Zambia – South Africa HPTN 071/PopART Study Community HIV Care Providers conduct joint field visits:
HPTN 071/PopART study Community HIV Care Providers (CHiPs) got a chance to work side-by-side in delivering the study intervention package in Kanyama and Chipata PopART sites during the recently held HPTN 071 annual workshop held in Lusaka. Other workshop delegates also braved heavy rains to visit some PopART sites in Zambia.
The field teams comprised from the Zambart and Desmond Tutu TB center (DTTC) comprised CHiP teams, District Administrators, CHiP supervisors, community mobilisers, social science research assistants, population cohort research assistants, district intervention coordinators, and Human Resources manager from DTTC also accompanied the teams.
The teams were twinned according to their respective work in the field. This allowed the Zambian team to share experiences and lessons, and also interact with their South African counterparts on the work they do. It also gave the South African team a direct glimpse of the Zambian field situation.
The teams drew more similarities in the PopART study implementation in both countries than differences, but noted some differences in the roles. In Zambia for example, the DICs have mixed professional backgrounds, while in South Africa DICs are nurses. It was also observed that under population cohort, quality control is done on site by the PC nurse in Zambia, while in South Africa, QC is done by the PC research assistant and where the PC nurses and research assistant’s daily targets are half of those for their Zambian counterparts. However, the number of clients an intervention team is expected to recruit per day was less for Zambia 8-9, than their South African colleagues recruit at 11 clients per day.
However, notable differences included a violent work environment for South Africa, particularly for their research assistants who because of violence have to move in a vehicle, than Zambia. In addition, it was learned that social science research assistants in in South Africa do not attend community meetings unlike their Zambian counterparts.
The South African field teams reported that houses in South African study communities were very close together than in Zambia, making it easier for the intervention and PC to reach more people in a smaller catchment area. However, PopART zones in Zambia are much larger than those in South Africa and the large distances enabled the Zambian CHiPs to be more thorough and spend more time with clients.
Zambart communications caught a group of the South African field staff upon their return from the site and they had this to say:
“It was a great experience, they do exactly the same consent forms as us. What is interesting is that the PopART staff here escort a sick client to the clinic, in South Africa we don’t, we refer them to other community health workers,” said Babalwa Solinjani, a South African CHiP among those paired with their Zambian colleagues at Chipata site.
Phindiswa Malangeni, another Arm “A” CHiP noted the different ethical considerations. “In South Africa, we write a referral letter and indicate the client’s HIV status, in Zambia they give the client a referral slip to take to the clinic.”
Another CHiP Siziwe Makonza, noted that the relation between Zambart PopART and staff at the government clinic is good. “But the stigma experiences and most of the problems our Zambian counterparts face in the field, we are also encountering the same challenges,” she said.
Chipata PopART site District Intervention Coordination Rosemary Zulu described the CHiPs twinning was a good initiative that should be encouraged as it helped field staff to interact with their counterparts. “This interaction made it possible for the field staff to share lessons learned from their respective countries,” she said.