Zvandiri provides a package of differentiated services for children, adolescents and young people living with HIV so that they know, understand accept their HIV status; that they start and remain on Antiretroviral treatment with understanding and confidence; that they remain engaged in treatment, care and support services and that they feel cared for, understood, supported and valued. Services are primarily led by trained, mentored adolescents and young people living with HIV, known as Community Adolescent Treatment Supporters or ‘CATS’. CATS provide information, counselling and support for other children, adolescents and young people living with HIV through home visits, clinic visits, support groups and MHealth. Services are fully integrated within national systems and service delivery across the HIV care cascade.
HIV Testing Services
Children and adolescents in need of HIV testing services are identified by CATS through index case testing. CATS ensure they are linked to testing, then followed up so that they get the counselling, support and services they need. They also provide self test kits for adolescents 16 years and above. Young people testing HIV negative are linked to prevention services led by the Ministry of Health and Child Care. Those that test HIV positive are supported with post-test counselling and disclosure and linked and engaged in national HIV treatment, care and support, including Zvandiri.
ART Initiation and Adherence
Zvandiri supports the Ministry of Health and Child Care in ensuring that all children, adolescents and young people have the information, skills and support to help them understand HIV, ART and adherence and to manage their healthcare. Those newly starting ART are provided with enhanced adherence support from CATS at home, clinic, support group and through SMS platforms. Counselling, monitoring and support is then continued by CATS for all on treatment. The frequency of support is determined by the clinical and psychosocial needs of individual children and young people. CATS identify and refer those facing challenges affecting adherence and well-being and work together with the clinic to enhance the support provided.
Sexual and Reproductive Health Services
Sexual and reproductive health services are integrated within support groups and clinic visits through the provision of information and counselling so that adolescents and young people living with HIV have the knowledge, skills and confidence to make decisions which keep them safe and healthy, are able to access the SRH services. They are linked to the services they need and provided with on-going counselling and support.
The mental health of children, adolescents and young people living with HIV is promoted through their engagement in child and adolescent focused information and counselling, led by CATS as well as trained support group leaders, Zvandiri Mentors and adolescent friendly services in clinic. Mental health is routinely assessed and those at risk of mental health disorders are linked to services for assessment, diagnosis and treatment. Zvandiri works together with mental health nurses to then support on-going counselling, medication support and adherence both at home and in the community.
CATS are trained and mentored to identify and refer HIV positive children, adolescents and young people living with disability, for management and support from health facilities and disability services. They provide information, counselling and support for those with disability and their caregivers, so that they may cope with their HIV and disability, and can participate fully in their schools, homes and societies.
Zvandiri works together with the Department of Social Welfare to identify social protection challenges which may be affecting the health, safety and well-being of children, adolescents and young people living with HIV. CATS identify and refer those they are concerned about to social protection services and work together with the national case management team to provide counselling and support for the child, adolescent and their family.
Adolescents and young people who are pregnant or already parents are supported with information, counselling and support for their own health and well-being, as well as that of their babies. Young mothers living with HIV are trained and mentored as young mentor mothers who support their peers through home visits and young mother support groups. They support the national programme by ensuring adolescent and young pregnant women are linked in to Prevention of Mother to Child Transmission services, and supported with adherence, disclosure, nutrition and SRH services.
Young advocates from Zvandiri are engaged at community, national and international level in speaking out for the needs of HIV positive children, adolescents and young people. They have successfully advocated for policy change, guidance, funding and service delivery for their peers at all levels by sharing their own life experiences, as well as those of their peers across Zimbabwe.
Zvandiri works together with national ministries to strengthen the capacity of health workers, social welfare officers and teachers to provide services which are responsive to the evolving needs of children and adolescents living with HIV. This has included the development of national training curricula and the training and on-the-job mentorship of service providers. CATS co-facilitate this training and mentorship.
As of 2018 Africaid Zvandiri along with the World Health Organization and respective Ministries of Health, developed a collaborative group to receive, review, incorporate, share and develop differentiated services throughout Africa.