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Category: Gender/Women & Girls

I-TECH Attends 25th IAS International AIDS Conference

Post categories: Cote d'Ivoire DIGI Gender/Women & Girls HIV Care and Treatment India Lydia Chwastiak Nancy Puttkammer Quality Improvement Stefan Wiktor Ukraine Zimbabwe
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Representatives from I-TECH, I-TECH Ukraine, I-TECH India, and Zim-TTECH attend the 25th IAS AIDS Conference in Munich, Germany.
Representatives from I-TECH HQ, I-TECH Ukraine, I-TECH India, and Zim-TTECH attend the 25th IAS AIDS Conference in Munich, Germany. Photo Credit: I-TECH

The International AIDS Society (IAS) hosted the 25th International AIDS Conference on 22–26 July 2024 in Munich, Germany, and virtually. The theme this year was “put people first” to emphasize the importance of “thinking of solutions from the point of view of those most affected.” The conference brings together HIV researchers and experts for presentations and discussions on a wide range of HIV- and AIDS-related topics.

This year, representatives from the International Training and Education Center for Health (I-TECH) presented findings from I-TECH-supported programs in Côte d’Ivoire and Ukraine:

Côte d’Ivoire

Ukraine

Additionally, representatives from I-TECH India, PLC, and the Zimbabwe Technical Assistance, Training, and Education Center for Health (Zim-TTECH)—two of I-TECH’s partner network organizations—as well as their program partners presented findings from I-TECH-supported programs being implemented in India and Zimbabwe:

India

Zimbabwe

Note: Bolded names represent I-TECH authors and an asterisk (*) indicates the presenting author

I-TECH Ukraine Team Partners with Shelter for Women and Girls

Post categories: Gender/Women & Girls Pamela Collins Ukraine
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Thanks to new generators, the Rehabilitation Shelter had electricity, heat, and Internet connection during massive shelling in Ukraine in fall and winter 2022-2023.

In February 2022, at the advent of the war in Ukraine, the International Training and Education Center for Health (I-TECH) launched the I-TECH Humanitarian Fund to support the work of our team in Ukraine. Many team members remain displaced, away from their homes, and isolated from their families and friends. However, their tireless work continues provide uninterrupted access and services to Ukrainians living with HIV, who are more in need of care and refuge than ever.

Supported by generous donations to the I-TECH Humanitarian Fund, I-TECH Ukraine has been able to advance the work of Eleos-Ukraine, a network of like-minded people and organizations that develop social services through 13 regional offices throughout Ukraine. The common goal of Eleos-Ukraine partners is to feed, clothe, and protect 1 million people in need.

“The compassion and solidarity of our American colleagues and friends with Ukraine and Ukrainians, including those expressed through generous donations to the I-TECH’s Humanitarian Fund just in the first few weeks of the full-scale war, are overwhelmingly moving,” said Anna Shapoval, I-TECH’s Country Representative in Ukraine. “We are eternally grateful.”

To date, the I-TECH Humanitarian Fund has been directed to Eleos’ critical work on behalf of Ukrainian women and girls subjected to sexual violence and other trauma (e.g., incarceration and torture) by the Russian army, notably the development and establishment of the Rehabilitation Shelter in August 2022.

Money from the fund has gone directly to outfitting the shelter with video surveillance, fire alarms, and powerful generators. Thanks to the generators, the shelter had electricity, heat, and internet connection during massive shelling by the Russian Federation in fall and winter 2022-2023.

“We appreciate your cooperation and thank you for helping the citizens of Ukraine during the war,” wrote Eleos-Ukraine Board Chair Serhii Dmytriyev, in a thank you letter to I-TECH Humanitarian Fund donors. “Our joint humanitarian project will help women not just today, at this time of crisis; it will also be important in reducing the consequences of war – which makes it an important contribution to the future of Ukraine!”

Since the shelter opened, more than 150 women from Kyiv, Donetsk, Kherson, Mykolaiv, and Luhansk Oblasts have received help remotely and within the shelter. The duration of a stay in the shelter for one client varies from one to six months and can be extended. The shelter houses 15-20 women and girls as well as their families, with accommodation for up to 30 people.

“Eleos-Ukraine is a truly passionate and efficient organization. They have been at the forefront of response to this war since 2014, the actual start of the Russian invasion,” said Ms. Shapoval. “Eleos put their minds and souls into supporting Ukrainian women and girls, and other civilians, who have suffered from horrifying violence and deprivation daily. They will continue helping people of Ukraine, no matter what – and so, I hope, we as I-TECH will continue supporting groups like Eleos on the ground.”

I-TECH Executive Director Pamela Collins lauded both the Ukraine team’s work with Eleos and those who have contributed generously to the I-TECH Humanitarian Fund. “I am very proud of I-TECH Ukraine’s activities with Eleos to respond to the humanitarian emergency in Ukraine,” said Dr. Collins. “Thanks to our donors, we had the resources to do what I-TECH does well: identify and collaborate with strong partners in the countries where we work to meet urgent needs in a times of crisis.”

 

I-TECH to Expand Psychosocial and Gender-based Violence Support in Trinidad and Tobago

Post categories: Caribbean Gender/Women & Girls Mental Health Pamela Collins Trinidad and Tobago
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From left to right: Conrad Mitchell, Program Coordinator, I-TECH Trinidad; Belinda White, Clinical Psychologist, I-TECH Trinidad; Heather Rodney, Chairperson, NACC Secretariat; Ian Ramdahin, Permanent Secretary, NACC Secretariat; Dr. Omoye Imoisili, Senior Public Health Analyst, HRSA; Aliyah Abdul Wakil, Strategic Information, HRSA; Alana Lum Lock Cardinez, Program Advisor, I-TECH Trinidad; Misti McDowell, Program Director, I-TECH headquarters.

Recently, representatives from the International Training and Education Center for Health (I-TECH) met with health officials in Trinidad and Tobago to discuss potential areas of support for strengthening the national response to HIV and AIDS in the country.

The meeting attendees discussed strengthening advocacy for people living with HIV (PLHIV); psychosocial support for vulnerable PLHIV; and providing services at the intersection of HIV and AIDS and gender-based violence (GBV).

With support from the Health Resources and Services Administration (HRSA), I-TECH has worked in Trinidad and Tobago since 2009, collaborating with the Ministry of Health and other partners to focus on healthcare worker training and technical assistance to improve the quality of care for PLHIV.

“I’ve always been impressed with the team and activities in Trinidad and Tobago,” says Misti McDowell, I-TECH Program Director, “especially the integration of much-needed mental health services into the HIV program.”

The assessment “Strengthening Delivery and Oversight of Mental Health and Psychosocial Services for PLHIV in Trinidad and Tobago” was completed by I-TECH and shared with the National AIDS Coordinating Committee (NACC), in an effort to identify future areas of collaboration. One of the intended outcomes is the establishment of a technical working group of national stakeholders who will collaborate with I-TECH to craft a strategy for implementing all priority interventions.

“The findings of this assessment revealed that there is a tremendous need for improved mental health support specifically in the areas of assessment and treatment throughout the national HIV treatment and care sites,” says Belinda White, Clinical Psychologist with I-TECH. “One treatment and care site reported that as much as 90% of its client population experiences symptoms of mental illnesses.”

The most common mental illnesses encountered within treatment and care sites include depression, anxiety, bipolar disorder and schizophrenia; substance use disorder is also common within the PLHIV client population. A key area of interest is the integration of the Collaborative Care Model into the already existing treatment and care system, in a manner that incorporates the unique features of each site. The Collaborative Care Model is an evidence-based approach to treating common mental health conditions (e.g., depression, anxiety) in primary care settings and was developed at the University of Washington.

I-TECH also assisted the NACC with the establishment of the National HIV Helpline and will continue to provide support over the next six months, while working to transition the program fully to NACC. This includes support for the HIV Helpline Coordinator and Active Listeners, as well as training of new Active Listeners.

“We must continue fighting the stigma associated with living with HIV,” says Conrad Mitchell, Program Coordinator. “It’s important to continue to battle misinformation and to have that coupled with positive true-life experiences. The Helpline–manned by persons living with HIV together, with HIV NGO advocates and allies–provides a unique opportunity to combat misinformation though empathy and education in direct, one-on-one engagements with the public.”

A 2017 Inter-American Development Bank (IDB) National Women’s Health Survey for Trinidad and Tobago[1] showed that more than 30 percent of women in Trinidad and Tobago had reported having experienced at least one incidence of either physical or sexual partner violence. The NACC is seeking support related to GBV and the risks it poses to the health and well-being of PLHIV. Activities would focus on raising awareness and providing resources and psychosocial support for vulnerable groups.

“There is a lack of general knowledge about GBV and what it entails among the public as well as in some health care settings,” says Ms. White. “There is an opportunity to yield enormously positive results by increasing the knowledge and insight of health care workers, and people living with HIV, regarding GBV.

“My hope is that the information that is shared empowers people living with HIV to advocate for themselves if they come to the realization that they are experiencing,” she continues, “and to make contact with the local resources that are available to receive the necessary support.”

I-TECH will also seeks to help strengthen civil society organizations through enrollment in I-TECH-developed courses such as UW Leadership and Management in Health, Fundamentals of Implementation Science, Project Management in Global Health, Global Mental Health, and Policy Development and Advocacy for Global Health.

[1] https://publications.iadb.org/publications/english/document/National-Women-Health-Survey-for-Trinidad-and-Tobago-Final-Report.pdf

 

From Beneficiaries to Mentors: Three Women Pass Their DREAMS On to Others

Post categories: Gender/Women & Girls HIV and STI Prevention Stefan Wiktor Zimbabwe
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A group of DREAMS ambassadors in Zimbabwe. Photo credit: Zim-TTECH

After facing incredible obstacles, three resilient 22-year-old women from Tsholotsho District, Zimbabwe, found their lives intersecting: Sitheni, Clemencia, and Faith are DREAMS ambassadors, equipping adolescent girls and young women with skills to reduce their vulnerability to contracting HIV–and helping them to find their own strengths.

DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe) is a PEPFAR-funded program that aims to reduce HIV infections among adolescent girls and young women through not only prevention and treatment, but also a core curriculum that addresses HIV prevention, financial literacy, and gender-based violence (GBV). Participants can also access services such as HIV testing, family planning, pre-exposure prophylaxis (PrEP), counseling, and screening for GBV.

The International Training and Education Center for Health (I-TECH) has been supporting the Zimbabwe Technical Assistance, Training and Education Center for Health (Zim-TTECH) and its ZimPAAC consortium to implement the DREAMS program since 2020. To date, nearly 20,000 girls and young women in Zimbabwe have completed the primary DREAMS curriculum, Health for Life.

Sitheni, Clemencia, and Faith were initially enrolled in the DREAMS program as beneficiaries, having turned to transactional relationships (trading sex for money or necessities) to survive poverty amid the deepening economic crisis in Zimbabwe. They now use their own experiences to give back to young women who face similar choices.

Sitheni had to abandon her life-long goal of attending university to support her parents and four siblings; carrying the burden of sole provider for her family took a toll on her. When earnings from her part-time jobs weren’t enough, she became involved in sexual relationships with older, cross-border traders—known as omalayitsha—to make extra money.

Once enrolled in the DREAMS program, she thrived within the Health for Life courses, which cover financial literacy, social asset building, condom education, and violence and HIV prevention. “I encourage young girls in my community not to depend on men, but to use their skills instead of waiting to be given money by men who will abuse them,” Sitheni says.

Training and services are often provided in a safe space such as a school or community center, where participants meet with a mentor trained to deliver the Health for Life curriculum.

“At the moment I mentor 140 adolescent girls and young women aged 15-24 in the district,” says Faith, who also dated older men for money in order to make ends meet. “It is my duty to link adolescents with the district clinical nurse to access services at health facilities and safe spaces. I also encourage women to support people living with HIV/AIDS in the community. I teach them about human rights and encourage them to utilize their talents to make a living.”

Another part of Faith’s job is enrolling and following up on beneficiaries as well as supporting community-based facilitators who teach social asset building. This includes facilitating relationships and connections within DREAMS safe spaces to share encouragement and survival skills.

These safe spaces were critical to providing hope and new options for Clemencia. “After my father passed away, there was no one to pay for my school fees,” she says. “I came to my wits’ end, and I ended up exchanging sex for livelihood. At that time, it seemed the only viable option.”

Clemencia traded sex for two-and-a-half years, placing her among those at highest risk for HIV acquisition in Zimbabwe.[1] “Luckily for me, I did not get infected with HIV,” she says. “Ever since joining DREAMS, I have become empowered, and I know how to protect myself from sexual violence.”

Thanks to what she learned in her financial literacy sessions, Clemencia has started a small business of breeding hens and selling them to community members. “I also sell clothes for extra income,” says Clemencia, who now encourages other young women to complete their financial literacy sessions so they can start their own businesses and become independent.

Faith is thrilled to be able to foster this independence, as well. “Little did I know that I could make an honest living without anyone having expectations from me,” she says. “I am now able to encourage other girls and young women to stop engaging in transactional relationships. I am able to do this because I have been mentored and I have knowledge about HIV/AIDS and violence against women.”

 

[1] Chiyaka T, Mushati P, Hensen B et al. Reaching young women who sell sex: Methods and results of social mapping to describe and identify young women for DREAMS impact evaluation in Zimbabwe. PLoS One. 2018 Mar 15;13(3):e0194301. doi: 10.1371/journal.pone.0194301. eCollection 2018.

 

I-TECH Supports First VACS in Namibia

Post categories: Gabrielle O'Malley Gender/Women & Girls HIV Care and Treatment Namibia
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The International Training and Education Center for Health (I-TECH), under the leadership of Government of Namibia ministries overseeing child welfare and health and in close collaboration with the Namibia Statistics Agency (NSA), UNICEF, and the U.S. Centers for Disease Control and Prevention (CDC), supported the implementation of Namibia’s first Violence Against Children and Youth Survey (VACS).

Cover of Namibia VACS Report
The final Namibia VACS report was published by the Government of Namibia and Together for Girls, a global partnership working to end violence against children, on 28 September 2021. Photo Credit: Together for Girls: www.togetherforgirls.org/.

VACS are national surveys that measure the prevalence and impact of violence on children and youth around the world. The survey results help inform future program decisions and policy approaches to ensure the safety of children and youth. On 28 September 2021, the Day of the Namibian Child, the Government of Namibia published the final Namibia VACS report.

The survey, funded by the U.S. President’s Emergency Plan for AIDS Relief and led by the Ministry of Gender Equality, Poverty Eradication and Social Welfare (MGEPESW), interviewed households with children aged 13-24 years in all 14 regions of Namibia from March 2019 through June 2019.

Survey operations—including data collection by field teams, data generation, and analysis—were carried out by the NSA, the central statistical authority responsible for all official statistics in Namibia. “It has been a pleasure working together with the Ministry of Gender Equality, the University of Washington, I-TECH, and CDC on this important survey,” says Ottilie Mwazi, Namibia’s Deputy Statistician General. “Our team has learned a lot from the process and is very proud to have contributed important data that will help to improve child welfare in Namibia.”

Prior to data collection, I-TECH alongside CDC colleagues hosted a two-week training for 130 enumerators, focused on best practices for data collection, interview techniques, and key aspects of the survey protocols. In addition to supporting VACS training, I-TECH and the Ministry of Health and Social Services (MoHSS) ensured all selected enumerators were trained and certified by the Namibia Institute of Pathology to conduct HIV rapid testing so any survey respondent aged 14-24 years who did not know their HIV status and wanted a test during their interview could immediately be tested.

In total, 5,191 individual interviews among 6,042 households (86.35% overall response rate) and 3,232 HIV rapid tests were conducted as part of data collection. Any respondent testing positive for HIV during the survey was linked to psychosocial and HIV/AIDS care and support in line with well-established MoHSS guidelines and the survey protocol.

Expanding Post-Violence Clinical Care

The survey results have informed important initiatives across Namibia’s wider social welfare and health systems. MGEPESW has moved forward with drafting the National Action Plan on Violence against Children and has accelerated the training of various child welfare stakeholders such as police officers and social workers, while operationalizing the establishment of more child shelters in several regions.

“The data coming out of Namibia’s VACS have really brought home how prevalent and serious violence against children and adolescents really is,” says Helena Andjamba, Director for Child Welfare at MGEPESW. “Having these hard facts readily available has helped greatly during our policy and planning engagement with multiple stakeholders during the past year. We are now moving forward with the Ministry of Justice in drafting a new Child Justice Bill, and at the same time we are engaged with the Ministry of Education on strengthening the National School Safety Framework.”

Following the completion of the survey, the MoHSS convened a technical working group with I-TECH, the World Health Organization, UNFPA, Project Hope, and other stakeholders to coordinate and strengthen first-line post-violence clinical care in primary health care facilities across Namibia. I-TECH also supported the compilation of clinical guidance on emergency care for survivors of sexual violence and its inclusion in the 2021 edition of the Namibia Standard Treatment Guidelines published by the MoHSS.

Much of the focus during the second half of 2021 was on integrating post-gender-based violence (GBV) clinical care in MoHSS HIV/AIDS clinics and antiretroviral therapy (ART) services throughout Namibia. As part of this work, I-TECH conducted a mentorship training-of-trainers for 28 HIV clinical providers, nurses, and testing services staff. These mentors now provide ongoing technical guidance and supportive supervision to frontline health workers through monthly facility visits.

To further improve post-violence care in clinics, I-TECH compiled a GBV care implementation guide for Namibian healthcare providers. This includes elaboration of best practices, as well as a suite of materials including posters, pamphlets, job aids, and a pocket booklet for communities, clients, health workers, and health facility managers, respectively. An intimate partner violence/GBV screening tool to be administered to ART patients with persistent high viral loads is also currently being piloted in ten health facilities.

Despite COVID-19 Challenges, I-TECH Supports Progress Toward Cervical Cancer Elimination

Post categories: Cervical Cancer COVID-19 Gabrielle O'Malley Gender/Women & Girls Jeff Lane Linda Eckert Malawi Mozambique Namibia Stefan Wiktor Uncategorized Zimbabwe
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The World Health Organization (WHO) Global Strategy to Accelerate the Elimination of Cervical Cancer, launched in November 2020, calls for a world where cervical cancer—which kills more than 300,000 women per year—is eliminated. To achieve this, the strategy proposes ambitious 90-70-90 targets over the next decade.

However, the COVID-19 pandemic has severely hindered critical work on cervical cancer interventions, including reduced clinic flow, training opportunities, and outreach.

Due to agile programs and dedicated staff, several teams within the International Training and Education Center for Health (I-TECH) network, despite the challenges presented by COVID-19, have continued to make strides toward the WHO cervical cancer elimination goal.

Record-breaking cervical cancer screening in Namibia

The I-TECH Namibia program focuses on cervical cancer screening services for women living with HIV (WLHIV). Namibia’s national antiretroviral therapy (ART) program has rapidly adjusted to COVID-19 and the need to decongest public health facilities through multi-month dispensing (MMD) of ART. While this has helped with ART access, it has significantly reduced opportunities for performing facility-based services, since the frequency of health facility visits by women on ART has declined rapidly.

In close collaboration with the Namibia Ministry of Health and Social Services (MoHSS), I-TECH is implementing enhanced facility-based screening campaigns to increase access and rapidly reach more women. For these enhanced screenings, clients within a district are mobilized and given paced appointment times at several facilities in-line with COVID-19 restrictions. Service providers are then assigned to the specific sites where they provide screening services.

From 8-12 February, 805 women were screened through visual inspection with acetic acid (VIA) or Pap smear, 95% of whom were women living with HIV (WLHIV). Of the 137 women screened VIA positive, 98% received treatment. This campaign broke national records by achieving the highest recorded number of women screened in a 5-day campaign, as well as the highest number of women screened in a single day (210).

“As the COVID 19 pandemic rages on, and preventative restrictions limit client screening, the downtime should be used in planning for catch-up screening activities,” says Dr. Laura Muzingwani, I-TECH’s Cervical Cancer Lead Physician in Namibia. “Resource and client mobilization are both key to prepare for any window of opportunity when COVID restrictions are relaxed to enable rapid mass screening.”

Mentoring and training continues in Mozambique via videoconferencing technology

In close collaboration with the Ministry of Health (MOH) and the University of Texas MD Anderson Cancer Center—a Project ECHO® “superhub” for oncology—I-TECH has continued its monthly cervical cancer ECHO sessions in Mozambique, with an additional focus on COVID-19 safety and risk reduction. An average of 40 participants attend each session, and topics have included cervical changes in older women; relevance of normal and abnormal colposcopic findings; and hygiene, disinfection, and asepsis of materials.

“Although the emergence of the COVID-19 pandemic was sudden, it was possible to adapt quickly using remote information and communication technologies,” says Dr. Ernestina David, Program Manager for the I-TECH Cervical Cancer Prevention Program. “The ECHO videoconference sessions made it possible to bring together providers across the country to address uterine cancer and diagnose and treat pre-cancerous lesions, using local cases and looking for ways to approach and treat them.”

In addition, the Mozambique team has continued its regional cervical cancer trainings in a blended format (both virtual and in-person components). I-TECH has implemented three trainings using a model spearheaded by MD Anderson, wherein a two-day LEEP and colposcopy training was adjusted so that trainers could join via Zoom in lieu of traveling to Mozambique.

While some participants join only the Zoom sessions, others are able to watch the sessions from a classroom setting and then work through skills-building demo stations, followed by practice on patients at a provincial hospital.

Access to services increase through health communication in Malawi

Despite the Malawi government indicating cervical cancer screening, care, and treatment as priority services, after the COVID-19 pandemic hit the country, most facilities did not include cervical cancer services on their priority lists. Facilities either completely suspended or heavily reduced screening and treatment. This, coupled with fears among targeted women about contracting COVID-19, marginalized access to services.

To combat these challenges, I-TECH delivered health talks within communities on how women can protect themselves as they access services (social distancing, hand washing, use of face masks, etc.). Those reached were encouraged to pass on information to others.

I-TECH also engaged district health officers and those in charge of affected facilities on the need to continue providing cervical cancer services, in line with MOH COVID-19 prevention guidelines. Presenters emphasized the burden of cervical cancer and how it would worsen should services be interrupted for the entirety of the pandemic. Discussion also touched on including cervical cancer providers on the rotation roster and ensuring that commodities were available.

In Malawi, 391 health facilities are currently providing cervical cancer screening services, and 80% of those health facilities are also providing treatment services. More than a quarter of a million women were screened between January 2020 and June 2021, 57% of whom were WLHIV.

Zimbabwe consortium takes measures to blunt the impact of COVID-19

I-TECH and its network partner the Zimbabwe Training, Technical Assistance and Education Center for Health (Zim-TTECH) implement cervical cancer screening and treatment via the local Zimbabwean consortium ZimPAAC.

By March 2021, ZimPAAC had achieved 53% of the annual target for the number of women on ART screened for cervical cancer. ZimPAAC implemented several measures to mitigate the impact of COVID-19 on continuity of cervical cancer screening services, including:

  • Training of all health care workers on COVID-19 safety and security, transmission, and prevention;
  • Support to ensure infection prevention and control (IPC) and triage at health facilities through training, procurement and distribution of personal protective equipment (PPE), hand washing stations/commodities, face masks for both staff and clients in need; and
  • Procurement and distribution adequate PPE for use by health care workers at facilities.

Expanding HIV Care and Treatment in Zimbabwe

Post categories: Cervical Cancer Differentiated Care Gender/Women & Girls Health Systems Strengthening HIV Care and Treatment Index Testing/Partner Notification Key Populations PrEP Stefan Wiktor Zimbabwe
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The ZimPAAC consortium collaborates with the Ministry of Health and Child Care (MoHCC) in Zimbabwe to meet the following primary HIV epidemic control objectives:

  • Diagnose 95% of all persons living with HIV through integrated testing
  • Ensure 95% of individuals diagnosed with HIV are initiated on antiretroviral therapy (ART), retained in care, and are virally suppressed using differentiated service delivery models

Using a Differentiated care model, a patient-centered model of service delivery designed to meet the diverse needs and expectations of all people living with HIV, ZimPAAC oversees activities such as:

  • facility and community-based HIV testing;
  • HIV self-testing, index case testing;
  • ART initiation; and
  • ART delivery through multi-month refills for stable patients, Family ART Refill Groups, and Community ART Refill Groups (CARGs). CARGs benefit group members—through decreasing health center visits, offering peer support, and allowing clients to take responsibility for their health—and staff, by decreasing workload and allowing greater time for patient care.
I-TECH Zimbabwe Care and Treatment Sites and Districts
A map of I-TECH’s Care and Treatment Sites and Districts in Zimbabwe.

In addition to differentiated service delivery, ZimPAAC conducts site-level mentoring at health facilities to strengthen health service delivery towards the “95-95-95” UNAIDS targets by improving patient linkages between HIV testing, initiation on treatment, and retention in care rates. This is accomplished in part by several hundred dedicated HIV testers and nurses who support ART initiation and management of opportunistic infections alongside MoHCC staff.

ZimPAAC also supports index testing through community linkages activities that help clients access HIV testing, especially sexual partners and biological children of existing HIV-positive clients who present to the health facilities. In an effort to improve index testing within MoHCC health facilities, ZimPAAC has implemented an assisted partner service model, known as Enhanced Index Case Testing. This program emphasizes reaching clients recently diagnosed with HIV and those whose blood tests show a high HIV viral load. Quality Improvement activities are a key part of ZimPAAC’s approach to improving outcomes for index testing. In 2019, a “change package” describing the interventions that have improved index testing was developed by ZimPAAC for national scale-up of the model.

ZimPAAC program activities also support retaining people living with HIV in care. Programs engage community linkage facilitators who work with facilities and communities to identify patients who have defaulted from treatment and return them to services.

In addition to HIV care and prevention for adults, ZimPAAC supports increased access to services for children and adolescents through Africaid’s community adolescent treatment supporters (CATS). CATS are HIV positive 18-to-24-year-olds trained to provide peer support, conduct demand-creation activities, build community engagement, and mobilize targeted HIV testing and outreach activities to bring services to this hard-to-reach group.

In addition to the first two objectives, ZimPAAC collaborates with MoHCC towards two additional objectives:

  • Strengthen and expand access to cervical cancer screening and treatment of precancerous cervical lesions among women living with HIV
  • Increase uptake of pre-exposure prophylaxis (PrEP) services through training, technical assistance and direct client support

In 2019, ZimPAAC began the expansion of cervical cancer screening for women living with HIV, beginning with a situational analysis to identify sites for implementation of a program serving women with visual inspection with acetic acid and cerviography.

Under the direction of PZAT, ZimPAAC also works closely with the MoHCC to support key-population-friendly programming in the public health sector facilities in Harare. PZAT supports health worker training at selected facilities and builds demand and knowledge of these services through community champions and engagement with vulnerable populations and advocacy and civil society organizations. PZAT also works to promote PrEP services for adolescent girls and young women in Mazowe district and among key populations in Harare.

Empowering Young Mothers in Namibia

Post categories: Gabrielle O'Malley Gender/Women & Girls Namibia PrEP
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A young woman learning to weave a basket during the September 9-13, 2019 craft-skills training session.
A young woman learning to weave a basket during the September 9-13, 2019 craft-skills training session.

Young mothers enrolled in the DREAMS program in the Zambezi region of Namibia had the opportunity to learn the traditional art of basket weaving through a series of craft-skills trainings facilitated by the International Training and Education Center for Health (I-TECH) and the Integrated Rural Development and Nature Conservation (IRDNC).

The all day, weeklong trainings taught the young women the basics of basket weaving and also empowered them to create marketable items that could lead to greater economic independence. For the trainings, I-TECH and IRDNC invited a Master Weaver to teach women about the technique, the types of natural fibers and dyes, and the necessary tools used in the craft. All of the women who participated in a training made at least one basket by the end of the week.

“Basket weaving is a traditional craft in this area and it is often a source of income for families,” explains Sharon Zambwe, Program Lead for DREAMS Zambezi. “One of the best parts about this program is that it not only teaches women the skills needed for basket weaving but it also connects them to a market for their works, and with each other for ongoing support and encouragement.”

The baskets that the young women crafted were made available for purchase during an event marking the end of their training. The event was attended by representatives from the Society of Family Health; Zambezi Regional Council; and Regional Ministries of Health & Social Services, Education, Arts & Culture, and Youth and Sport. The special event provided attendees with a background of the DREAMS program and included a keynote address from the special advisor of the Zambezi Governor’s Office who presented the future vision of the DREAMS program.

A basket woven by one of the participants at the September 9-13 craft-skills training session.
A basket woven by one of the participants at the September 9-13 craft-skills training session.

I-TECH launched the DREAMS program in the Khomas region in February 2018 and expanded the program to the Zambezi region in June 2018. Since the launch, I-TECH has enrolled over 20,000 girls and young women aged 9-24 years old in the program. DREAMS is a PEPFAR-funded initiative that aims to give girls and women the tools to be Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe (DREAMS). The program not only addresses the HIV epidemic through prevention and treatment, but it also focuses on the structural drivers of the epidemic, such as gender-based violence (GBV) and poverty.

“The DREAMS program has been able to provide girls and young women with the mentoring and social support needed to help encourage them to make positive and healthy decisions in their everyday lives,” says Ellen MacLachlan, DREAMS Program Director for I-TECH. “The activities in Khomas and Zambezi have had a profound impact on the girls and young women in the program. Economic strengthening activities such as the basket weaving classes can directly empower women by giving them a way to make their own money so they are less dependent on a male partner, especially one who may put her at risk of HIV.”

Since the DREAMS program first launched in the Zambezi region, it has provided social and health services (such as pre-exposure prophylaxis, or PrEP) as well as HIV/GBV prevention education to girls and young women and in August 2019, the program expanded into the field of economic empowerment by providing craft-skills trainings. Since the beginning of the service expansion, I-TECH and IRDNC have trained 82 young mothers, aged 15-24, in the art of basket weaving.

While the craft-skills training program in Zambezi is still in its infancy, there are plans to expand the scope of the training to incorporate other crafts skills such as clay pot artistry, knitting, and needlework. In addition to expanding the scope, DREAMS Zambezi plans to partner with tourism organizations as a way for the women participating in future trainings to showcase and sell their wares.

“We have been impressed with the response from the women who have participated in the program over these past four weeks,” says Zambwe. “We can’t wait to expand this program to incorporate more skills that will benefit not only the young women and their families but the community.”

Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe women (DREAMS) in Namibia

Post categories: Gabrielle O'Malley Gender/Women & Girls HIV and STI Prevention Namibia
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In 2017, I-TECH began the DREAMS program in Khomas and Zambezi regions. The DREAMS program aims to reduce HIV infections among adolescent girls and young women (AGYW) through a core package of evidence-based interventions across health, education, and social sectors. At a safe space such as a school or community center, participants meet with a mentor who is trained to deliver a curriculum focused on the prevention of HIV and gender-based violence (GBV). Mentors help AGYW build strong social networks and empower them to make healthy and positive decisions. AGYW can also access on-site services like HIV testing, family planning, PrEP, counseling, and screening for GBV to protect against HIV infection. I-TECH has supported over 150 safe spaces since its launch and enrolled over 20,000 AGYW in the program.

I-TECH also supports programming for caregivers through the Families Matter! Program, which promotes healthy communication between parents and AGYW around HIV and GBV topics. I-TECH works closely with the Ministry of Education, Arts, and Culture; Ministry of Gender Equality and Child Welfare; Ministry of Health and Social Services; Centers for Disease Control and Prevention; and other implementing partners.