The key idea of the Mentor Mother Programme is to engage capable women in the task of improving the lives of families in their own communities. (Photo: Supplied)News & Features
20th October 2025 | Sue Segar
Mothers and babies in South Africa can easily fall through the cracks and end up going hungry and not getting the healthcare they need. Sue Segar spent time with an innovative project that is helping thousands such women and kids in parts of the Western Cape and Eastern Cape. Their model has been adopted by organisations in several other countries.
In a large hall in the sprawling Cape Town township of Khayelitsha, a group of community health workers listens attentively as a colleague shares information about one of her vulnerable clients.
The health worker, employed by Philani, an NGO which focuses on maternal and child health, is describing her concern for a young mother whose baby is at risk of neglect and malnutrition.
Known as a “mentor mother”, who does daily home-based visits to community members, the health worker explains that the vulnerable mom, barely twenty, gave birth three months ago, and is suffering from severe depression, and abusing alcohol. The baby’s father has reportedly abandoned her. Instead of looking after her baby, the health worker says the mother is walking the streets at night, has gone off her anti-depressants, and her behaviour and general wellbeing have deteriorated. The baby’s grandmother who lives in the same house is apparently an alcoholic and offers no help with the baby. The baby’s young aunt, the sister of the new mom, who also lives in the house, has been desperately looking for help.
The fellow mentor mothers listen attentively as murmurs of empathy echo through the packed hall. Then, in orderly fashion, several women in the group raise their hands to offer advice, based on their experiences, on how their colleague can handle this case.
The gathering of mentor mothers is taking place in Philani’s head-office in Khayelitsha’s Site C. Surrounded by shacks which sit cheek by jowl, Philani is a secure hub, comprising classrooms, offices, an educare library, and a shop selling items made by local screen printers and seamstresses.
The mentor mothers outreach programme is Philani’s flagship programme, in which the trained women walk from house to house in their own communities, identifying pregnant women, malnourished children and people at risk due to HIV, tuberculosis and other issues.
Sharing stories from the field
Every second month, Philani’s mentor mothers, along with their outreach team leaders, converge at the bustling head office for workshops on different topics related to maternal and child health, TB, HIV and other chronic illnesses. “It’s an opportunity for them to come together to have a day away from the field to debrief, exchange stories and get feedback on cases, and just to talk about the challenges they have in their communities. They rely on each other’s input and enjoy the fellowship and the chance to bond with colleagues,” says Mikera Bassuday, a manager for the Mentor Mother programme. “We usually have an educational aspect to these workshops, such as a speaker, and we try and coincide our topics with the health calendar.”
The hall is quiet as mentor mothers share their stories: A pregnant teen who initially refused help went into premature labour and had to be helped at the last minute to get to hospital; a five-year-old girl, sick, with no appetite, who is being cared for by a bedridden grandmother who is defaulting on her ARVs and needs to go to hospital; a 40-year-old woman living with HIV who is pregnant and needs medical assistance; new mothers struggling with breastfeeding.
Though their main focus is maternal and childcare, the mentor mothers are not exempt from other community issues. As one tells it: an old woman, bedridden at home, is in serious need of healthcare. But her gangster son, recently released from prison, won’t let health workers into the house.
“He sits outside with friends, and whenever I arrive, he says his mother is asleep. I need to get in because the old lady has pressure sores which need treatment,” she says. “But she protects this son who uses all her pension money … she tells me she loves him so much.”
House to house, every day
The mentor mothers – often, but not always, chosen for their personal experience as mothers – work on the ground, every day, guiding women on antenatal care, nutrition and the health of their children as well as looking after the elderly and chronically ill.
Philani, meaning Be Well in IsiXhosa, targets pregnant women to support them before problems arise – ensuring they register at an antenatal clinic, have regular checkups, test for HIV and learn about breastfeeding.
Mentor mothers are community health workers. In the Western Cape, they are part of the provincial health department’s community-based programme, which also provides their main funding. While Philani also works in the Eastern Cape, it receives no funding from that province’s health department.
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Bassuday explains that mentor mothers work in specific areas, with about eight to eighteen women in each area. Each group is supervised by an outreach team leader who reports to a programme manager.
“New mentor mothers undergo eight weeks of intensive training on a range of topics, starting with how to negotiate entry into the households, and covering the various topics in which they must be knowledgeable – such as antenatal and postnatal care, and nutrition,” says Bassuday. They also screen for pregnancy, TB, high blood pressure and diabetes, as well as mental health issues, and make referrals to clinics, social workers or whatever relevant service is needed. They continue to provide support through regular visits to households.
“Heartbreaking stories” – every single day
“Some of the stories are heartbreaking – involving abandoned, neglected or abused children; or alcohol abuse taking place in the home,” says Bassuday. “The most difficult cases are those where they go inside and see absolutely no food. It often comes down to poverty. And the mentor mothers show up every single day and are willing to go into the houses and do whatever they can. I’m proud every day.”
Bassuday says stories of this special relationship between mentor mother and client abound, with one mother describing her mentor mother as “my everything … my mom, my sister … and someone whose shoulder I can cry on”.
A history of nearly 50 years
Philani was founded in 1979 by Swedish-born doctor Ingrid le Roux. She had moved to Cape Town after marrying a South African man. After completing her registrar post at the Johannesburg General Hospital, she took a post at Groote Schuur Hospital in 1978. There, she worked closely with the student-led nonprofit SHAWCO whose members asked her to help them with mobile paediatric clinics they were running in Crossroads.
“I started going into Crossroads to help them … and soon I was hooked,” Le Roux recalls.
She says Philani started as a nutrition rehabilitation clinic in Crossroads for malnourished children. The mothers would bring their children there to play and be fed. Recognising a need for the mothers to earn an income, not long after its formation, the organisation added a weaving and printing workshop. “Then, because the children were there all day, we realised they needed a preschool,” says Le Roux.
In the mid-1980s, Philani moved to Khayelitsha and expanded to open nutrition clinics in Site B, Site C, Town 2, Mayibuye, and Browns Farm in Phillipi, with its headquarters in Site C. These clinics, similarly, evolved from clinics to Early Childhood Development centres, in which nutrition rehabilitation is integrated into the preschool work.
The mentor mothers programme came about after Philani conducted a study, funded by UNICEF, on nutrition problems in Khayelitsha. “We mapped the whole community, visited thousands of households, weighed and measured the children, and found that 12% of the kids in Khayelitsha were malnourished and 27% were stunted. We realised this was the real challenge. The worst malnutrition was in the very marginalised groups where there was no understanding about malnourishment. We realised we needed to go out and find these children,” says Le Roux.
“So, in 2000, we started the outreach, and we started calling the health workers our mentor mothers. In 2010, Philani opened a programme at Zithulele in the Eastern Cape, and two years later in Coffee Bay.”
Today, there are about 236 mentor mothers in the Western Cape and 50 in the Eastern Cape. Each mentor mother is responsible for about 250 households, and does more than 100 home visits a month.
In the Western Cape, a small number of them are based at, and supporting, government clinics in their areas.
The mentor mother model has been adopted by various organisations around the world, and Philani has established programmes in Eswatini, Ethiopia and Egypt as well in refugee communities in Sweden – in partnership with the Church of Sweden.
A ‘positive deviant’ model
The programme is inspired by the “positive deviant” model that recognises that women in even the poorest communities can work out how to cope and raise healthy children. It aims to build independence and find solutions within communities; with the core understanding that, while not all problems can be solved, there is value in learning from shared experiences.
“The key idea of the mentor mother programme is to engage capable women in the task of improving the lives of families in their own communities, prioritising mothers and children and people with non-communicable diseases … and taking the rehabilitation of under-nourished children and care for people with chronic diseases beyond clinics and institutions and into the community,” says Le Roux.
Besides regular support, the mentor mothers’ performance is monitored on outcomes such as rehabilitation rates, exclusive breastfeeding, antenatal attendance, and other interventions.
Philani has a number of satellite offices – there are 17 in the Western Cape, with eight in Crossroads, five in Site C, and four in Mfuleni – which operate as team hubs for mentor mothers to store files, do training, and meet every morning before setting out into the field.
At each satellite office is a wellness hub which runs weekly clinics offering preventative health services for the community. These include screenings for TB, HIV, diabetes, hypertension, and mental health conditions, family planning, pregnancy testing, nutrition interventions, and general health education.
Philani also runs nutrition clinics to attend to severely malnourished young children from birth to age 3 who are too young for preschool but require support, as well as an ARV programme that serves as a pickup point for people living with HIV to collect their medication without having to queue at a clinic.
Children learn while being fed
There are about 800 children enrolled in Philani’s Educare programme: comprising 17 classes in the Western Cape and 11 in the Eastern Cape. Children attending the schools receive two nutritious meals per day. The provincial education department supports the preschools in the Western Cape.
“If a mentor mother finds a child in the community who is malnourished, that child automatically gets a place in our preschool, and is put onto a nutrition rehabilitation schedule at the school,” says Le Roux.
Outreach Team Leader Aviwe Lutshiti, who works from Site C, supervises eight mentor mothers in the area, each of whom sees 10 to 12 clients daily. “They work in pairs, always with their scales to weigh the children, and with household assessment forms from the Department of Health. After their visits, they return to the satellite office to write down the details from their patients in a daily service point register,” she says.
Ntombozuyo Malantabi has been working as a mentor mother for nearly three years. “We start our day making sure we have our folders,” she explains, “yellow for TB and bedridden patients; blue for malnourished children under five; green for pregnant mothers and postnatal clients; and the alcohol reduction folders. And we always take our scale. We can’t perform without scales.”
Malantabi says she loves her work, even though it’s tough. “The other day, I arrived at a house and found a 20-year-old girl, living alone with her two-week-old baby. She said she was from KwaZulu-Natal. She’d become pregnant back home but [had] hidden the pregnancy because she wanted to study in the Western Cape. She was waiting for her NSFAS money.”
“What made my heart sore was that the baby was naked, and without food or clothes. The mother didn’t know how to breastfeed and was extremely stressed. She said the baby’s father lives in KZN and is married to another woman,” she says.
“I opened a household form and gave her a food parcel from Philani. Our social worker supplied her with baby clothes. I showed her how to breastfeed. I visit her regularly and she’s doing well. She’s getting her NSFAS money. She told her parents about the baby, and her stepmother is now looking after the baby so she can study,” Malantabi says.
Positive outcomes
According to Le Roux, a culture of respect, care, trust and listening is key in the mentor mother/client relationship. “That’s how a mother’s behaviour will change over time to benefit her child.”
And there is evidence that it works. A study led by Professor Mark Tomlinson of Stellenbosch University found that children in households who received help from Philani health workers were significantly less likely to be underweight or severely underweight than children in households who did not receive the home-based support. “The ongoing study which involves 12 intervention areas in Khayelitsha and 12 control areas has found that in the areas where we have mentor mothers, the malnutrition rates are half of those where we don’t have them,” says Le Roux.
“We’ve made a significant impact on nutrition through doing two things. First, we find the malnourished children in the community through growth monitoring by the mentor mothers, and if the child is underweight, we intervene. Secondly, we look after the low birth-weight babies. When a mother on our programme has a low birth-weight baby, we are there supporting her to ensure she can breastfeed, that the child is protected, and we follow that child to ensure the child grows.”
Le Roux says almost all those low birth-weight babies are fully rehabilitated within a year.
Not slowing down any time soon
In May this year, Le Roux, now in her late 70s, travelled back to her country of birth to receive the prestigious Royal Order of Vasa at the Royal Palace in Sweden, for her significant contributions to the health of women and children in vulnerable areas.
Could this be the time to rest on her laurels? “Not a chance,” she tells Spotlight.
She says she still drives into Khayelitsha every day of the week to do a full day’s work at Philani’s head office.
“I originally planned to do internal medicine, but my career took a turn in another direction. I’ve had the most interesting, rewarding career. I love working closely with people to solve important challenges,” she says. “This work has made me humble.”
