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.

Zimbabwe is on track to be one of the first nations in sub-Saharan Africa to virtually eliminate mother-to-child transmission of HIV. This is a remarkable feat, considering that, as of 2009, Zimbabwe had one of the highest burdens of new HIV infections in the world and was experiencing a mother-to-child HIV transmission rate of approximately 30%.

This breathtaking progress is a testament to the power of partnerships. Two global health leaders, the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) and the Children’s Investment Fund Foundation (CIFF), collaborated with the Ministry of Health and Child Care (MOHCC) to turn the tide on this epidemic by focusing on improving maternal, newborn, and child health in Zimbabwe while working hand-in-hand with a country eager to address a widespread HIV epidemic and strengthen child survival.

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

(2010-2016) 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 as a catalyst to improve access to critical and proven HIV prevention methods in Zimbabwe, the partnership is expanding access to more comprehensive prevention of mother-to-child transmission of HIV (PMTCT) services nationwide, and optimizing 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 and commitment of all levels of the existing health system to ensure an integrated, sustainable, and cost-effective approach. The partnership also aims to ensure that the lessons learned from Zimbabwe will be used to implement similar programs in other high-burden countries, and to strengthen efforts to eliminate pediatric HIV/AIDS globally.

Over the five-year project period, EGPAF and its sub-grantee partners will implement the following approaches and strategies to maximize HIV-free survival at 24 months:

1. Increase support to existing districts and expand to new districts to achieve national geographic coverage of comprehensive PMTCT services;
2. Ensure eligible pregnant women receive antiretroviral therapy (ART);
3. Ensure that non-eligible women and HIV-exposed infants received appropriate antiretroviral (ARV) prophylaxis and support for appropriate infant feeding;
4. Improve follow-up of mother-baby pairs;
5. Increase awareness and demand for PMTCT services;
6. Ensure care and treatment for HIV-exposed and HIV-infected infants;
7. Strengthen M&E systems and human resources for health;
8. Document program results and best practice for dissemination to other high-burden countries in the region.

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Publications

Country Fact Sheet: Zimbabwe

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Haba Na Haba: Technical Assistance Provision at the Elizabeth Glaser Pediatric AIDS Foundation (2014)

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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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Bringing Rural Sub-Saharan African Communities and the Global Response to the HIV and AIDS Epidemic (2015)

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Technical Report: Accelerating the Elimination of Pediatric HIV and AIDS in Zimbabwe (2015)

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