The KidzAlive@Home project in South Africa puts the child at the centre of care. Its needs are taken care of within a circle of key players, including their caregiver, the child’s family, community structures and the health facility. With this approach the project aims to improve the finding of children and adolescents living with HIV and to link them to sustainable HIV treatment and care.
Targeting eThekwini and uMgungundlovu districts in KwaZulu-Natal, South Africa, its strategy will be threefold:
a) Community strengthening: Sensitisation of existing community structures to prioritise children in HIV case finding, treatment and adherence;
b) Training and mentorship to community health workers: To introduce child-friendly approaches and improve confidence, competence and willingness to provide children with HIV services;
c) Engagement at household level by community-based organisations: Active linkage to care of children living with HIV, support in adherence and disclosure, community advocacy, and creation of community-based child friendly spaces in communities.
KidzAlive@Home is implemented by Zoë-Life Innovative Solutions. The University of KwaZulu-Natal will conduct research around effectiveness, quality and cost effectiveness of the strategies implemented as well as an evaluation at the end of the project.
KwaZulu-Natal, eThekwini and uMgungundlovu districts
KidzAlive@Home specific objectives are:
- A community environment that is optimised for enabling comprehensive service provision related to HIV, TB, malnutrition, child abuse and other health related issues pertaining to children, adolescents, and their caregivers in two targeted communities in eThekwini and uMgungundlovu districts in KwaZulu-Natal province
B: Children and adolescents living with HIV are diagnosed as early as possible and linked to care, treatment and ongoing psychosocial support effectively and sustainably.
C. Improved quality of child-friendly HIV services and health outcomes of HIV-infected and affected children and adolescents
D. Share evidence of effective and tested community intervention models
To reach these objectives KidzAlive@Home will train 120 community health workers on the KidzAlive Family Support Intervention. The KidzAlive Foundations of HTS, Disclosure and Adherence with Children, create 15 child friendly spaces, start 32 KidzClubs and 32 Primary Caregiver Adherence Support Groups in the community, and develop Quality Improvement Plans together with community leaders and supporting structures.
We aim to reach over 16,000 primary caregivers with KidzAlive activities. We anticipate the same number of children to be tested for HIV, of which 742 will be tested HIV positive. These families will be supported with KidzAlive interventions to ensure they remain in care, and are virally suppressed.
320,000 children aged 0-14 years are living with HIV in South Africa, only 55% were enrolled into ART and 9,300 children died from AIDS related deaths (UNAIDS, 2016). The majority of HIV infections are due to mother to child transmission and the South African government has invested in the prevention of mother to child transmission (PMTCT) programme. In 2016, 95% of pregnant women living with HIV receive ARVs resulting in averting 69,000 new HIV infections in newborns in 2016. Despite the successes of the PMTCT programme, there is a high loss to follow-up among children after 12 months. Finding these missed HIV exposed children is still a huge challenge as health facility-based HIV testing and counselling programmes seldom prioritise children post PMTCT age. As a result, these HIV exposed children are continually missed by the system until such time that they present with advanced HIV symptoms in late childhood or adolescent stages.