Ask-Boost-Connect-Discuss (ABCD)

Ask-Boost-Connect-Discuss (ABCD) is a mobile-based tool to improve maternal mental health among adolescent mothers living with HIV, delivered by peer supporters in low-resource settings. Peer supporters are young people living with HIV who are engaged in service delivery, offering peer education, adherence and psychosocial support. ABCD offers a package of care that can be led by peer supporters which includes: screening psychosocial needs of young mothers (“Ask”), mental health support through structured sessions (“Boost”), help with accessing services (“Connect”), and ongoing supervision and self-care (“Discuss”). ABCD content was adapted from the World Health Organisation, Thinking Healthy Programme.

The original ABCD concept and app (an ABCD prototype) was designed through an ongoing co-development process with end-users, YPLHIV and peer supporters. It was initially implemented as a feasibility study (supported by the Bill and Melinda Gates Foundation) in partnership with the Universities of Cape Town and Oxford in target sites across four focus countries (Uganda, Tanzania, Malawi, and Zambia). Across all sites, and supported by 20 peer supporters, the pilot study, with 147 enrolled young mothers enjoyed high levels of attendance in group activities.  The pilot was found to be feasible, acceptable, valuable, and responsive to the needs of both peer supporters and the young moms who were enrolled in ABCD groups.

The initial pilot study report highlighting key lessons is available for download.

Download the report

ABCD training and related tools will be integrated into PATA programmes.  Peer-led safe spaces that are structured and supported with ‘Thinking Healthy’ tools co-developed with young people, will be expanded and optimized to meet diverse needs. PATA would like to scale ABCD further and seeks opportunities to integrate, expand and leverage ABCD tools so that they may contribute to delivering comprehensive care and support for children, young families and marginalized youth.


The mental health treatment gap – estimated 75% in sub-Saharan Africa – persists due to lack of knowledge and stigma, poor linkages to care, and limited specialist services, especially in contexts of prevalent HIV, poverty and maternal and child mortality.

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