Overview of the CHAPPL Network, Zimbabwe ( C are for H IV/ A IDS P revention and P ositive L iving Network)

1. Overview of theCHAPPL Network, Zimbabwe(Care for HIV/AIDS Prevention and Positive Living Network) Charity Alfredo (CDC) alfredoc@zimcdc.co.zwVulyewa Chitimbire (ZACH) chitimbire@zach.org.zw CCIH Annual Conference, May 2003

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. CHAPPL Network Hospitals

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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