Country Spotlight: Zimbabwe

Country Overview

Zimbabwe is one of the countries hardest hit by AIDS in sub-Saharan Africa. In 2013, there were 33,000 new HIV infections among women ages 15-49 and a mother-to-child HIV transmission rate of 13%.

Our Work in Zimbabwe

The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) in Zimbabwe brings both clinical HIV expertise and a focus on strengthening data quality and health systems to address the HIV and AIDS epidemic in-country. Since 2001, EGPAF has been a lead partner to Zimbabwe’s Ministry of Health and Child Care, supporting the national prevention of mother-to-child transmission of HIV (PMTCT) and pediatric HIV care and treatment programs. In 2011, the Ministry of Health and Child Care made elimination of pediatric HIV and AIDS a national goal, renewed commitment to decrease the rate of new HIV infections among children to 5% by 2015 and adopted the World Health Organization’s PMTCT guidelines, recommending lifelong ART among all pregnant and breastfeeding women living with HIV.

As of 2015, EGPAF-Zimbabwe helped the country reach closer to its goal of near elimination of new pediatric HIV infections. EGPAF provides direct support to a total of 1,495 sites across 62 districts of Zimbabwe, representing a 96% coverage of the total 1,560 national antenatal care sites. We focus on four major program implementation areas including 1) increasing access to comprehensive and integrated HIV services; 2) strengthening data collection and use for evidence-based programming; 3) community-level programming; and 4) health systems strengthening.

In addition to direct health service delivery support, EGPAF advocates for policy development, aligned with local community needs, focused around PMTCT, implementation of globally-recommended HIV prevention and treatment guidelines and the scale-up of early infant HIV diagnosis (EID). We also engage in operations research in Zimbabwe, which aims to increase access and use of the most effective HIV and AIDS services. Our research has, to date, focused on the acceptability of lifelong antiretroviral therapy among HIV-positive pregnant and breastfeeding women; result turnaround time for EID; health worker capacity to manage patients; use and acceptability of recently-adopted client tracking tools (to ensure better retention of clients on treatment); and effects of a set of community-based interventions on increased demand for, access to, and retention in maternal, newborn, and child health (MNCH) and PMTCT services.


Key Projects in Zimbabwe

Advancing Community-Level Action for Improving Maternal and Child Health/Prevention of Mother-to-Child Transmission of HIV (ACCLAIM) Program

(2012 - 2016) Project ACCLAIM implements and assesses the effect of three community-based interventions in Uganda, Swaziland, and Zimbabwe. Through ACCLAIM, EGPAF aims to increase community demand for, uptake of, and retention in maternal and child health and PMTCT services. The project utilizes three interventions including community leader engagement, community health days, and peer support groups. ACCLAIM is made possible through a four-year grant from the Bill & Melinda Gates Foundation, administered through the Department of Foreign Affairs, Trade, and Development Canada.

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Family and Communities for Elimination of Pediatric HIV (FACE-Pediatric HIV)

(2013 - 2015) As a sub-grantee to the Organization for Public Health Interventions and Development (OPHID), EGPAF has built on the achievements from the Family AIDS Initiative (FAI) to expand access to high-quality PMTCT services that are closely linked to HIV/AIDS treatment, care, and support for families, including children living with HIV. Under this project, EGPAF worked to provide technical guidance to the national PMTCT program and strengthen human resource capacity; coordinate among other donor-funded PMTCT and maternal and child health programs; and provide capacity building support to partners and stakeholders in technical, monitoring and evaluation, and financial systems.

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Integrating Comprehensive Pediatric Care and Treatment into Maternal, Newborn, and Child Health (MNCH) for Elimination of Pediatric HIV in Zimbabwe (DfID)

(2012 - 2015) Building on past and current program efforts to expand the delivery of comprehensive and integrated services for prevention of mother-to-child transmission of HIV (PMTCT), this project is focused on strengthening support to pediatric care and treatment services for infants and young children within the HIV continuum of care in Zimbabwe. Key objectives for the project include:

  • To strengthen the capacity of the Ministry of Health and Child Welfare (MOHCW) to scale up and provide pediatric care and treatment services in Zimbabwe;
  • To strengthen the delivery of pediatric care and treatment services in Zimbabwe;
  • To strengthen the national health information system in support of pediatric care and treatment services.

Working within this framework, EGPAF will support the integration of pediatric HIV diagnosis and treatment within maternal and child health (MCH) sites while strengthening human resources for health, including training, supportive supervision, and mentorship at the national, district, and site level for the pediatric HIV elimination agenda. Through the project, EGPAF will also strengthen management, coordination, leadership, and accountability for pediatric HIV care and treatment services at the national level towards achieving an AIDS-free generation in Zimbabwe.

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Virtual Elimination of HIV Infection in Infants and Young Children in Zimbabwe and Beyond

(2010 - 2015) In December 2010, EGPAF received an award from the London-based Children's Investment Fund Foundation (CIFF) to significantly scale up EGPAF programs and dramatically accelerate the elimination of pediatric HIV/AIDS in Zimbabwe. Using the new 2010 WHO guidelines, and later the 2013 WHO guidelines, as a catalyst to improve access to critical and proven HIV prevention methods in Zimbabwe, the partnership has expanded access to more comprehensive PMTCT services nationwide, and optimized the quality and impact of PMTCT programs to ensure more children are born free of HIV and that HIV-positive mothers are kept alive. The project focuses on strengthening the capacity of all levels of the existing health system to ensure an integrated, sustainable, and cost-effective approach. EGPAF also works to strengthen monitoring and evaluation systems and document program results and best practice to share with other high-burden countries in the region and globally. As of the end of June 2015, EGPAF provided direct support to a total of 1,495 sites in 62 districts of Zimbabwe, representing a 96% coverage of the total 1,560 ANC sites.

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Country Fact Sheet: Zimbabwe

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Haba Na Haba: Technical Assistance Provision at the Elizabeth Glaser Pediatric AIDS Foundation

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Journal article: Lessons learned from early implementation of B+: The Elizabeth Glaser Pediatric AIDS Foundation experience (2014)

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Technical Report: Unmet Need for Family Planning, Contraceptive Failure, and Unintended Pregnancy among HIV-Infected and HIV-uninfected Women in Zimbabwe (2014)

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Zimbabwe Program 2012 Annual Report

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Program Brief: Strengthening Antiretroviral Treatment for Women and Children in Maternal, Neonatal, and Child Health Services (2015)

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Program Brief: Supporting Improved Health Outcomes for Mothers and Babies Through the Use of Electronic Database Systems (2015)

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