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Paidamoyo Chipunza in Gutu
When collecting anti-retroviral drugs or related opportunistic infection medications, one no longer needs to move from one department to another at Gutu Mission Hospital.

In fact, after getting one’s medical card stamped, the next stop would be the outpatients department where one is assessed before collecting one’s medication; a concept known as a one-stop shop.

This was revealed by adolescents and youths living with HIV here during community monitoring of HIV and Aids services organised by the Advocacy Core Team in partnership with the Zimbabwe HIV/Aids Activist Union Community Trust (ZHAAU CT), who commended the initiative calling on all health institutions in the province to follow suit.

In addition to the one-stop shop concept, the adolescents want HIV and Aids services to be integrated into the general public health delivery system, arguing that both concepts go a long way in curbing stigma and discrimination.

One of the youths, Mr Enias Mugwagwa of Gutu centre, said there was still much stigma and discrimination among adolescents, hence the need to continue upholding privacy of those not ready to disclose their status.

“We commend and want to urge all other health institutions in the province to emulate what Gutu Mission Hospital is now doing,” he said. “They have devised a one-stop shop concept from which you get all your assessments and medication from one room instead of shuttling from one end to the other.

“This concept reduces levels of stigma and discrimination as no one would know what took place inside that one room.”

Another youth who spoke on condition of anonymity called for the integration of HIV and Aids services into the general healthcare delivery system, again, arguing that it reduces stigma and discrimination associated with where one is receiving treatment from.

“Existence of an opportunistic infections clinic in isolation from the rest of the health system promotes stigma and discrimination,” said the youth. “If you are seen at the OI clinic, it therefore goes that you are HIV positive.

“Why not just integrate HIV and Aids services into the normal health system so that all people with HIV and Aids, colds, flue or whatever it is are treated the same way without any separation of conditions.”

Zimbabwe National Network for People Living with HIV and Aids (ZNNP+) district chairperson for Gutu Mrs Shamiso Mudyiwa said HIV and Aids services were disintegrated from the general delivery system at the onset of HIV and Aids following repeated advocacy on challenges people living with HIV and Aids were facing then.

“Then, the idea was to enhance efficiency of services to people living with HIV and Aids,” she said. “Some would have walked long distances to the facility, while others would need to eat first before taking their medication, hence a separate OI clinic sped up the process, thereby encouraging more people living with HIV and Aids to seek treatment.”

Mr Munyaradzi Chimwara from the Advocacy Core Team, which operates under the Compass Project, said stigma and discrimination were key to adherence.

Adherence is a key component to achieving two of the three United Nations 90-90-90 targets, which seeks to increase the number of people with HIV and Aids on ARVs by 90 percent and have at least 90 percent of those on treatment have a viral load suppression.

“Apart from reducing stigma and discrimination, both projects save costs from running services as separate programmes,” said Mr Chimwara.

The Global Fund to Fight Aids, Tuberculosis and Malaria is also promoting and supporting health systems strengthening through its Resilient Sustainable System for Health.

The RSSH do not only focus on ending HIV, TB and malaria as epidemics, but yield broader health outcomes, delivering health services in a sustainable, equitable and effective way.

Resilient and sustainable systems for health are necessary for accelerating progress towards universal health coverage, and help countries prepare.