The Community based systems in HIV treatment (CoBaSys) programme is empowering
communities to support antiretroviral delivery programmes for patients with HIV infection in east
and southern Africa (ESA). This is done through a regional network for policy advocacy
targeting vulnerable groups in ESA and Europe with support from the European commission
through the African Caribbean and Pacific (ACP) group of States. The project primarily focuses
on building solid ‘community based systems that support the HIV treatment to benefit most
vulnerable social groups at primary care level. The learning and evidence from this tier of the
health system within the Kariba Urban District-Zimbabwe is collated, synthesized for national
level advocacy and further integrated at regional level for global engagement.
Zimbabwe is experiencing a decline in HIV AIDS prevalence and in new HIV infections, first of
such kind in southern Africa. The estimated HIV and AIDS prevalence in adults in the 15-49 age
groups was 14.1% in 2008 and declined to an estimated 13.7% in 2009 (MOHCW 2009).
However, the prevalence remains high with more than one in seven Zimbabweans still infected
with HIV. In Kariba District, HIV prevalence is estimated at 19.1% based on the Mashonaland
west province statistics from Central Statistics Office (CSO 2008).
The research used qualitative Participatory Reflection and Action (PRA) research methods.
PRA research provides a powerful means of improving and enhancing practice by involving
community dialogue at the very early stages of programme planning. Thus, it builds a basis for
negotiation and partnership between researchers, resource holders and beneficiaries. However,
PRA is often time-consuming and should not be used to provide detailed information about
problems without a follow-up commitment to take action on the problems identified. A PRA
study protocol used in the research was developed by TARSC; peer reviewed and pretested
prior to implementation (Machingura F et al 2010). The Kariba PRA research participants were
drawn from Ministry of health and Child Welfare (MOHCW), local authorities, health workers,
community representatives, people living with HIVAIDS (PLWHA) and other key stakeholders.
This report provides findings and an analysis from a PRA research held in Kariba in May 2010
to investigate and provide collective recommendations to community based systems in HIV
treatment. The PRA research explored factors that facilitate and block access to, use and
effective coverage of services and responses to HIV, and identified relevant and effective
approaches to building community systems for responding to HIV /AIDS and services that
support these systems.
The Research findings indicate that Kariba urban has a number of economic activities and
groups that could be tapped into to facilitate an efficient HIV/AIDS treatment and support system
at primary care level. Economic activities included fish farming, tourism industry and vending. It
also has social groups that are potential channels for enabling an interlinked system delivering
on HIV/AIDS activities including Home Based Care, Support groups, primary care volunteers
and PLWHA income generating projects.