Development and assessment of feasibility of a community-based peer support intervention to mitigate social isolation and stigma of adolescent motherhood in Harare, Zimbabwe

Chiwoneso B Tinago; Edward A Frongillo; Andrea M Warren; Vivian Chitiyo; Ashley K Cifarelli; Shannon Fyalkowski; Victoria Pauline

doi:10.1186/s40814-021-00832-0

Development and assessment of feasibility of a community-based peer support intervention to mitigate social isolation and stigma of adolescent motherhood in Harare, Zimbabwe

Pilot Feasibility Stud. 2021 May 17;7(1):110. doi: 10.1186/s40814-021-00832-0.

Authors

Chiwoneso B Tinago¹, Edward A Frongillo², Andrea M Warren³, Vivian Chitiyo⁴, Ashley K Cifarelli¹, Shannon Fyalkowski¹, Victoria Pauline¹

Affiliations

¹ Department of Health, West Chester University of Pennsylvania, 855 S. New Street, West Chester, PA, 19383, USA.
² Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Room 529, Columbia, SC, 29208, USA.
³ Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Room 529, Columbia, SC, 29208, USA. warren5@mailbox.sc.edu.
⁴ The Organization for Public Health Interventions and Development (OPHID), 20 Cork Road, Belgravia, Harare, Zimbabwe.

Abstract

Background: Adolescent mothers in Zimbabwe often experience stigma, isolation, and lack coping skills and resources to successfully navigate motherhood. Social isolation and stigma are linked to poor mental health outcomes. No interventions currently address mental health of adolescent mothers in Zimbabwe. Peer support groups in other contexts have been effective at increasing social connectedness, self-esteem, and self-efficacy, providing coping mechanisms to manage stigma experiences, in addition to empowering and improving mental health of adolescents and adolescent mothers. To develop a community-based peer support intervention, we aimed to understand the unique needs of adolescent mothers, how peer support groups could address those needs, and the feasibility of implementing the intervention.

Methods: Focus group discussions were conducted with 86 adolescent mothers aged 14-18 years, 24 community health workers, and 25 key community stakeholders in a low-income high-density community in Harare. Data were analyzed thematically using NVivo 12 software.

Results: Participants described adolescent mother experiences with stigma and social isolation, in addition to challenges including gossip, lack of employment and educational opportunities, and gaps in services and programming. Peer support groups for adolescent mothers were welcomed to improve mental health, social support, knowledge sharing, and skills building. Participants identified varying preferred frequency and duration of group sessions addressing topics including income generation, mental health, and gossip, facilitated by community health workers at health and community centers. The use of WhatsApp Messenger to support intervention efforts was welcomed as an affordable and user-friendly platform to share information. Implementation (i.e., training, supervision, frequency, location, and co-facilitation) was feasible.

Conclusions: Adolescent mothers, community health workers and key community stakeholders welcomed the peer support groups as a feasible way to address the mothers' needs.

Keywords: Adolescent health; Adolescent mothers; Maternal health; Mental health; WhatsApp Messenger; Zimbabwe.

Grants and funding

OPP1190830/Bill and Melinda Gates Foundation