Zimbabwe is working to overcome political, economic, and social instability. Declining resources for public health, together with a shortage of qualified health care workers, have made it more difficult for Zimbabweans to access quality health services. Despite these challenges, global and local leaders have continued to invest in the promise of a better future for Zimbabwe’s people. I-TECH, with funding from the US Centers for Disease Control and Prevention (CDC) and the US President’s Emergency Plan for AIDS Relief (PEPFAR), is working closely with the Ministry of Health and Child Care (MOHCC) and local partners to strengthen national health systems. Drawing on resources at the University of Washington and the University of California, San Francisco, I-TECH emphasizes sustainable, wide-reaching, and context-appropriate responses to HIV and AIDS. I-TECH is partnering with the Zimbabwe MOHCC to expand intensified care and treatment, strengthen laboratory and diagnostic testing, and support locally based clinicians to deliver safe, voluntary medical male circumcision (VMMC) and other health outreach services to prevent HIV and AIDS.
All of I-TECH’s efforts are implemented with an eye to sustainability, efficiency, and local ownership. Gradually this work is providing more consistent, quality care for Zimbabwe’s citizens—a confident step toward strengthening the nation’s health system.
In Zimbabwe, I-TECH collaborates closely with local partners on a range of context-appropriate health interventions to improve access to—and quality of—HIV prevention, treatment, care, and support services through site-specific interventions and community outreach.
HIV Care and Treatment
- Strengthen the capacity, skills and knowledge of health care workers.
- Work with health facilities to improve availability and quality of HIV prevention, treatment, care and support services through site support and quality improvement activities.
- Partner at the facility level to provide HIV testing and ART initiation.
- Provide community outreach to identify persons needing HIV services and link them to HIV testing and treatment services. Activities include partner testing and tracking of patients lost to follow-up.
Innovation: Using Technology for Blended Learning, Discussion Groups and Data Collection
- Tablet-based self-study modules: Over 800 nurses and primary counselors have completed self-study courses in either PMTCT Client Retention or HIV Testing Services for Children and Adolescents.
- Mobile phone text messaging groups for peer-to-peer learning and support.
- TrainSMART: Open-source, web-based training data collection system housed at the MOHCC that allows users to accurately track data about training programs, trainers, facilities, and trainees; over 13,000 participants entered by 19 partners.
- Tablet-based data collection at facilities.
Scaling Up VMMC
- Since 2013, the ZAZIC consortium, led by I-TECH in partnership with the Zimbabwe Association of Church Related Hospitals (ZACH); Zimbabwe Community Health Intervention Research Project (ZiCHIRe) and UZ-UCSF, has implemented an integrated VMMC program jointly with MOHCC initially in 21 districts and now in 10 following the PEPFAR pivot.
- ZAZIC’s integrated VMMC approach uses existing health care workers and MOHCC infrastructure, focusing on capacity building and sustainability.
- From October 2013 through September 2016, ZAZIC expanded services to include static and outreach VMMC sites and performed a total of over 150,000 MCs.
- Approximately four-fifths of the circumcisions occurred in outreach settings, ensuring wide coverage.
- ZAZIC provides both surgical and PrePex circumcisions.
- Safe and high quality VMMC service delivery remains ZAZIC’s priority.