Dramatic new family and parenting focus on tackling HIV & AIDS in Zimbabwe
Zimbabwe may be the first country in Africa to officially change its Prevention of Mother to Child Transmission (PMTCT) programmes to a more inclusive Prevention of Parent to Child Transmission (PPTCT) approach.
The recommendation from the multi-sector National Conference on HIV & AIDS this September will align Zimbabwe’s country theme with the Global Plan for the Elimination of New HIV Infections Among Children and Keeping Their Mothers Alive that was launched at the United Nations High Level Meeting on AIDS held in New York in June this year. A key factor in the new global plan is strengthening more family centered approaches and stepping up male engagement in HIV & AIDS initiatives from its current low levels.
A stunned audience at the Zimbabwe conference opening applauded the most uncompromising statement yet from President Mugabe on the way that men can affect the fight to eliminate the disease from the country. “The role of men in our society is unquestionable. It is for this reason that men should take their place in HIV response, both for their own health as well as in support of women and children”, he stated.
He lambasted some of his senior government officials engaging in risky sexual behaviours. “I know of cases of men, who even though they are taking ARVs are running from one woman to the other. These are not men l know because of my extended family but because of my being Head of Government”.
The President asked the question, ‘What about the fathers too? Are they not important in the ability of our families to fight the disease? In my own extended family we are supporting widows and children in desperate circumstances after the deaths of their young husbands. We must keep our fathers alive.’
His remarks set the ensuing tone of the conference that saw unprecedented debate on changing the paradigm of low male involvement in the country.
For example, the conference heard from researchers that male circumcision is reducing male infection rates by up to 60% and subsequent onward transmission to mothers and babies but needs expansion across the country. The Ministry of Health and Child Welfare (MOHCW) intends to scale up male circumcision coverage among the youth from 10% to 80% in the next five years, planning to reach a population of 1,9 million young males of 13 to 29 years.
The feared ‘disinhibition’ factor in which circumcised men then drop condom use is in fact proving to be a very low phenomenon when reinforced by behavior change counseling and promotion of responsible and safe sex messaging specifically aimed at men.
The African Fathers Initiative had the biggest audience at any of the parallel sessions when it presented evidence from around the continent of how involving fathers works to improve lifelong outcomes for women and children. Äny society, whatever it’s other successes’ in which large numbers of adult males fail to nurture their children is a failing society’, said Trevor Davies from AFI, ‘but we know from the evidence base emerging that fathers’ involvement is one of the greatest, yet most underutilized, sources of support available to children in our world today‘.
He told the conference that fathers support for mothers is identified as a very real factor in pregnant women’s take up of ante natal services (ANC) and enrollment in prevention of mother to child transmission (PMTCT) programmes. Communication between couples was also identified as a significant factor in reducing stigma for young women who want to access family planning and other sexual and reproductive health services including those helping couples who may be positive but still want to have children and to do so with the lowest risks to the child.
‘The number of times the following words appear in the South African and Zimbabwean National PMTCT Guidelines: men, man, male, father, parent, fatherhood, dad – is ZERO! Can we not change this please! He finished to much applause.
Traditional chiefs came to the conference through Padare Enkhundleni and an audience of hundreds in the community village debated the role of the chiefs in combating HIV & AIDS. Chief Chiveso from Bindura was uncompromising in explaining the commitment of the chiefs to tackling gender based violence, encouraging men to go for circumcision and in encouraging fathers to stay involved with their children.
‘Culture is dynamic’, he said. ‘We are the guardians of culture and we will emphasise afresh that we must have a culture in our country that protects and cares for our women and children who are the future of our country.’ Chief Gambisi, of Gweru added, We are the social fathers of our society, this is the task we have to succeed at if we are to stay relevant to our communities and particularly our young people and our vulnerable children’.
Africaid, an NGO in Harare, erected a mock graveyard at the conference to symbolize the 10 872 children who died from HIV related illnesses in 2010 in Zimbabwe. The graveyard bearing hundreds of plaques with names of deceased children who died of AIDS was a stark reminder of how much needs to be done to prevent child deaths that are now completely avoidable with political commitment to eliminating pediatric aids completely.
Elizabeth Gwenzi, a Counselor with Africaid, said, ‘the graveyard serves as a graphic reminder of the reality of the disease. It is a call from HIV positive children to stop new HIV infections in children and to make PMTCT happen,” Gwenzi said.
Zimbabwe has over 650 000 adults and children living with HIV. Presently 360 000 people living with HIV are receiving lifelong ART treatment, which is about 60 per cent of those in need and still short of the universal access target. This gap is even wider for children as 80 000 of those living with HIV are in need of treatment and yet only 23 000 are receiving it.