Despite ongoing disruptions from the COVID-19 pandemic, in 2021 mothers2mothers (m2m) was able to increase our scale, and deepen our impact—including achieving all of UNAIDS 95-95-95 targets, four years early. These are among the key highlights from our 2021 Annual Programme Review, released today (Click here to download the full factsheet: 2021 Annual Programme Review.)
We are proud that we were able to deliver life-changing health services, information, and support to more people at a time when they were more needed than ever. This achievement was possible thanks to the rapid adaptation and innovation of our service delivery in 2020 to a hybrid approach of in-person services, combined with virtual eServices.
Growing our reach
m2m reached a total of 1,630,558 new and returning clients in 2021 through direct services and technical assistance, a 22 percent increase over 2020. An increase in new enrolments (up 20% to 1,251,581) was a primary driver of our growth in 2021. Among the drivers in new enrolments is the wider range of relevant, integrated services we provide—including the expansion of our integrated Early Childhood Development (ECD) and Reproductive, Maternal, Newborn, Child Health (RMNCH) programming, and launch of new projects focusing on orphans and vulnerable children, non-communicable diseases, and adolescent health. Another factor is our expansion into four new countries (Angola, Ghana, Mozambique, and Tanzania) in the past four years, where we have continued to scale and deepen our operations. For example, in Tanzania, we expanded our work to provide direct service delivery in 2021, in addition to the technical assistance we have provided there since 2020.
Ensuring health for the most vulnerable
m2m is committed to ensuring vulnerable populations, including children and adolescents, are not left behind in accessing vital health services.
- 99% of children enrolled in our Early Childhood Development (ECD) programme achieved their developmental milestones by their first birthday in countries where we provide ECD services integrated into our Reproductive, Maternal, Newborn, Child Health services (Ghana, Kenya, Malawi, South Africa, and Uganda).
- 99% of our clients who are orphans and vulnerable children and adolescents (ages 0-18) and who tested HIV-positive, were linked to antiretroviral therapy (ART). This is a remarkable achievement, given that globally only 54% of children are on treatment.1
- m2m reached 402,616 adolescents (ages 10-19) in 2021, a 51% increase from 2020—a priority for m2m since adolescent girls and young women continue to be one of the most at-risk populations for contracting HIV.
- In addition, we created meaningful jobs for 1,866 frontline health workers living with HIV, most of whom are women, a 10% increase over 2020—providing much-needed income during a time of unprecedented economic crisis.
Advancing the Global Goal of ending HIV/AIDS by 2030
We are proud to report that we have achieved virtual elimination of mother-to-child transmission of HIV among our enrolled clients for eight consecutive years, with a transmission rate of just 0.7% in 2021.2 That is well below the United Nations benchmark of 5% for virtual elimination.
This achievement was possible because we met all of the ambitious UNAIDS Fast-Track Targets among our enrolled clients in 2021, four years ahead of the 2026 target date—including ensuring our clients test for HIV, access and stay on treatment, and are virally suppressed. Detailed results include:
- Target 1: 95% of people living with HIV (PLWHIV) know their HIV status.
Ensuring our clients know their HIV status is a critical first step to preventing mother-to-child transmission of HIV during pregnancy, birth and throughout the breastfeeding period. In 2021, m2m achieved excellent results among our clients, with 97% of pregnant m2m clients at health facilities testing for HIV, compared to benchmark of 91% in Eastern and Southern Africa (UNAIDS 2019).
- Target 2: 95% of PLWHIV who know their status initiate treatment.
Mentor Mothers remain instrumental in supporting their clients to start ART if they test positive for HIV, which is essential to keep them healthy and protect their children from contracting the virus. One hundred percent (100%) of m2m clients who tested HIV-positive accessed ART, compared to an 85% benchmark for Eastern and Southern Africa (UNAIDS 2019).
Starting HIV treatment is essential, and staying on ART is critical as well. Ninety-seven percent (97%) of m2m clients adhered to their treatment more than 95% of the time in 2021, which was well above the 80% adherence rate that the World Health Organization says is necessary to achieve viral suppression.3
- Target 3: 97% of PLWHIV on treatment are virally suppressed.
In 2021, 97% of m2m’s pregnant and breastfeeding clients achieved viral suppression, surpassing the 91% benchmark for Eastern and Southern Africa (UNAIDS 2019). This is the fourth consecutive year that m2m’s clients have achieved viral suppression. Viral suppression is key to stopping HIV in its tracks. That’s because viral suppression reduces or eradicates the risk of transmission of HIV to a partner, or to an unborn or breastfeeding child.
Furthermore, 91% of m2m breastfeeding clients had an undetectable viral load, which further reduces the risk of transmission. “Undetectable = Untransmitable (U=U)” means that a person living with HIV is on ART with a consistently undetectable HIV viral load, and the virus cannot be transmitted to others.
Digital health services and tools underpin our success
m2m’s eServices continued to play an important role in providing more clients with health services, education, and support in 2021. m2m reached 188,552 clients through peer support by phone (100% of our target)—structured monthly calls to clients, ranging from education and psychosocial support to free flow interaction. We also reached 36,392 individuals our Virtual Mentor Mother Platform (34 times more clients than the year before)— an interactive WhatsApp chatbot that provides information translated into 27 languages on a wide range of health issues translated, including COVID-19, health pregnancy and motherhood, child health, and living with HIV.
m2m is committed to achieve 100% coverage of our digital health tools. m2m’s mobile applications track clients’ progress and our service performance— enabling our frontline team to rapidly respond to client needs and identify service improvement areas. In 2021, 80% of m2m field staff were digitally enabled.
Growth and impact driven by women on the frontlines
m2m’s growth and impact in 2021, and over the last 20 years, have been made possible by the efforts of the women at the heart of our work—women living with HIV employed and trained as Community Health Workers. This story from Magreth Baltazary Shirima, a Mother Champion at m2m Tanzania, highlights one of the many reasons they are so effective;
“Many of my clients, when they find out that they are living with HIV, they become in denial, they refuse to accept their status because of stigma and discrimination, thus resulting in them not taking their treatment. One client was admitted in our hospital, and it turned out that she was also living with HIV and she had not been taking treatment for a year. I spoke to her and shared my journey of living with HIV, and why it is important for her to adhere to treatment. Most importantly, I listened to her, she was comfortable, and we related to each other well. I managed to convince her to take her treatment, and today she is healthy and adherent to her medication. My colleagues and I are seen as role models in the community and at the health centres.” – Magreth Baltazary Shirima