Goodstart: a cluster randomised effectiveness trial of an integrated, community‐based package for maternal and newborn care, with prevention of mother‐to‐child transmission of <scp>HIV</scp> in a <scp>S</scp>outh <scp>A</scp>frican township

Abstract

The trial coincided with national scale up of ARVs for PMTCT, and this could have diluted the effect of the intervention on HIV-free survival. We have demonstrated that implementation of a pro-poor integrated PMTCT and maternal, neonatal and child health home visiting model is feasible and effective. This trial could inform national primary healthcare reengineering strategies in favour of home visits. The dose effect on exclusive breastfeeding is notable as improving exclusive breastfeeding has been resistant to change in other studies targeting urban poor families.