By Tariro Mhute & Osiah Chinemo
It is past midday and 22-year-old Portia Ndlovu* arrives at a clinic in Filabusi, Matabeleland South province, after a 7km walk from her homestead. Winter is fast-approaching, and it is windy.She bends down to wipe the dust off her feet using a cloth and fixes her mask as she walks briskly towards the gate. From a distance, Ndlovu sees the clinic is not as busy as she had anticipated. Ndlovu quickly washes her hands with the soapy water at the entrance and cheerfully waves at the other clients as she sits at the very end of the wooden bench, placing her feet on the social distance sticker on the floor. She waits patiently in the queue to collect her antiretroviral therapy (ART) medicine.
“I tested positive for HIV and I was initiated on ART in February 2019 while I was eight weeks pregnant with my second child,” Ndlovu said.
“I had visited the antenatal clinic when the nurse did the routine HIV test and I found out about my status.
“Although at that time I was very ill, I just assumed it was pregnancy-related sickness. It came as a shock.
“After being initiated on ART, the nurse took me through adherence counselling, and I was handed to the point of contact (POC) — a Pathways volunteer stationed at the clinic for continued adherence support at community level.”
Pathways is a project funded by the US government’s President’s Emergency Plan for Aids Relief (PEPFAR), through the United States Agency for International Development (USAID). The project is being implemented by Catholic Relief Services (CRS) in partnership with Insiza Godlwayo Aids Council (IGAC) in Matabeleland South province and other implementing partners across Zimbabwe.
“The volunteer enrolled me into the Pathways OVC project. At first, I was a bit hesitant, but the POC explained the stages for prevention of mother-to-child transmission (PMTCT) until I felt determined — I didn’t want to transmit HIV to my child,” said Ndlovu.
“Later, I started the integrated mother-baby course (IMBC) sessions being facilitated at the clinic by the POC as well. I did IMBC sessions with other pregnant and breastfeeding mothers where I learnt a lot about taking care of my baby.
“The IMBC platform also allowed me to meet other women who are in the same situation and share ideas to support each other.”
The IMBC model provides a platform for postpartum depression prevention support for pregnant and lactating mothers living with HIV and on ART treatment. Additionally, it also provides pregnant and postpartum mothers with skills to manage their mood, recognise how depression and stressors (including HIV) can affect their parenting efficacy, their relationship with others and adherence to ART treatment.
Ndlovu’s viral load sample was collected upon completion of adherence counselling and there was great improvement — her viral load had dropped.
“I am so grateful to the Pathways project; my baby tested negative for HIV because of the adherence counselling I got from the nurse and the POC,” said Ndlovu.
Since 2018, PEPFAR has been supporting the CRS Pathways Project to offer child-centred, family-focused, community-based, and evidence-informed interventions to 61 385 OVC and their caregivers.
The project is being implemented in nine districts — Guruve, Mazowe, Harare, Gweru, Nkayi, Lupane, Bulawayo, Matobo and Insiza — and focuses on HIV epidemic control ultimately contributing to the UNAIDS 95-95-95 global goals.
Although Zimbabwe has made significant progress towards achieving epidemic control, it is of paramount importance that these positive gains are sustained. This can only be achieved through rigorous efforts aimed at tracking the remaining undiagnosed HIV+ children and adults like Ndlovu and at the same time facilitating testing and linking them to treatment for comprehensive epidemic control.
As such, the Pathways Project, through community-facility linkages (bidirectional referral), plays a critical role in facilitating diagnosis, enrolment into ART and retention on treatment for highly at risk OVC and their caregivers.
lTariro Mhute is the CRS-Pathways communication and documentation officer and you can get hold of her at firstname.lastname@example.org
- Osiah Chinemo is the CRS-Pathways HIV community linkages specialist and you can get hold of him at email@example.com