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Draft Outline Zimbabwe HIV Care and Treatment (ZHCT) Project Quarter 3 Progress Report Year 1 : April 1, 2016 to June 30, 2016 Cooperative Agreement Number: AID-613-A-15-00009 Project Start and End Date: September 24, 2015 to September 24, 2020 Prepared for: Dr Ruth Bulaya-Tembo, AOR Submitted by: Dr Kwame Essah, Chief of Party Family Health International (FHI 360) 65 Whitwell Road, Borrowdale West, Harare, Zimbabwe Tel: +263-8677 0042 18 Email: [email protected] This report was prepared with funds provided by the U.S. Agency for International Development under Cooperative Agreement No. AID-613-A-15-00009. The contents of this report are the sole responsibility of Family Health International (FHI 360) and do not necessarily reflect the views of USAID or the United States Government. Table of Contents Table of Figures ................................................................................................................................... 3 List of Tables ........................................................................................................................................ 3 List of Acronyms ................................................................................................................................. 4 1. Executive Summary .................................................................................................................. 5 2. Introduction ............................................................................................................................... 6 3. Detailed Activity Implementation Progress ........................................................................ 6 3.1 HIV Testing Services ................................................................................................................ 6 3.2 Symptom Screening ................................................................................................................ 13 3.3 Referrals and Retention in Care and Treatment ............................................................. 13 3.4 Defaulter Tracking ................................................................................................................. 13 3.5 CARGs ...................................................................................................................................... 14 4. Summary ZHCT Achievements to Date ........................................................................... 15 5. Laboratory Services Strengthening ..................................................................................... 16 6. Implementation Challenges .................................................................................................. 16 7. Monitoring and Evaluation .................................................................................................... 17 8. Collaboration with Other Stakeholders ........................................................................... 17 9. Administrative and Operational Issues .............................................................................. 18 10. Lessons Learnt ........................................................................................................................ 19 11. Planned Activities for Q4 (July 1 to September 30, 2016) ............................................ 20 Annex I: ZHCT Annual Progress Summary ................................................................................ 21 Annex II: Overall Implementation Status .................................................................................... 23 Annex III: Success Story: Benefits of CARGS ............................................................................. 27 Table of Figures Figure 1 ZHCT HIV Testing Cascade ................................................................................................................................................ 7 Figure 2: Number of individuals tested by age category and sex ............................................................................................... 8 Figure 3: Clients testing HIV positive by district............................................................................................................................. 8 Figure 4: Yield rate by district ............................................................................................................................................................. 9 Figure 5 Linkage to care by District ................................................................................................................................................. 10 Figure 6: Linkage rate by age category ............................................................................................................................................ 10 Figure 7 Sources of index cases by entry point ............................................................................................................................ 11 Figure 8 HIV services in DREAMs districts. ................................................................................................................................... 11 Figure 9: HTS by month ...................................................................................................................................................................... 12 Figure 10 Cumulative District HTS against Annual Target ........................................................................................................ 12 Figure 11: Defaulters Tracking Cascade .......................................................................................................................................... 14 Figure 12: ZHCT project vehicles, motorbikes and bicycles// Photo Credits FHI 360 ...................................................... 19 List of Tables Table 1: TB Screening by Sex ............................................................................................................................................................. 13 Table 2: Clients referred for different services after symptoms screening ........................................................................... 13 Table 3: Summary of Achievements ................................................................................................................................................. 15 3 List of Acronyms APHL Association of Public Health Laboritories AR&P Annual Review and Planning ART Antiretroviral Therapy AWP Annual Workplan CARG Community ART Refill Group CATS Community Adolescent Treatment Supporters CHO Community Health Officers COP Country Operational Plan CPF Community Program Facilitator DATIM Data for Accountability, Transparency and Impact DHIS2 District Health Information System DMO District Medical Officer FHI 360 Family Health International 360 GOZ Government of Zimbabwe HTS HIV Treatment Services LTFU Lost To Follow Up MOHCC Ministry of Health and Child Care MOU Memorandum of Understanding OPHID Organization for Public Health Interventions and Development PEPFAR President’s Emergency Plan for AIDS Relief PMD Provincial Medical Director PMP Performance Monitoring Plan PLHIV Persons Living with HIV PSI Population Services International SOP Standard Operating Procedures TBD To Be Determined UNAIDS Joint United Nations Programme on HIV/AIDS USAID United States Agency for International Development ZHCT Zimbabwe HIV Care and Treatment Project 4 1. Executive Summary This quarterly report is an outline and analysis of progress made towards achievement of annual targets during the period from April 1 to June 30, 2016 under the Zimbabwe HIV Care and Treatment (ZHCT) project. The reports highlights major results achieved as the project intensified implementation of HIV testing services activities initiated in the first two quarters in eight target districts in Manicaland and Midlands provinces. It also brings out critical lessons and challenges encountered during the period under review, while sharing effective strategies and approaches that will be intensified in Q4 as the project prepares for scale up in Year 2. As a comprehensive community-based intervention, data from the period under review shows that the ZHCT project is establish and maintain providing with sustained linkages for the target clients between the community and health facilities. In the first half of Year 1, the project was mainly focused on start-up activities as well as commencement of index case HIV testing. In this reporting period, the focus was on intensified provision of services ranging such as HIV testing and counselling and provision of results, enrolment in care and treatment, symptoms screening, defaulter tracking and tracing, as well as laboratory services strengthening support to the Ministry of Health and Child Care (MOHCC). The achievements in Q3 show that ZHCT project is well on course to surpassing most of the Year 1 targets (see Annex I: ZHCT Annual Progress Summary). The following bullets summarize the programmatic highlights during the period under review:- 10,258 individuals were tested for HIV and received their results against a quarterly target of 5,240, which reflects the intensified provision of HTS in Q3. Out of those tested, 640 (343 females and 287 males) tested HIV positive giving an overall yield of 6%. The majority (46%) of clients tested during this quarter were in the 25 – 49 year age group As in Q2, Kwekwe district achieved the highest yield rate (8%) this quarter while Buhera district had the lowest (3.6%), even though the latter
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