Developing a Toolkit for health care professionals working with Pregnant People who use Drugs in Southern Africa

In South Africa, the institutions that capacitate and train nursing staff do not include a formalised module on Addictions. Although the risk of substance and alcohol use is mentioned throughout their curriculum there is no dedicated module providing evidence informed information on Harm Reduction, Psychopharmacology, Influence of Substance on the Somatic system, Stigma and dicrimination  etc... This is particuarly concerning in Perinatal Public health systems, who are constantly engaging with young, high risk pregnant people.  
In 2022, I was afforded the opportunity to develop a Toolkit for Health Care Professionals (HCP) Working with Pregnant people who use drugs. The aim of the project was to develop  a hard copy document  for public health care settings that was easy to understand, visually supportive and factually informed.  Nurses could make use of this document to improve adherence to prenatal care and assist people to achieve healthier pregnancies. The Toolkit provided an overview of substance use, the harms and risks associated with the different drug classes and extensive contextual information on assisting people to have healthier pregnancies whilst using substances. The Toolkit also detailed nutrition, various birthing options, the importance of adherence and encourages Health Care Professionals to adopt an informed, less stigmatising approach to  this vulnerable population. The Toolkit was developed in collaboration with the Academy of Perinatal Harm Reduction, the Harm Reduction Coallition and the South African Network of People who use Drugs to ensure evidence informed information as well as direct input from people who use drugs. Once developed, training on using the toolkit and basic substance use capacitation was piloted in a rural region within the Western Cape area of South Africa.Three case studies with three pregnant women who were all under the age of 21 were also carried out. These women attending local, public health facilities with HCPs who had attended our training. In Semester one, all three case studies were using Methamphetamine, smoking nicotine and consuming alcohol. By the third semester - they had all stopped using Methamphetamine and alcohol and had reduced their nicotine intake to between 3-8 cigarettes per day (This from over 20 in semester one) Two of the three case studies have given birth to healthy babies both weighing over 3.3kg's and 50cm in length. The third birth is due to take place at the end of January. 
This Toolkit speaks specifically to the African context where vulnerable women have limited access to comprehensive health care and first world Neonatal and Perinatal care. By raising further awareness and sharing positive outcomes from this project - I hope to expand evidence based knowledge on pregnancy and substance use not only to health care practioners, but also peers and other mental health professionals that work in the Addictions sector.