Catherine Murombedzi HIV Walk
Mashonaland Central has eight districts, namely Bindura, Mazoe, Guruve, Muzarabani, Mbire, Shamva, Mt Darwin and Rushinga with a population of 1 million. Of these 93 000 are living with the HIV virus.
Then 52 000 are on active anti retroviral therapy (ART) and 41 000 are not. The 41 000 are to commence ART when they require it. This means that their CD4 Count was above 350 as of August 2013.
With the new WHO guidelines which state that an HIV positive person has to commence ART at a CD4 count of 500, about 18 000 would have to be accommodated on the ARVs free Government programme. The province has 141 ART initiating sites. Three districts, Bindura, Mazoe and Shamva have moved onto computerisation of patients’ data.
The province has decentralised ART access as seen by the number of sites initiating ART. Some of the sites now order directly from Natpharm thereby removing bottlenecks and artificial shortages. There is programme ownership with people living with HIV (PLHIV) volunteering to work as peer counsellors and village health workers at some of the ART sites.
With the community participating it makes client-follow up much easier. The province was cited as a best practice by the National Aids Council. A report from the community monitoring group which visited the area in the second quarter of 2013 reported a marked increase of community participation as compared to other provinces nationally.
The report also highlighted the challenges faced by ART clients on the border with Zambia eg Kanyemba and Mozambique, Chikafa area who accessed medication from neighbouring countries due to proximity.
“Some ART clients in Kanyemba prefer to access their medication from Zambia. They cross the Zambezi river using canoes. The danger is when the river floods, they sometimes fail to cross thereby defaulting. Clients from Chikafa area also prefer to access their medication from Mozambique. Zimbabwe uses different regimens where they use fixed doses. The fixed dose in Zambia is effavirence and in Zimbabwe we use tenolam and stalanev, lamuvidine, zidovudine and nevirapine combinations for first line. So a client initiated in Zambia can’t change willy-nilly and access locally because we use different regimens. The same applies to our neighbours in South Africa and Mozambique,’ said Mr Stanley Takaona a compiler and spokesman in the community monitoring team.
“At Chapoto Rural Health Centre near Zambia 194 clients were registered on ART. Of these 129 clients were not collecting their medication from the centre, so no-one knows where they are collecting their medication from. They were lost to follow-up in the difficult to reach terrain. The outreach service catered for 29 clients while 40 were known to be collecting from Zambia,” said Mr Takaona. The provincial medical director for the province, Doctor Solomon Mukungunugwa, speaking at a feedback meeting organised by the National Aids Council in Kadoma in November said that community ownership of anything that is health related by the people in the province made work easier for health personnel.
“In my province, for example in Chiweshe, Mazoe District at Rosa Clinic 12 houses for staff members at the clinic were built with input from the village committee. “Their local Member of Parliament provided cement, the villagers made bricks, those who afforded contributed a dollar to the project and some even brought grain which all helped to see the smooth building of the houses and an opportunistic infections (OI) wing,” said Doctor Mukungunugwa.
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