Mentor mothers in Kamuli trace and bring back 57 adolescents into HIV care

Kamuli District had a high HIV/AIDS prevalence and most girls in her community were not adhering to their medication

By Alex Taremwa
Midwife preparing to measure a baby.
26 May 2021

Sarah Nabirye will turn 42 on May 31. In August 2009, she found out that she was pregnant when she visited Lubaga Hospital in Kampala for a check-up. She was told that she was HIV positive and referred to the Joint Clinical Research Center (JCRC) to start on antiretroviral treatment immediately.

“That was too much bad news for one day. My world was shattered. I did not talk to anyone for two months. The antiretroviral (ARV) tablets were traumatizing to even look at, later on, swallow. I didn’t go back for refills, instead, I travelled to Kamuli and hid there,” she narrates.

After serious introspection, Nabirye decided that her child should not be born with the same virus. She boarded a bus to Kampala and resumed her treatment with loyalty. She would later give birth to a healthy baby boy at Kitebi Health Centre IV in Kampala.

After her baby was born, she got a transfer from JCRC to Namwendwa Health Centre IV in Kamuli District where she continued to get her ARV refills.

Unknown to Nabirye, Kamuli District had a high HIV/AIDS prevalence and most girls in her community were not adhering to their medication and as a result, they were giving birth to HIV positive babies. Soon the children would be orphaned.

At first, Nabirye was ashamed to share her story but she decided to get training from Mothers2Mothers as a mentor mother at Namwendwa Health Centre IV’s so she could link HIV/AIDS adolescents to care, help them adhere to medication, keep track of their refill schedule and follow-up on those who fail to return through phone calls and home visits.

Nabirye has been a mentor mother at the hospital for 10 years – mostly as a volunteer. She has brought over 800 adolescents back into care and helped deliver over 500 HIV-free babies over the years.

“It is my passion to use my story to support adolescent girls deliver healthy babies. I was trained by M2M in 2011. I worked with them for two years as a mentor mother at this hospital [Namwendwa]. When the project closed, I stayed here as a volunteer until recently when M2M returned in December to implement a similar project,”

Nabirye says.
Mentor mother helping adolescent mother while at the health centre
Para-social worker conducting a training with adolescent mothers

Poor retention in care

Despite Nabirye’s best efforts, Kamuli District had one of the lowest rates of retention in care for children between 0-14 years and 15-24 years at 66 per cent for antiretroviral therapy (ART) and 75 per cent for elimination of mother-to-child transmission of HIV respectively.

According to Michael Adengo, the M2M Senior Programs Manager, there were gaps in linkage to care for both children and adolescents hence the need for catalytic interventions at facility and community levels.

With funding from the FNS Charity Campaign, M2M identified four high-volume health facilities: Kamuli General Hospital, Kamuli Mission Hospital, Namwendwa Health Centre IV and Nakandulo Health Centre IV in four sub-counties as key project sites.

All of these hospitals conduct HIV tests in communities, referrals, follow-ups, ART services and prevention of mother-to-child transmission (PMTCT) programmes.

According to Dr Gonzaga Mankumba, the Health Facility In-Charge at Namwendwa Health Centre IV, the ART clinic now serves 1,004 patients including 80 mothers in baby-mother care and over 130 in PMTCT.

“We have three mentor mothers at the hospital, and they have been able to trace and bring back all 57 adolescents that were lost back to into care. With support from M2M and UNICEF, we are even able to reach communities out of our catchment area to do testing, ART and PMTCT,” Mankumba says.

One of Nabirye’s patients is Aisha Namukose, 21, who got pregnant while at school. Her parents were unreceptive of her and neither was her boyfriend. To add salt to injury, when she visited Namwendwa Health Centre IV, she was tested and found to have HIV/AIDS.

“At that moment, I even thought about taking my own life. I didn’t see any purpose in life. But when musaawo (mother mentor) Sarah talked to me and told me her story, I felt strong. She told me to adhere to my treatment so that I could keep my viral load low and promised that I would give birth to a healthy baby. Sarah is now a grandmother to my baby girl,” Namukose tearfully narrates.

Nabirye is one of the 30 mother mentors, 130 para-social workers, 24 adolescent peer educators and 29 Village Health Teams (VHTs) trained by M2M with support from UNICEF in Kamuli district.  

She fears that the gains they have made could be reversed by the ending of M2M’s project. She argues that the project could have achieved more impact if it was given more time to further penetrate local communities.


A midwife looking for a file at the health centre
At the health centre seeking for health services