title: Thirty-Six-Month Outcomes of a Generalist Paraprofessional Perinatal Home Visiting Intervention in South Africa on Maternal Health and Child Health and Development.
abstract: Almost all pregnant women (98 %) in 24 Cape Town neighborhoods were randomized by neighborhood to (1) the standard care (SC) condition (n = 12 neighborhoods; n = 594 pregnant women) or (2) the Philani Intervention Program (PIP) in which home visits by Community Health Workers (CHW) were conducted (n = 12 neighborhoods; n = 644 pregnant women). At 36 months post-birth (84.6 % follow-up), PIP mothers were significantly less depressed compared to the SC mothers. Children in PIP were significantly less likely to be stunted (24.3 vs 18.1 %, p = 0.013), to have better vocabularies, and were less likely to be hospitalized than children in the SC condition. These data suggest home visits may need to continue for several years post-birth. Sustainable, scalable perinatal intervention models are needed in LMIC.
authors.affiliation: Department of Psychology, Stellenbosch University, Private Bag X1, Matieland, 7602, South Africa.
authors.forename: Mark
authors.initials: M
authors.lastname: Tomlinson
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, Semel Institute, University of California at Los Angeles, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA, 90024, USA. mrotheram@mednet.ucla.edu.
authors.forename: Mary Jane
authors.initials: MJ
authors.lastname: Rotheram-Borus
authors.affiliation: Philani Maternal, Child Health and Nutrition Trust, PO Box 40188, Elonwabeni, Cape Town, 7791, South Africa.
authors.forename: Ingrid M
authors.initials: IM
authors.lastname: le Roux
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, Semel Institute, University of California at Los Angeles, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA, 90024, USA.
authors.forename: Maryann
authors.initials: M
authors.lastname: Youssef
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, Semel Institute, University of California at Los Angeles, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA, 90024, USA.
authors.forename: Sandahl H
authors.initials: SH
authors.lastname: Nelson
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, Semel Institute, University of California at Los Angeles, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA, 90024, USA.
authors.forename: Aaron
authors.initials: A
authors.lastname: Scheffler
authors.affiliation: Department of Biostatistics, Fielding School of Public Health, University of California at Los Angeles, Los Angeles, CA, 90095, USA.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Weiss
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, Semel Institute, University of California at Los Angeles, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA, 90024, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: O'Connor
authors.affiliation: Department of Anthropology, Emory University, 1557 Dickey Drive, Atlanta, GA, 30322, USA.
authors.forename: Carol M
authors.initials: CM
authors.lastname: Worthman
mesh_terms: D000328:Adult; D000067576:Child Health; D003150:Community Health Workers; D019052:Depression, Postpartum / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006792:House Calls; D006801:Humans; D000068097:Maternal Health; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D013019:South Africa / Q000453:epidemiology; D055815:Young Adult
keywords: Community health workers; Maternal depression; Perinatal home visiting