The Zvandiri programme in Zimbabwe provides HIV and mental health care in low resource settings. The programme trains HIV positive young people between the ages of 18 and 24 as peer supporters, called CATS (Community Adolescent Treatment Supporters), who provide information, counselling, monitoring and support for children, adolescents and young people living with HIV through home visits, clinic visits, support groups and mHealth. There are 1,400 trained mentors in 51 districts of Zimbabwe who give support to 82,000 beneficiaries.
The success of a peer-led intervention however depends largely on the well-being of the peer supporters themselves. Therefore, as the peer supporters could also experience poor mental health outcomes, it is important to build strong support mechanisms for them.
The SHM Foundation has responded to a challenge by Positive Action Challenges (PAC) and Africaid, developing an innovative solution that will help support CATS with the issues that they are faced with. The innovation was to be one that complements the Africaid Zvandiri model.
We believe that people are the experts of their own lives, and therefore, in order to create a support system that worked for the CATS workers, they would have to be involved in the building of the system at every level. This collaborative approach was ensured through a participatory workshop run by the SHM foundation team and some of the young mentors from the SHM’s Khuluma project alongside some of the CATS workers.
Through these workshops, we decided to pilot a two-pronged intervention. First, a Zvandiri Lounge – a peer-to-peer anonymous support platform. Here 60 CATS are put into 6 groups of 10 peers to discuss the issues that they may be facing in their lives and at work. 6 CATS were given specific training to act as ‘mentors’ in these groups. Topics discussed within the groups were suggested by the peer supporters during the workshops. The groups are facilitated by SHM staff, SHM peer mentors in South Africa and trained Zvandiri peer supporters.
Second, a Zvandiri Tool Box – a set of resources for CATS will be designed based on the topics and challenges they raise in the Zvandiri Lounge. These may specifically focus on supporting the transition beyond the age of 24, covering topics of disclosure, grief and economic sustainability.
A platform of social support was created called the Zvandiri lounge using Rocket.chat app. The CATS used the platform to access peer support and professional support informally; anywhere and at any time. The CATS felt comfortable to reach out and use the platform because of its anonymous nature which allowed them to feel safe sharing some of the most intimate problems they were facing.
Our pre and post intervention questionnaire revealed that:
98% of the CATS reported that sometimes they had difficulty taking their medication, both before and after the groups. Some of the reasons they gave included peer pressure, disclosure, complications due to faith healing, side effects and difficulty swallowing, stigma and discrimination.
Only 7 of the CATS had disclosed to their partner before the intervention, but afterwards 24 reported that they had.
83% of the CATS reported that they had a friend whom they could look to for support before the intervention, after the intervention this number had jumped to 91%.
The CATS reported a high incidence of internalised stigma before the intervention, which notably decreased after the intervention across all three measured scores. Before the intervention, 22% of the CATS indicated that they had lost respect or standing in their community because of their status (agree or strongly agree), compared to 15% after the intervention. Significantly, 48% indicated that they thought less of themselves because of their status before the intervention, compared to only 9% after the intervention.
Interested to hear more? Read the full report here.