Zimbabwe: Male partners participation in Prevention of Mother to Child Transmission (PMTCT) programme at Rimuka Maternity Home

The City of Kadoma has 125 women on Anti-Retroviral Treatment (ART) attending Ante Natal Care (ANC) yearly. The council realized that in order to manage the incidence of Human Immuno-Virus (HIV) there was need for male partner involvement with a view to change their behaviour vis-à-vis use of condoms. The programme also came about after the realization that HIV+ positive mothers viral loads were increasing. The project activities included Capacity building, client sensitisation about program, taking baseline data on adherence, weight, height, CD4 and Viral load, treatment of HIV, male involvement community campaigns, Do-It-For-Her Initiative, Incentives for couples (queue skipping/first served), Health related Quality of Life surveys, repeat tests on weight, height, CD4 Count and Viral load, clinical assessment on every visit.

The project’s main objective is to improve male partner involvement in attending ante-natal clinic with their pregnant female partners.

Specific Objectives are as follows:

1. To improve turnout of men consenting to HIV testing at Antenatal clinic.

2. To increase knowledge of male partners on significance of HIV testing with their female partners

3. To promote HIV free generation.

4. To promote safe sex practice among HIV+ partners.

The project has benefited about 1 789 people (1157 women and 632 men).  Of these 380 are direct beneficiaries; 1140 indirect beneficiaries and 269 online beneficiaries. 65% of these are women. The intervention resulted in the birth of 126 children. Of these 124 tested HIV negative. Only 2 tested HIV positive. The City of Kadoma allocated $620 393 to this project. Of this $415 000 was donated by Welt Hunger Hilfe, $158 000 was for HIV and Tuberculosis (TB) collaboration activities which include ART and TB treatment excluding medicines. The remaining $47 393 was for renovation and purchase of TB machines.

The project has a monitoring and evaluation framework. These are mostly quantitative in nature. The Monitoring and Evaluation plan includes the following tools:

1. ANC , Pre-ART & ART registers,
2. Admission Forms and Patient Health Note Book.
3. CD4 Count and Viral Load registers.
4. Weight & Height Check
5. Electronic Patient Monitoring System (EPMS).

Perhaps the major innovation in the monitoring and evaluation of the programme is the existence of an electronic patient monitoring system used to screen patients for Anti-retroviral treatment (ART).

Kadoma City Council has faced the challenge of not having their own viral load machine, a situation that has impacted the implementation of the project. Other challenges include low male participation and lack of knowledge on the programme. To curtail these set-backs Kadoma shares a viral load machine with Chinhoyi Municipality. They have also embarked on awareness campaigns to close the knowledge gaps and also ensured male-involvement campaigns.

Lloyd Mujuru one of the male beneficiaries of this project says “Chirongwa chekuperekedza madzimai edu ku maternity ndakachigamuchira zvakanaka. Ndakadzidziswa ndikaziva kuti ndinofanira kuve supportive kuna madam toita bonde rakadzivirirwa kuti tikwanise kuva nemwana ari negative nehutano hwakanaka. Ndakafarirawo kuti hatichamira mu queue kwenguva refu patinoenda tiri vaviri” (I have received this project well. I was educated to be supportive to my wife and practice safe sex so that we can bear HIV negative children. I am also happy that now we do not have to wait in a queue for a long time if I accompany my wife to the clinic).

In the community Kadoma City Council introduced Family ART Referral Group that allows one person to collect refill/ supply of ART for every other member on ART on one specific visit. The parents attending ANC can receive a comprehensive package and treatment for all the other members. It acts as a support mechanism for community members in the same area.

The project can be replicated as Kadoma is now decentralizing the same project to its other clinics. The project enables improved interaction between the service providers and the patients. The project allows for peer learning through exchange visits. These exchange visits allow for training of the council health workers through information exchange.