Elimination of Paediatric AIDS in Zimbabwe (EPAZ)

Eliminating of Paediatric AIDS in Zimbabwe which was a four year study which started in 2012 ended in 2016. It was being funded by the World Health Organization. The research was an assessment of the feasibility and acceptability of an integrated model of PMTCT care by providing critical information on the uptake and effectiveness of comprehensive services to prevent the spread of HIV from mothers to their exposed infants with early initiation of ART in HIV-infected infants. The goal of this research was anchored at Eliminating Paediatric AIDS in Zimbabwe (EPAZ) specifically to test whether Mother Support Groups based at health facilities have the potential to increase retention of HIV- exposed infants in PMTCT programs. The assessment was targeting hard to reach areas in two districts of Manicaland Province namely Makoni and Mutare. Thirty clinics were randomly selected into the study, 15 from each district. There were 15 control clinics and 15 intervention clinics. The 15 interventions clinics were randomly selected as follows; 9 in Makoni and 6 in Mutare while the fifteen control clinics were as follows; 9 in Mutare and 6 in Makoni. The results of the study showed that;

1. Differentiated care: Providing Mother Support Groups (MSGs) is not enough. Targeting high risk mothers (such as newly diagnosed, primipara, young single, late booking etc) and educated mothers to join MSGs to improve retention and reduce loss to follow up is also needed.

2. Retention and loss to follow up definitions: MOHCC point/period retention and loss to follow-up definitions needed to enable monitoring of retention rates at facilities by health managers and assist local health care workers to identify loss to follow up mothers so they can implement tracing mechanisms.

3. Supporting Community Art Refill Groups (CARGs): MSGs have potential to support Community ART Refill Groups.

4. Supporting HIV Exposed Uninfected infants (HEU): MSGs have potential to reduce excess morbidity and mortality of HIV exposed uninfected (HEU) infants.

5. Disclosure: Status needs to be recorded in health records to assist disclosure leading to increased male involvement in PMTCT programs.

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