Zimbabwe

Health and HIV

Since 2010, we have worked closely with the Ministry of Health and Child Care to expand OVC access to primary health care and comprehensive pediatric HIV services. Through this collaboration, we have developed an HIV-sensitive case management system that strengthens identification and referral of high-risk children to HIV testing, care, and treatment services. To support that system, Bantwana Zimbabwe developed HIV-sensitive data collection and case management tools that assess children and adolescents for HIV risk and track adherence and retention in care plans for HIV+ children and teens. We have also introduced training and clinical mentorship to rural health providers on diagnosis and management of pediatric HIV, counselling, ART initiation, and retention in care. Another innovation includes Multi-Sectoral School Health Assessments that coordinate critical primary health and child protection services to vulnerable children through head-to-toe screenings in primary and secondary schools by trained nurses. We collaborate with DREAMS clinical partners to ensure that vulnerable adolescent girls and young women are linked to HIV prevention and testing services, including pre-exposure prophylaxis, as well as to family planning/reproductive health, antiretroviral therapy, and prevention of mother-to-child transmission services where needed.

Economic Strengthening

Bantwana’s Youth and Livelihoods activities offer practical life skills training and entrepreneurship opportunities to vulnerable youth. We combine income-generating skills training with entrepreneurship and business skills coaching and mentorship from successful professionals. Youth can choose from activities that include budgeting and management, family financial management, and access to consumer credit.

Our Siyakha Girls model is designed to develop the economic and social assets of vulnerable adolescent girls and young women ages 18-24 to enhance their work readiness and reduce their risk of HIV. This robust program builds foundational life and soft skills, coupled with vocational and business skills in demand within local micro-value chains that enable young women to successfully break into trades that offer sustainable livelihoods and might be male-dominated. The program also provides mentorship, sexual harassment training, internships, and job placement support through a network of sensitized employers.

Our Household Economic Resilience and Savings model stabilizes families as they gradually progress along a pathway from vulnerability to resilience. This intervention combines savings and lending groups facilitated by community-based trainers with market linkages and business skills training provided by private sector partners and coaches.

Education

Our Second Chance Education model is an accelerated learning program that helps out-of-school children catch up in school with an integrated package of academic skills, life skills, and case management support. Second chance education targets children who may be orphaned, HIV positive, or disabled, as well as those who come from poor families, child-headed households, or who live on the streets. It places particular emphasis on girls and prioritizes child protection, gender, HIV & AIDS, and disability issues. Children who need additional services are referred to case care workers.

In 2014, we worked with the Ministry of Primary and Secondary Education to scale up this second chance education model to more than 602 schools in 25 districts reaching over 32,000 vulnerable children. For non-formal alternatives for secondary school-age children and children with disabilities for whom reintegration is more difficult, we provide life skills training, as well as a part-time and continuing education and inclusive education program, which includes the strengthening of community learning sites and advocacy for inclusion of children with disabilities and older youth in the formal education sector. Related to our efforts to advocate for out-of-school children and those with disabilities, we have an existing Memorandum of Understanding with the Ministry of Primary and Secondary Education.

Our Early Childhood Stimulation model empowers over 6,767 mothers with practical parenting skills to promote health child development. Taught by a trained facilitator, the program follows a parenting skills curriculum covering 12 parenting topics, including motor, social, emotional, cognitive development, communication and language development, health, and nutrition. The mothers are supported by home visits from trained Case Care Workers and also receive training on savings and lending schemes to improve economic resiliency and support children’s medical needs.

We reach children under 5 through both in-school and community-based Early Childhood Development Centers by linking vulnerable children to community case workers who connect families to health, psychosocial support, legal and child protection services; by conducting head-to-toe health screenings by nurses who can refer to HIV testing and ART services; and by referring caregivers to income generating opportunities to help them afford critical healthcare and educational services.

Social Protection

We work closely with Zimbabwe’s Department of Social Welfare to strengthen and support the National Case Management System. To date, Bantwana has trained over 2,100 community care workers to identify, assess, refer, and support vulnerable children and families to access critically needed social protection services (education, child protection, household economic strengthening, nutrition, gender-based violence, and psychosocial support). We have introduced and tested an integrated HIV and social protection case management model and tools for training Case Care Workers and Department of Social Welfare officers in HIV-sensitive case management, including expanded HIV/gender-based violence risk assessments for home visits with vulnerable children and adolescents and their caregivers.

We launched an electronic management information system in conjunction with the Department of Social Welfare to improve the efficiency and accountability of the national case management system. It enables the department to identify and address key challenges and risks, such as infrastructural limitations and workforce shortages, and generate and utilize evidence for planning and decision making from national to district level. As part of our COVID-19 response, Bantwana is working to support a virtual referral desk and tracking system for remote case management.

Systems Strengthening

We provide technical support to national and local government ministries in education, child protection, and health interventions for vulnerable children, youth and their families. Bantwana helped pilot, develop, and roll-out Zimbabwe’s flagship National Case Management System, which was adopted by the Government of Zimbabwe in 2012 as part of its policy for the care and protection of children and serves as a successful model for other countries in the region. We also developed innovative case management components such as the Early Warning System to retain adolescent girls and young women in school as well as HIV-sensitive and GBV-sensitive training materials for Community Case Workers to counsel, support and refer girls and young women for appropriate clinical and counseling services.

We have worked closely with the Ministry of Primary and Secondary Education to develop its Non-Formal Education Policy and resuscitate its Part-Time Continuing Education (PTCE) setup for children who have dropped out of school, which builds on our accelerated learning programming approach. Finally, we have supported the Ministry of Health and Child Care by providing increased access to treatment and care for children living with HIV through complementary community and facility interventions that include strengthening the capacity of nurses and district-level clinics to test and treat pediatric patients.

Adolescent Girls and Youth

As a PEPFAR/DREAMS partner in Zimbabwe, we address the structural drivers of HIV affecting adolescent girls and young women through comprehensive gender-based violence prevention and care services (including clinical care, legal services, psychosocial support, and emergency shelters); formal and non-formal education for vulnerable girls and teen mothers; social protection services to strengthen family and caregiver responses to HIV through parenting support groups and case management; and economic empowerment and resilience building that reduces girls’ vulnerability through livelihoods training and employment or entrepreneurship opportunities.

Through our layered approach, we ensure each adolescent girl or young woman receives a core package of services. We have tailored programs for those most at risk of HIV due to factors including school drop-out, poverty, early marriage, teenage pregnancy, lack of vocational and life skills, exposure to gender-based violence, and limited access to HIV services. Our innovative early warning system model identifies at-risk girls and links them with targeted support to retain them in school and reduce their vulnerability to HIV and gender-based violence.