condoms consistently, breastfeed exclusively for 6 months, and have infants with healthy height-for-age measurements.
  
  
  CONCLUSIONS
  PIP is a model for countries facing significant reductions in HIV funding whose families face multiple health risks.
authors: Philani Maternal, Child Health and Nutrition Project, Cape Town, South Africa.
authors: Ingrid M
authors: IM
authors: le Roux
authors: Mark
authors: M
authors: Tomlinson
authors: Jessica M
authors: JM
authors: Harwood
authors: Mary J
authors: MJ
authors: O'Connor
authors: Carol M
authors: CM
authors: Worthman
authors: Nokwanele
authors: N
authors: Mbewu
authors: Jacqueline
authors: J
authors: Stewart
authors: Mary
authors: M
authors: Hartley
authors: Dallas
authors: D
authors: Swendeman
authors: W Scott
authors: WS
authors: Comulada
authors: Robert E
authors: RE
authors: Weiss
authors: Mary Jane
authors: MJ
authors: Rotheram-Borus
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000592:standards / Q000706:statistics & numerical data; D019380:Anti-HIV Agents / Q000627:therapeutic use; D003150:Community Health Workers / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control*; D006699:Home Care Services / Q000592:standards* / Q000706:statistics & numerical data; D006792:House Calls / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008427:Maternal Health Services / Q000379:methods / Q000706:statistics & numerical data*; D008429:Maternal Welfare / Q000706:statistics & numerical data; D009035:Mothers / Q000523:psychology*; D011247:Pregnancy; D013019:South Africa; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents