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Usaid Zimbabwe Dreams /Game Changer Py6q2 LEADERSHIP, MANAGEMENT AND GOVERNANCE PROJECT SOUTHERN AFRICA QUARTERLY REPORT USAID ZIMBABWE DREAMS /GAME CHANGER PROJECT PY6Q2 JANUARY-MARCH 2017 The views expressed in this publication do not necessarily reflect the views of the United States Agency for International Development or the United States Government. Africaid acknowledges BMSF, CBM, CPF donors, ELMA, EJAF, JSI, MSH, Maruva Trust, PATA, PEPFAR, SAT, UNAIDS, UNICEF, USAID, and WHO for funding the organization’s programs. 2 Contents Acronyms ....................................................................................................................................... 4 INTRODUCTION AND EXECUTIVE SUMMARY ..........................................................................5 BACKGROUND .......................................................................................................................7 PLANNED AND ACCOMPLISHED ACTIVITIES IN Q2 ...................................................................8 Game Changer ............................................................................................................................... 8 CATS provide differentiated care and support to 13,030 unique CAYPLHIV in Q2 and a cumulative 19,642 CAYPLHIV ........................................................................................................................ 8 Increase in quality of HTS, HIV treatment and care services, and other sexual and reproductive health (SRH) services provided to children, adolescents, and young people............................. 9 Africaid drives movement towards elimination of mother-to-child transmission (EMTCT) with engagement of 318 dyads of exposed babies and HIV positive mothers ................................ 10 Performance Data ..................................................................................................................... 12 Featured Closer Look ................................................................................................................... 13 MK’s Second Chance ................................................................................................................. 13 DREAMS ....................................................................................................................................... 14 Stakeholder engagement for improved coordination of DREAMS activities ........................... 15 16,234 community members mobilized for HTS ...................................................................... 15 182 health workers supported through mentorship ................................................................ 15 Performance Data ..................................................................................................................... 15 Featured Closer Look ................................................................................................................... 18 USAID Visit to Gweru ................................................................................................................ 18 Africaid Capacity Improvements ................................................................................................. 18 Improved M&E capacity of CATS .............................................................................................. 18 Zvandiri Database roll-out ........................................................................................................ 18 Grant management and capacity development support ......................................................... 19 Challenges, Solutions, and Lessons Learned ............................................................................... 19 The Way Forward ........................................................................................................................ 21 3 Acronyms AGYW Adolescent girls and young women AIDS Acquired Immunodeficiency Syndrome ALHIV Adolescents living with HIV ART Anti-retroviral therapy ASRH Adolescent and Sexual Reproductive Health CATS Community Adolescent Treatment Supporters CAYPLHIV Children, Adolescents, and Young People Living with HIV CBO Community-based organization CSO Civil society organization DBS Dried blood spot test DREAMS Determined, Resilient, Empowered, AIDS-Free, Mentored, and Safe EID Early Infant Diagnosis EMTCT Elimination of mother-to-child transmission GC Game Changer HTC HIV testing and counseling HTS HIV testing services M&E Monitoring and evaluation MoHCC Ministry of Health and Child Care MOU Memorandum of Understanding MSH Management Sciences for Health NAC National AIDS Council PMTCT Prevention of mother-to-child transmission PSI Population Services International PVO Private Voluntary Organization SRH Sexual and reproductive health TB Tuberculosis USG US Government 4 INTRODUCTION AND EXECUTIVE SUMMARY The following document is the Leadership Management and Governance (LMG) DREAMS and Game Changer (GC) Zimbabwe quarterly report covering the period January to March 2017. During this period LMG continued to provide Africaid with funding through a USAID cost reimbursable grant to implement adolescent-responsive HIV prevention, treatment, care and support programmes. MSH has also issued Modification #4 to this USAID cost reimbursable grant in order to increase the obligation and extend the period of performance to sustain the organization’s growth and expansion as well as facilitate additional experience in grant management. LMG support to strengthen Africaid’s capacity to deliver their services in a manner that aligns with USAID policy and procedures, has been limited to support to grant management. In addition to this, LMG provided support to M&E with a focus on report writing, data collection and analysis. During quarter two, Africaid’s work consisted of transforming from the planning and set up process of quarter one to an operational program, successfully providing care and support to children, adolescents, and young people living with HIV (CAYPLHIV). During this quarter, Africaid observed significant evidence showing the Zvandiri Community Adolescent Treatment Supporters’ (CATS) improved reach when offering quality adherence counselling, monitoring of their beneficiaries, and home visits to their peers. The district team and head office team mentored health care workers and CATS, ensuring quality management, monitoring, and support. Although Africaid experienced some external challenges during the reporting quarter, the teams managed to successfully implement most of the planned activities with support from key district partners, who were instrumental in ensuring that Africaid’s work is accomplished. Key Achievements in Quarter Two (January–March 2017): 1. All 24 districts started quarter two (Q2) with protocols and inception meetings completed, memoranda of understanding (MOUs) in place, offices set up, and a foundation of collaboration started with the District Administrators, District Nursing Officers, Rural District Council CEOs, District AIDS Coordinators, ITECH, community leaders, local NGOs, and other relevant key line ministries. 2. A total of 643 trained and mentored CATS actively provided care and support to beneficiaries within 260 facilities and surrounding communities. 3. Increased formation and attendance at support groups in 22 districts: 189 unique support groups met and discussed adherence, viral suppression, ART, and other topics, and 2,355 CAYPLHIV attended of the 10,765 currently on ARV treatment (Target - 43,082), the majority of whom were 10-19 years old. Africaid facilitated some support groups in conjunction with the National AIDS Council (NAC) and other partners, who provided transport funding and refreshments to participants. 4. Africaid prioritized a program focus on CATS’ engagement with mother-baby dyads by providing enhanced care to HIV positive young mothers and their exposed infants. CATS reached a total of 318 individuals, which was 93 percent of the quarterly target and 33% of the annual 5 target. This engagement increases the number of infants receiving early infant diagnosis (EID) testing, mothers knowing the baby’s results, and prevention of mother-to-child transmission (PMTCT) final outcome after 18 months. 5. CATS provided 13,030 CAYPLHIV across 24 districts with differentiated care during the months of January–March 2017 (achieving 66 percent of the quarter two target). A total of 19,597 CAYPLHIV have received care and support since the start of the program (65 percent achievement of quarterly target and 30% of the annual target). Challenges and lessons learned: Quarter two marked the end of the establishment of set up and protocols and the beginning of full- scale operation. While Africaid worked at capacity to complete trainings, recruit staff and complete district preparation, other factors hindered the on-the-ground achievements and productivity of the CATS and staff. Significant challenges faced by the 24 districts affected varied aspects of the program and achievement of targets. • Limited access to funding and cash precluded activities such as CATS coordination meetings, purchase of bicycles, and visibility materials. • A lack of program vehicles severely limited the mobility of the district teams, thereby rendering mentorship very challenging. • The changing political environment means that Africaid must plan with care and follow additional protocols, occasionally requiring additional time and funding, in order to proceed with necessary activities. • Natural disasters such as flooding caused by heavy
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