Zimbabwe HIV Care & Treatment Project ANNUAL PROGRESS REPORT O C T O B E R 1, 2015 – S E P T E M B E R 30, 2016 . Zimbabwe HIV Care and Treatment (ZHCT) Project Cooperative Agreement Number: AID-613-A-00009 Project Start and End Date: September 24, 2015 to September 24, 2020 Prepared for: Dr Ruth Bulaya-Tembo, Agreement Officer’s Representative 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-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. October 1, 2015 – September, 30 2016 | Year 1 Annual Progress Report 1 TABLE OF CONTENTS TABLE OF CONTENTS ..................................................................................................................................................... 2 TABLE OF FIGURES.......................................................................................................................................................... 3 LIST OF TABLES............................................................................................................................................................... 3 LIST OF ACRONYMS ........................................................................................................................................................ 4 1. EXECUTIVE SUMMARY ........................................................................................................................................ 5 2. INTRODUCTION ................................................................................................................................................... 6 3. DETAILED ANNUAL RESULTS AND ACHIEVEMENTS ........................................................................................ 8 3.1 HIV Testing Services ...................................................................................................................................... 8 3.2 Quality assurance for household index testing .................................................................................... 10 3.3 HIV testing yield............................................................................................................................................. 10 3.4 Enrolment into care ...................................................................................................................................... 12 3.5 Symptom Screening ..................................................................................................................................... 16 3.6 Defaulter Tracking ......................................................................................................................................... 17 3.7 PLHIV receiving ARVs through CARGs .................................................................................................. 17 4. PERFORMANCE INDICATOR SUMMARY ........................................................................................................... 18 5. LABORATORY SERVICES STRENGTHENING ..................................................................................................... 19 6. CHALLENGES ENCOUNTERED .......................................................................................................................... 20 7. MONITORING AND EVALUATION...................................................................................................................... 21 8. ZHCT PROJECT COLLABORATION WITH OTHER PARTNERS ...................................................................... 22 9. FHI 360 REGIONAL AND TECHNICAL SUPPORT ........................................................................................... 23 10. ADMINISTRATIVE AND OPERATIONAL ISSUES ................................................................................................ 23 11. LESSONS LEARNT ............................................................................................................................................. 24 12. LOOKING AHEAD: ZHCT PRIORITIES FOR YEAR 2 ....................................................................................... 25 Annex I: ZHCT Annual Progress Summary...................................................................................................... 27 Annex II: Year 1 Implementation Update ......................................................................................................... 29 Annex III: List of ZHCT SOPs and Data Collection Tools ........................................................................... 33 TABLE OF FIGURES Figure 1: ZHCT Implementation Districts ................................................................................................................................................. 7 Figure 2: ZHCT HIV Testing Cascade ....................................................................................................................................................... 8 Figure 3: HIV Positive Target versus Achievement .............................................................................................................................. 9 Figure 4: Individuals receiving HTS by Age Category ........................................................................................................................ 10 Figure 5: CHOs undergoing rapid HIV testing training .................................................................................................................... 10 Figure 6: Yield Rate by District ................................................................................................................................................................... 11 Figure 7: HTC_Positives and Yield Rate by District ............................................................................................................................. 11 Figure 8: Outreach Workers receive bicycles, phones and bags .................................................................................................... 12 Figure 9: Linkage Rate by District ............................................................................................................................................................. 13 Figure 10: Linkage Rate by Age Category ................................................................................................................................................ 14 Figure 11: Yield Rate by Entry Point ........................................................................................................................................................... 14 Figure 12: Linkage Rate by Age Category per District ....................................................................................................................... 15 Figure 13: ZHCT Annual HTS ...................................................................................................................................................................... 15 Figure 14: Yield for Sexual Partners ........................................................................................................................................................... 16 Figure 15: Defaulter Tracking Cascade ..................................................................................................................................................... 17 LIST OF TABLES Table 1: TB Screening...................................................................................................................................................................................... 16 Table 2: Annual Indicator Performance Table, Sep. 2015 - Sept. 2016 ........................................................................................ 18 Table 3: Challenges and Mitigation Measures ...................................................................................................................................... 20 Cover Photos: Top left: Members of a family-based CARG; Top right: A young girl successfully returned to care; Bottom left: Members of a sex work-based CARG; Bottom right: Motorbikes used by ZHCT Project community nurses. All Photo Credits in Report: FHI 360 October 1, 2015 – September, 30 2016 | Year 1 Annual Progress Report 3 LIST OF ACRONYMS APHL Association of Public Health Laboratories APR Annual Progress Report AR&P Annual Review and Planning ART Antiretroviral Therapy ARVs Antiretroviral medicine 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 DREAMS Determined Resilient Empowered AIDS-Free Mentored and Safe DCT Data Collection Tool DHIS2 District Health Information System version 2 DMO District Medical Officer EQA External Quality Assurance FHI 360 Family Health International 360 GOZ Government of Zimbabwe HTS HIV Testing Services LIMS Laboratory Information Management System LTFU lost to follow up MMD Multi Month Dispensing MOHCC Ministry of Health and Child Care MOU Memorandum of Understanding NMRL National Microbiology Reference Laboratory OPHID Organization for Public Health Interventions and Development