Girl-POWER

Overview

While many programs target AGYW for pregnancy prevention and antenatal care (ANC) programs or HIV prevention and treatment programs, few combine both aspects of young women’s healthcare. The Girl-POWER initiative is a high-impact intervention package that covers ANC care for AGYW; AGYW-focused prevention of mother-to-child transmission of HIV (PMTCT); case management for prioritized AGYW in ANC; management of labor and delivery and postpartum care for AGYW; prevention of HIV, sexually transmitted infections (STIs), GBV, and unwanted pregnancy; and tailored retention activities to support ongoing engagement in care for AGYW. Health care workers and AGYW peer mentors were trained and sensitized on optimizing these interventions, including awareness for GBV; HIV retesting in ANC; mental health and depression in pregnant and postpartum AGYW; and AGYW-focused PrEP.

Girl-POWER is implemented across 36 health care facilities in Homa Bay County and spearheaded by 40 trained AGYW who serve as peer mentors. These peer mentors are AGYW who have been pregnant and/or are young mothers themselves and who have been trained and integrated into the client flow at supported health care facilities. Their role is to provide tailored, individualized support throughout pregnancy, delivery, and the postnatal period for the mother and infant. This support includes managing the client’s care by helping AGYW navigate the care continuum through different health care providers, linking them to counselling services where appropriate, and ensuring ongoing engagement in care for the mother-infant pairs.

All AGYW (aged 10-24 years) visiting an outpatient department (OPD) at a Girl-POWER facility receive a standardized pregnancy risk assessment to identify suspected, at-risk, and confirmed pregnancy status. AGYW confirmed pregnant are enrolled in G-POWER or linked to pregnancy prevention services, if screened negative. STI screening, linkage, and navigation to GBV and HIV services are also provided by peer mentors for all AGYW presenting for pregnancy screening. All PBF AGYW are enrolled in Girl-POWER, regardless of HIV status, and they complete an individualized case contact form with an AGYW peer mentor. A case management form guides the individualized care plan for the AGYW with messaging, mentorship, and social support needs throughout their pregnancy, delivery, postpartum, and early motherhood period including: tailored resources about HIV prevention; adherence to antiretroviral therapy (ART) or pre-exposure prophylaxis (PrEP); antenatal care; postnatal care (PNC); nutrition; GBV care and/or prevention; and early childhood development information, support, and services, including regular HIV retesting for the mother-baby pair. AGYW who are not pregnant receive pregnancy prevention messaging and access family planning methods if applicable. All AGYW who test positive for HIV are immediately linked to ART, and those who test negative are counselled about pre-exposure prophylaxis (PrEP) and initiated when eligible.

Girl-POWER was intentionally designed to identify pregnancy early and offer facilitated linkage to quality services for AGYW while addressing the triple threat. As compared to the standard of care, Girl-POWER integrates activities focused on the needs of HIV-positive and HIV-negative AGYW and makes sure that these needs are prioritized to ensure continuation of treatment and prevention, as well as optimized GBV screening, identification, and linkage to treatment and post-violence care if needed.