Overview of theCHAPPL Network, Zimbabwe

(Care for HIV/AIDS Prevention and Positive Living Network)

Charity Alfredo (CDC) alfredoc@zimcdc.co.zw

Vulyewa Chitimbire (ZACH) chitimbire@zach.org.zw

CCIH Annual Conference, May 2003

Zimbabwe

• Southern African country • Landlocked• Population of 12,851,000

(2002 DHS)• HIV prevalence 25% (28-

35%)• Life expectancy: 37 years• Adult mortality M/F:

826 / 777 per 1000• CMR, M/F: 129 /119 per

1000

Zimbabwe

Health care provision:– Public Health sector - government, mission hospitals, local health authorities

– Private Health sector - medical aid systems, private health institutions

– Majority of mission hospitals in rural areas– Approx. 50% health care - mission hospitals– 68-70% bed space in rural areas provided by

mission hospitals

The CHAPPL Network

Care for HIV/AIDS Prevention and Positive Living Network

Founding partners:Zimbabwe Association of Church-related Hospitals (ZACH)Centres for Disease Control and Prevention (CDC) Zimbabwe

Vision for CDC in support of Zimbabwe’s response to HIV/AIDS

• Vision: Capacity-building and technology transfer to key Zimbabwean partners in the multi-sectored response to change the course of the epidemic

• Systematically support + document progress toward UNGASS and Zimbabwe Goals

CDC-ZACH cooperative agreement

Funding support and membership

• Funding and technical support for 5 years

• Ten hospitals (initially)

Selection Considerations

• Innovation in HIV work

• Geographical distribution

• Religious Denomination

Goal of the CHAPPL Network

• To develop and implement a set of core HIV/AIDS prevention and care activities

• High impact, cost effective and appropriate interventions to the health care context of Zimbabwe

• A basis for expansion to rural health institutions in the country

CHAPPL Network HospitalsHospital Province Chidamoyo Mission Hospital Mashonaland West St. Albert’s Mission Hospital Mashonaland Central Howard Mission Hospital Mashonaland Central Louisa Guidotti Mission Hospital Mashonaland East Tshelanyemba Mission Hospital Matabeleland South St. Luke’s Mission Hospital Matabeleland North Bonda Mission Hospital Manicaland Murambinda Mission Hospital Manicaland St. Theresa Mission Hospital Midlands Gutu Mission Hospital Masvingo

Initial activities of the Network

• Identification of best practices/ innovations already underway

• Identification of key program areas and specific goals for the Network

• Establishment of an implementation plan based on requirements analysis

Examples of best practices

• Nearly 90% uptake of VCT among staff at Chidamoyo Hospital

• HIV/AIDS education for all staff at St. Theresa’s• HAART program at Louisa Guidotti• Integrated approach to HIV counseling and

support at St. Albert’s, Chidamoyo and St Theresa’s )

• >90% uptake of CT for PMTCT at Murambinda and St. Theresa’s

Priority Program Areas • Training

– All hospital staff - general HIV knowledge– Integrated counselling for prevention and care - nurse

counsellors– Integrated counselling for prevention and care for lay

counsellors

• HIV care program and special clinic for staff (with or without HAART); VCT> 80%

• Integrated approach to counselling, testing and services; Special CTS centres

• Increased PMTCT uptake (80%) and enhanced services

Strategies to meet objectives

• Consultation and meetings with various experts and stake holders ( HAQOCI, USAID, Mildmay, ZVITAMBO, MOH)

• Support capacity building at ZACH and CHAPPL hospitals

• Support infrastructure development at hospitals– Renovations for CTS centres

– Improvement of communication ability of hospitals

Implementation Plan

• Needs assessment by individual hospitals guided by the key program areas identified

• Training curricula for – all health workers, community leaders– specialized health staff (nurses and counselors)

• Establishment of equipped CTS centres within the hospitals; plus new, trained counselors

• Documentation of interventions as they are implemented; tools for replication

Conclusion

• Network aims to serve as a model for expansion of HIV care, not intended to be restricted to the ten hospitals

• Resource base for expertise, training and expansion to other hospitals — provision of ARV therapy

• Other hospitals with interest in promotion of HIV CTS, Care issues, can be co-opted into the Network activities