In South Africa cultural issues were far more challenging [20] and the peers struggled much more to get acceptance. The peer supporters required substantial supervision and follow-up from their respective trainers and supervisors. Issues like no previous job experience, own health problems, emotional stress through fear and rejection, safety issues and HIV disclosure issues among study mothers were of far greater concern in the study than the intervention itself [21]. In other words, the South African peer supporters expressed a need for far deeper and more comprehensive understanding for themselves, combined with supervision and follow-up. With South Africa’s high HIV prevalence, it could be argued that a community intervention alone without intervening at facility-level was not enough to alter behaviour