Forbes Road Wellness Clinic
With support from Global Fund through the North Star Alliance, FACT continued to work with key populations at its Forbes Road Wellness Cross Border Project which targets sex workers and long distance truck drivers. The project is situated at the Forbes Border Post, entry to Mozambique. In 2016, the project continued to offer services to Long Distance Truck Drivers (LDTDs), sex workers (SWs) and the general community members within 5km radius of the clinic. Services offered include Sexually Transmitted Infections (STI) care and treatment, Malaria treatment and control through prophylaxis provision, Blood Pressure Checks, CD4 count testing, TB screening, HIV Testing and Counseling and Behavior Change Communication (BCC) materials and sessions. The project aims to improve the coherence and the effectiveness of the regional response to HIV and AIDS with regard to mobile and most at risk populations in order to reduce HIV infections in the SADC region. Critical achievements the organization is celebrating under this project are;
a) Forbes clinic was nominated for best practices in the SADC region in 2016.
b) The centre launched the Southern African Prevention and Treatment Intervention Study (SAPTIS) in June 2016 and has provided critical data for understanding behaviour patterns of the mobile populations.
c) Allocation of a site by Mutare city council for constructing a clinic.
A total of 1925 clients received HIV Testing Services at the Forbes Road Wellness Clinic (RWC). The target populations who received services were community members residing near the clinic, long distance truck drivers (LDTD) from different SADC countries and sex workers (SW). The last two categories are considered to be at high risk of contracting HIV.
Data captured through the Client Intake Form which FACT uses for every visit which individual client makes to the RWC showed that sex workers are more vulnerable to HIV because they have multiple casual partners with whom they normally have unprotected sex as this is what the clients prefer. They cite that satisfied clients pay them more money which they need for sustenance. For community members, there was a mixture of non-use of prevention, as well as unfaithfulness to regular partners. The majority of drivers on the other hand revealed that they are faithful to one partner and use condoms for protection, most times.
Forbes clinic was nominated for best practices in the SADC region in 2016 mainly because in its effort to increase the number of Long Distance Truck Drivers accessing prevention, HTS and treatment services, it came up with what the clinic called the “Pizza delivery approach”.
This is a holistic package of bringing the earlier mentioned services to the clients at their doorstep(the transit truck park commonly known as the Dry port) instead of waiting for them to come to the clinic. During the outreaches routine blood pressure checks, CD4 count testing, and T-shirts distribution were used as the entry point to reach clients. This approach ensures uptake of services by truckers who normally chose to stay in the Dry port rather than visit the clinic.
Forbes RWC decided to use this approach after trial outreaches where they saw high numbers of drivers queuing up for services each time these were offered from the transit port.
The Behaviour Change Program (BC) – HIV Prevention
The Behaviour Change (BC) program focuses on transformation of individual and group behaviour as a means to reduce new HIV incidences. The overall goal of the program is to create demand and uptake for health related service and contribute to improved sexual and reproductive health outcomes through reducing incidences of maternal morbidity and mortality, cervical cancer, HIV and GBV for women and girls as well as the community at large.
Under the program, people and communities are sensitized to promote responsible practices, communication and behaviour change in sexual relationships. In 2016, the BC program continued to be implemented in all the seven districts covering 260 wards of Manicaland Province. FACT constantly enjoyed the voluntary services of its 234 Behaviour Change Facilitators (BCFs) and 30 Sista2sista mentors. The BC program is dually funded by Global Fund under the New Funding Model and United Nations Population Fund (UNFPA) under the Integrated Support Program. Both programs offered Sexual Reproductive Health and Rights (SRHR), HIV and Gender Based Violence (GBV) prevention used the home visit approach to reach families, couples and individuals to deliver messages aimed at creating demand and making referrals for uptake of health related services. The Sista2Sista Girls’ Clubs is a component of the Integrated Support Program that targets girls and young women. The club mentors provide information on SRHR, HIV and GBV prevention and social support network for vulnerable girls through scheduled meetings on various themes which enhance their self-efficacy and life skills.
The objectives of the BC program include:
• To generate demand for people to access HIV and AIDS and SRHR services and products.
• To improve availability of services and products for HIV and AIDS and sexual reproductive health.
• To integrate SRHR and GBV services into existing HIV prevention services and reproductive health care delivery.
• To strengthen community’s access to, uptake and utilization of Family Planning, HIV, Cervical Cancer and GBV services
• To increase community awareness of gender responsive laws, services and women’s rights
• To create awareness and strengthen the capacity of girls and young women to seek SRHR, HIV and GBV prevention services.
In the New Funding Model districts, FACT reached to 207 773 people with various services against a target of 137 088 whereas in the Integrated Support Program districts, a total of 132 026 people were reached against a target of 134 784. Services offered include information on maternal morbidity and mortality, cervical cancer screening, HIV and GBV prevention and sexual reproductive health.
The Health and HIV Pillar aims to reduce the number of new infections in intervention sites. Through the Health and HIV initiatives, FACT empowers vulnerable groups such as women, youths, the disabled and children to claim their rights to access treatment, care and support. The pillar will also strengthen women and girls to challenge and reject gender based violence and other harmful cultural and religious practices which contribute to the spread of HIV. More so, the initiatives target the general population, capacitating them to mitigate the spread of HIV and promote sexual reproductive health. FACT’s commitment to a holistic approach to HIV informs its increasing support towards interventions that integrate livelihoods, food and nutrition security. The department also supports the work of the Ministry of Health and Child Care (MOHCC) through offering a variety of health-related social services. FACT’s Health and HIV department works within the three national frameworks namely; The National Health Strategy [2013 – 2015], the Zimbabwe Agenda for Sustainable Socio-Economic Transformation (ZIMASSET) [2013 – 2018) and the Zimbabwe National HIV and AIDS Strategic Plan (ZNASP III) [2015 – 2018].
To attain the general goal of both the department and the organization, the following units are providing support to Health and HIV directly to the various communities where FACT works;
• HIV Testing and Counselling services (New Start)
• ART Program
• Youth Interventions
• Church Communities Programs
• HIV Care and Support to OVC and PLWHIV
• Mobile Populations Road-Wellness Clinic.
• Women’s Rights Interventions. Strategic Goal
Strengthen capacity of communities to respond and cope with HIV, infectious and non-communicable diseases (NCDs), gender based violence (GBV) and other health related issues through delivery of integrated services.
To improve uptake of SRH, HTS and GBV services and products by young people (sex disaggregated) aged 10-24 by 30% by 2018.
2016 - 2018
To increase number of males (10-49 years) by 60% taking up prevention services by 2018.
To increase the uptake of SRH, HTS and GBV services by key populations (sex and KP disaggregated) 25% by 2018.
To increase the number of women & girls participation in leadership and decision making processes at local level by 40% by 2018.
To improve uptake of SRH, HTS and GBV services by 15% of women by 2018