Switzerland aims to improve health and psychosocial outcomes for adolescents and young people infected with HIV through support to the Zvandiri peer-to-peer programme. Peer interventions positively influence HIV testing rates, treatment uptake, retention in care and viral suppression. This programme is integrated within and seeks to strengthen the public health system. SDC will partner with Africaid, the primary government partner for this approach, and support Africaid’s ambitions to expand the model to Zambia.


Country/region Topic Period Budget
Zimbabwe
Health
Sexually transmitted diseases incl. HIV/AIDS
01.11.2021 - 31.10.2025
CHF  6’850’000
Background

An estimated 1.2 million people live with HIV in Zimbabwe, 16% of whom are under the age of 24. Although AIDS related deaths have significantly decreased over the last decade, AIDS-related complications remain the leading cause of death among children, adolescents and young people.

HIV positive adolescents and young people have poor health, protection and psychosocial outcomes compared to adults across the HIV care cascade mainly due to perceived and experienced stigma and discrimination, as well as challenges related to emerging sexuality and concerns about relationships, future child bearing and marriage.

Entrenched social norms and gender inequality continue to hamper access to quality HIV related services for this age cohort. In addition, public health systems are very fragile, in particular due to inadequate resources, which affects the morale and retention of critical health care personnel. 

Switzerland brings a wealth of experience and lessons learnt from its regional programme in reaching adolescents and young people through schools, youth centres and community activities, as well as success in promoting HIV prevention policies and credibility in advocating for psychosocial support.  

Objectives To improve the physical, social and mental wellbeing of children, adolescents and young people living with HIV and to prevent HIV through reduced transmission, morbidity, and mortality.
Target groups The direct beneficiaries are 33,131  children, adolescents and young people living with HIV in 19 districts across Zimbabwe and indirect beneficiaries are 261,793 children, adolescents and young people living with HIV(57% females) across Zimbabwe (who benefit from improved care, support and services rendered by Africaid capacitated government workers), primary caregivers; households of children, adolescents and young people living with HIV; and youth friendly service providers in 1700 Health Facilities. 
Medium-term outcomes

1.    Increased access to quality treatment, care, support, retention, adherence and protection services for children, adolescents and young people living with HIV

2.    Strengthened health system service delivery through increased and strengthened capacity of health workers to implement and replicate the Zvandiri model

3.    Improved policy environment regarding HIV related issues for children and AYP living with HIV

Results

Expected results:  

-    380 Community Adolescent Treatment Supporters in 19 districts of Zimbabwe (20 per district) directly reach 33,131 children, adolescents and young people living with HIV with a comprehensive package of information, counselling and support services through home visits, Support Groups, m-Health and caregiver targeted services delivery;

-    Standardised technical assistance and capacity strengthening to government at national, provincial and district level, reaching 64 District level multi-sectoral teams (HIV, mental health, TB, SRHR, protection, disability);

-    Policy advocacy on HIV issues related to children, adolescents and young people.


Results from previous phases:  

Results from programme implementation demonstrate that the Zvandiri model brings to scale holistic support of children, adolescents and young people that is responsive to their medical, developmental, and psychosocial needs. In particular, to assure sustainability, the programme is nested within the public health system with capacity strengthening of national, regional, and local service providers and trained, mentored Community Adolescent Treatment Supporters supporting their peers, families, and communities.

A Peer Support in the 95-95-95 cascade study commissioned under the Zvandiri programme in 2019, revealed that a peer-led intervention focused on adolescents and young people living with HIV using a cadre of dedicated peers Community Adolescent Treatment Supporters led to high rates of HIV testing (80%), anti-retroviral treatment uptake (97%), retention in care (99%), viral load testing (90%) and viral suppression (99%) in a large cohort of household contacts and sexual partners of people living with HIV in Zimbabwe.

Baseline figures for Phase 1

-    The current reach with index case testing is on average 3400 clients getting tested per year.

-    92% of the HIV positive children, adolescents and young people are on treatment.

-    67790 of the children, adolescents and young people of the Zvandiri database have access to health and social services or are on treatment but have indicated non-adherence.

-    Capacity strengthening on HIV testing, treatment and care and subsequent routine follow-up with mentorship has been done for 5208 Health Care Workers 


Directorate/federal office responsible SDC
Project partners Contract partner
International or foreign NGO
Private sector
  • Foreign private sector South/East


Other partners
AFRICAID
Coordination with other projects and actors

Synergies with the Child Protection Fund, Ruedi Luethy Foundation, Safeguard Young People Programme, Gender Transformative approaches to SRHR Programme will be continuously fostered.

Coordination with the PEPFAR and National AIDS Council programme will be improved.

Budget Current phase Swiss budget CHF    6’850’000 Swiss disbursement to date CHF    925’550 Budget inclusive project partner CHF    34’800’000 Total project since first phase Swiss budget CHF   6’850’000 Budget inclusive project partner CHF   14’000’000