adminSamuel Kadungure Health Reporter
THE Zimbabwe Population-based HIV Impact Assessment (ZIMPHIA) survey – whose outcome will inform the country on the impact of the current HIV interventions and what still needs to be done has been rolled out in Manicaland targeting 1 631 randomly selected households.
The survey, which already has the endorsement of the apostolic sects and the traditional leaders in the province, was launched by the Minister of State for Provincial Affairs Cde Mandi Chimene, in Mutare last Tuesday.
The survey started with community mobilisation in Nyanga, then Buhera, Mutasa, Makoni, Chimanimani, Chipinge and Mutare, respectively.
ZIMPHIA was first conducted in Mashonaland Central and Matabeleland North provinces, where uptake by participants was above 70 percent and entered its third leg in Manicaland this week.
Cde Chimene said Manicaland was not only ready to participate in the survey, but also in execution of its findings.
Manicaland boasts 16 percent prevalence rate, which is one of the lowest in the country.
“All stakeholders are called upon to relay the correct information to communities for the success of ZIMPHIA. I want to assure you of Manicaland’s full commitment to not only ZIMPHIA rollout, but also implementation of the results thereof,” said Minister Chimene.
More than 50 bishops from different apostolic and Zionist churches – including the Johanne Marange and Masowe sects which dominate Mancaland have thrown their full weight behind the survey arguing that HIV was a reality whose impact had not spared the church.
“HIV is a reality, and its impact is being felt in our churches. Apostolic sects have now seen the light, and we should embrace this survey and have a meeting of minds in finding a way to prevent new infections. We are taking the HIV gospel to our flock, preaching abstinence, faithfulness and condom use,” said UDACIZA secretary general Reverend Edison Tsvakai.
Christians, biblically, are instructed to be both salt and light to those around them, and the warming up by these former objectors is likely to see the survey meet and exceed expectations.
Rev Tsvakai said dialogue had been the missing link in the past interventions, leading to mistrust, suspicions and misconceptions between health implementers and sect followers.
The sect culture has been criticised for the martyr of children based on parental beliefs that objected essential health care which limited government’s ability to protect children from preventable diseases and deaths.
“This dialogue has cleared the air, and each of us here has endorsed the programme, meaning that if any of our followers’ homestead is among the 1 631 that were randomly selected, will definitely participate.
“Sect churches are not ignorant, but have proper structures that we can introduce you to so that you can work with. In the past we used to be sidelined and that alone created tension, mistrust and suspicions. That made us inferior and unwanted. We are happy that the same authorities have realised the mistake and sort to engage, before condemning us. It is important that we understand each other first as this will motivate us into learning what we do not know. This will evolve into a lasting relationship,” said Rev Tsvakai.
His sentiments were echoed by one Bishop Chikosi, who said that sects were ready to compromise and accommodate opposing views.
Bishop Chikosi added that compromise is part of the glue that holds us together as a nation and such rare tolerance lubricates the varied moving parts of us as a people.
ZIMPHIA will collect information and conduct laboratory tests in order to estimate the magnitude of the HIV epidemic in adults and children and to measure access to prevention, care and treatment services at national and provincial levels.
Provincial Medical Director (Manicaland), Dr Patron Mafaune, said ZIMPHIA will give guidance and insight to future countries on technical, strategic and operational survey issues, provide feedback on how the national HIV response is doing and allow the country to benchmark progress towards the UNAIDS 90-90-90 targets.
“After a decade of successful scale up of HIV prevention and treatment efforts in Zimbabwe, there is need to evaluate accomplishments to date, to better understand the impact of HIV programmess on the trajectory of the epidemic in order to better refine our response to the epidemic in the coming years,” said Dr Mafaune.
“The survey will offer free HIV testing and counselling with clinical referral in the privacy and comfort of the participant’s home. It is both a survey and a service,” said Dr Mafaune.
ZIMPHIA teams will visit 1 631 randomly selected households in Manicaland and 15 000 across Zimbabwe and administer tablet-based questionnaires to consenting household members.
Consenting survey participants receive HIV and syphilis testing and counselling, with immediate return of results.
Those who test positive are referred to their preferred health care facility for treatment.
ZIMPHIA project director Ms Hazel Dube said 1 631 randomly selected households will be visited in Manicaland’s seven districts, starting with Nyanga, where the teams have started community mobilisation.
“The idea is to draw conclusions about Zimbabwe HIV and Aids burden and response based on randomly selected sampled participants. The households were randomly selected, like a lottery, and it does not mean the households have people living with HIV, some will not,” said Ms Dube.
Dr Godfrey Musuka said the survey has benefits for both individuals and their families.
“Those on ART will know how well their treatment is working. About 30 000 individuals will know their status through ZIMPHIA, and those found HIV positive will be referred for HIV care while those found HIV negative will receive information on they can prevent HIV and stay Aids free. Families are better able to support another with their health and address the reality they are dealing with,” said Dr Musuka.
Through ZIMPHIA, Zimbabwe has become the torch bearer, leading the continent in generating new information that will be used to guide programmes and policies to achieve an AIDS-free generation. ZIMPHIA is the first survey of its kind to be implemented worldwide, and during the next three years the United States’ President’s Emergency Plan for AIDS Relief will support similar surveys in 19 other countries.
ZIMPHIA will advance HIV insights, programming and policy in Zimbabwe, serve as a template and example for other African countries that will conduct similar surveys in the coming years.
ZIMPHIA is designed around the UNAIDS’ 90-90-90 goal.
Dr Mafaune said information obtained through ZIMPHIA will help guide the Ministry of Health and Child Care to develop and improve programming to ensure that 90 percent of people living with HIV know their status, 90 percent of them are on treatment, and 90 percent of them have suppressed viral load.
The achievement of 90-90-90 is an ambitious goal that would control the HIV epidemic.
PEPFAR has invested $3 million for implementation of the survey and an additional $5 million to strengthen the health and laboratory systems to support ZIMPHIA.
PEPFAR will next year invest a total of $103 million in Zimbabwe to work toward epidemic control of HIV.
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