Online Reporter
Sukulwenkosi Dube-Matutu, Mat South Bureau Chief
THE National Aids Council (NAC) is working with more than 50 rural health facilities in Matabeleland South Province to strengthen adherence to anti-retroviral therapy (ART) through the Community ART Refill Group (Carg) model.
The programme is being implemented in Bulilima, Mangwe, Beitbridge, Gwanda and Insiza districts, and is designed to empower people living with HIV to take greater control of their treatment and overall health.
Under the model, Carg leaders are trained and deployed to monitor adherence to ART, collect medication on behalf of group members and disseminate critical HIV and Aids information within their communities. Each group consists of 10 members.
The model has eased congestion at health facilities by reducing the number of patients visiting clinics for routine medication refills. Instead, one representative collects treatment for the entire group, allowing health workers to devote more time to patients requiring attention.
At Matjinge Clinic in Bulilima, Ms Nonhlanhla Bhebhe oversees five groups with a combined 50 members, ensuring every individual receives their medication on time and remains in care.
“This system has made a big difference for us as people used to travel long distances to the clinic every few months and some would miss their refill dates. Now, only one of us goes to collect medication for the whole group every six months on a rotational basis. No one is left behind,” she said.
Beyond distributing medication, Ms Bhebhe also acts as an HIV ambassador, promoting responsible behaviour and educating community members.
At Ingwizi Rural Health Centre, Ms Samkeliso Nkomo, another Carg leader, said the model has provided relief for ART patients, who previously travelled long distances to access treatment. She said group leadership requires openness and trust and as such leaders are required to disclose their HIV status.
Ms Nkomo also conducts regular meetings where members discuss HIV-related issues and provide peer support.
“Some patients were defaulting on their treatment because of the long distances they had to walk to health facilities. Through the Carg model, these distances have been reduced as the nearest person can collect treatment on behalf of others,” she said.
Ms Nkomo added that collective ART collection also benefits patients who feel uncomfortable being seen at health facilities due to stigma.
“There are some patients who are not yet comfortable being seen collecting their treatment. The group system is convenient for them,” she said.
Ms Nkomo emphasised that Carg leaders are trained to respect confidentiality and uphold ethical standards.
According to NAC, Bulilima has an HIV prevalence of 17,6 percent, the highest in Matabeleland South. In neighbouring Mangwe, prevalence stands at 16,8 percent, while the incidence rate among those aged between 15 and 49 is 0,27 percent — the highest in the province. These statistics highlight the critical need for effective community-driven interventions such as Cargs.
Cargs are made up of clinically stable ART clients living in the same area. They meet monthly to review adherence, discuss health topics and support one another. Each group keeps a refill monitoring tool to track medication pick-ups, potential defaulters and members requiring clinical follow-up.
Bulilima District Aids co-ordinator, Mr Ronald Hanyane, said Cargs are instrumental to the ART decentralisation programme and have helped shift community perceptions about HIV and Aids. He said the model aims to reduce the workload on healthcare workers, remove access barriers for patients and improve long-term treatment retention by empowering ART clients to manage their condition.
— @DubeMatutu
