THE Community Antiretroviral Treatment (ART) Treatment Facilitator (CATCF) model, a new ART collection and delivery program, has greatly enhanced HIV treatment adherence through offering door to door delivery of medications to ART clients in Makoni District.
By Michael Gwarisa in Makoni District
Across Zimbabwe, the CATCF model is currently being implemented only in seven health facilities in Makoni District. These are St Therese Hospital, Matsika Clinic, Masvosva Clinic, Chiduku Clinic, Chinyadza Clinic and Tatseka Clinic.
Briefing Journalists during a media tour at St Therese Hospital in Makoni District in Manicaland province, Spencer Banguza, the National AIDS Council (NAC) District AIDS Coordinator (DAC) said even though the CATCF model was introduced as a pilot in 2020, the district has maintained a stable viral load suppression trajectory despite the COVID-19 induced service disruptions.
The aim of this program is to improve treatment adherence. On the 95-95-95 goals, the last one speaks about viral load suppression where 95% of people who are on ART are supposed to be viraly suppressed. We can only achieve that through treatment adherence, this is where this CATCF program comes in now. They collect ART for clients from this facility and then take it to communities to refill stocks for each and every client under the programme.
“We have registered tremendous progress under this model by reducing the number of defaulters. Without such a program, at times you find that clients who collect ARVs may later on disappear from the picture. Under the CATCF, every cadre has his/her own clients and they follow-up to ensure they take their medications religiously. From the facilities we work with, the number of defaulters is very minimum and we are doing extremely well in terms of viral load suppression,” said Banguza.
The total number of community cadres that are working under this model is 50 and each clinic has seven cadres working under the CATCF program, whilst St Therese has eight cadres. Banguza added that they only give clients medications on the date they are supposed to be collecting and not any day afterwards. They also assist through giving clients reminders of the dates they should go for viral load testing.
“We don’t offer these services to every client that is living with HIV, we only offer to stable clients, those that have a suppressed viral load. Basically, what we are doing is that we taking the health facility to the community’s doorstep in terms of HIV and AIDS management.
“We have different clients in the community that also have different needs and some clients might not be comfortable coming to the facility to collect their medications due to numerous reasons such as time constrains, distance to and from the facility and some maybe it will be issues to do with disclosure. So what we have done is that we have recruited cadres on the ground that we have trained as NAC working alongside Ministry of Health and Child Care (MoHCC). We have trained these cadres to offer these services within the community on behalf of the facility.”
NAC in collaboration with partners have been implementing a number of Differentiated service delivery (DSD) models around the country. Some of these models include Community ART Refill Groups (CARGs), Family ART Refill Groups (FARGs), and the Out of Facility Community ART Distribution (OFCAD) among others.
Pius Makomo, a Nurse and Opportunistic infections (OIs) Focal Person at St Therese Hospital said they have enrolled at least 502 ART clients over the past few years.
“We have different DSD models, we have the CATCF, the FARGS and we also have individuals whom we also avail services to. We also have what we call fast tracks, these are individuals who approach us requesting to be initiated on ART but prefer to keep their status a secret. These ones collect from the facility after making arrangements with us here at the facility.
“We also have a group of people whom we can’t take medications to their homes for example pregnant and lactating mothers. These ones have got special needs and monitoring of conditions that require them to visit the clinic or facilities regularly so we do not give then medications at home,” said nurse Makomo.
Meanwhile, Itai Madondo, a CATFCT cadre said, “We started this job on January 16, 2020 and the job involves taking medications to ART clients at home. We also encourage clients to have their viral load checked on time. Viral load testing is done once every year for adult clients. Because at times clients forget, we also follow-up and inform them that their days are drawing near and should visit the facility to get their Viral Load (VL) checked.”
