Zimbabwe CSO Case Study Report on TPT in the time of COVID-19

Amplified Voices in Scaling up Short-course Preventive Therapy for TB in Zimbabwe 

Partners: Zimbabwe National Network of People Living with HIV(ZNNP+) & Jointed Hands Welfare Organization (JHWO)

ZNNP+ and JHWO received advocacy grant from TAG and we advocated for the integration of TB Preventive Therapy (TPT) in Differentiated Service Delivery (DSD) models. The DSD models we have in Zimbabwe included Community ART Refill Groups (CARGs), Family ART Refill Groups (FARGs), Fast track, Outreach, Conventional and Club refill. ZNNP+ also participated in the Rapid Assessment of the feasibility and acceptability of integrating TPT in CARGs with Ministry of Health and Child Care (MOHCC) and other partners. Findings also indicated that acceptability of providing TPT in CARGs was over 90%.

EFFECTS OF COVID 19 ON TPT PROVISION

Expert patient, Margret Cement, who provided TPT information during the outreach program in Budiriro area.
Expert patient, Margret Cement, who provided TPT information during the outreach program in Budiriro area.

Covid 19 impacted negatively on other health services required by recipients of care. More attention was given to COVID 19 response thereby shortchanging some of the essential services required by recipients of care like TB screening, TPT initiation, HIV testing among other services. COVID 19 preventive measures put in place also hindered people to seek some of the above-mentioned services. However, through support from TAG, efforts were made to support expert patients with Personal Preventive Equipment (PPEs) like sanitizers and masks to continue with their work in the face of COVID 19. We also collaborated with partners like Harare City Health department who also supported with other PPEs as shown in the picture below. Through the work of expert patients, we advocated for the outreach model so that people will be able to access other health services since most clinics were now turned to quarantine centres and some were even closed due to shortage of nurses who were quarantined after getting into contact with covid 19 cases. We also received support from one of our partners, Zimbabwe Technical Assistance, Training and Education Centre for Health (ZIMTECH) in collaboration with Harare City Health to roll out outreach program to different communities. Recipients of care were really impressed by the outreach program in the face of COVID 19 because the model came with quite a number of benefits like TB screening, TPT, Viral load screening, ART refill services. Recipients of care also confirmed that waiting time to receive services was minimal, no user fees were charged for them to receive services and outreach sites observed their privacy and confidentiality.

UPDATE ON 3HP IN ZIMBABWE

Zimbabwe has started the rolling out 3HP targeting 20 sites through a feasibility study with support from IMPAACT4TB through CHAI. ZNNP+ and JHWO are working closely with CHAI on the 3HP feasibility study. The study was being affected by COVID 19 because some of the selected health sites were closed down and some trained nurses to initiate 3HP were quarantined thus disturbing the smooth running of the study. ZNNP+ assisted health facilities in the follow-up process on those initiated on 3HP using our toll-free line. ZNNP+ has established a situation room with toll-free lines to continue engaging with PLHIV in the face of COVID 19.  PLHIV Situation Room is a communication and data collection system aimed at improving PLHIV engagement, inform service providers, and foster positive change in the TB/HIV response. The program comes with a toll-free line and can send alerts to PLHIV, collecting real-time responses.   

ZNNP+ TAG Project focal person, in orange mask with two expert patients pausing for a photo after an outreach program in Budiriro area in the face of COVID-19.

 

Two expert patients, Stanely Sibanda and Grace Rimayi during an outreach program in North Western District in PPE.

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