KidzAlive@Home, South Africa
KidzAlive@Home, South Africa
The KidzAlive@Home project implemented by Zoë-Life Innovative Solutions has a main aim to improve casefinding, linkage to care and retention to treatment for children and adolescents living with HIV using a quality improvement approach within two targeted communities in eThekwini and uMgungundlovu districts in KwaZulu-Natal province in South Africa. The proposed strategy will be divided into three components
a) Ideal community strengthening- which will involve sensitization and lobbying of existing community structures to prioritise children in HIV case finding, treatment and adherence
b) KidzAlive training and mentorship- to introduce child-friendly approaches to community care workers and improve their confidence, competence and willingness to provide children with HIV services
c) Implementation of household level- active case finding, linkage to care, adherence and disclosure support, community advocacy, creation of community-based child friendly spaces among other strategies.
The project will adopt the model for improvement where change ideas introduced will be tested and measured using process, outcome and balancing measures. Change ideas that show the highest yield or success will be scaled up and their change package will be shared with interested parties. The University of KwaZulu-Natal will conduct cross-sectional and longitudinal studies to answer specific research questions around the effectiveness, quality and cost effectiveness of the strategies implemented. The research partner is also conducting an evaluation at the end of the project.
KwaZulu-Natal, eThekwini and uMgungundlovu districts
KidzAlive@Home specific objectives are:
A. 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 diagnosed as early as possible and linked to care and treatment and ongoing psychosocial support effectively and sustainably.
C. Improved quality of HIV services (child friendly care) and health outcomes (adherence, disclosure, viral suppression and mental health, nutrition) 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 and 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 Developed 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 (16,000) 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 virally suppressed.
In 2016, the UNAIDS reported that 320,000 children aged 0-14 years are living with HIV in South Africa. In the same year, 172,000 (55%) in this age group were enrolled into the ART programme. Sadly, in the same year, 9,300 children in this age group died from AIDS related deaths. 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 programme (PMTCT) which has seen, 95% of HIV infected pregnant mothers receiving ARVs for prevention of mother to child transmission in 2016 resulting in averting 69,000 new HIV infections in 2016. Despite the successes of the PMTCT programme, there is a high loss to follow-up among exposed 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 during postnatal care until such time that they present with advanced HIV symptoms in late childhood/ adolescent stages. In order to strengthen comprehensive HIV service provision, it is necessary to ensure that the primary healthcare model is fully functional where the health facility is complemented by an ideal community environment in fully functional community structures which ensure that HIV positive children are identified, linked to care, treated and retained into care for life. To achieve this, KidzAlive@Home implements child-focused approaches in which the child is at the centre of their care and his/her needs are taken care of within a circle of key players, including their caregiver, the child’s family, community structures and the health facility.