PSI: News

New Start Takes VCT to the People

HARARE, Zimbabwe —2002 was a banner year for PSI/Zimbabwe's New Start voluntary counseling and testing (VCT) program, as almost 4,000 of the record 60,686 clients met last year were seen through a mobile outreach service.

The mobile VCT outreach traveled to roughly 20 rural and peri-urban locations, delivering services to people living outside the reach of stationary New Start centers. New Start is funded by the U.S. Agency for International Development.

The objectives of the mobile outreach services were:
a)	To take VCT services to peri-urban and rural communities for easier, broader access;
b)	To meet demand from locally identified areas where partner organizations have been approached by local population for such services;
c)	to probe demand feasibility for a potential static site.

In addition to the mobile outreach, three new sites were opened last year, bringing the total to 14 and existing sites were consolidated and strengthened. A number of innovative promotions were held and a pilot program integrating family planning and sexually-transmitted infection services at two free-standing sites was initiated.

A PSI New Start center typically provides the following:
•	Manpower to execute the VCT outreach
•	Materials and some assistance for community mobilization
•	Test kits and all other consumables
•	Transport
•	Refreshments for clients

The collaborating partner organization typically provides the following:
•	Space
•	Community mobilization
•	Refreshments for staff
•	Linkages with post-test services

Once a partner expresses interest and demonstrates commitment and sufficient community demand for VCT is established, a meeting is held to discuss logistics and partner input. The New Start center team will typically visit the proposed site to physically assess the site for suitability and to make suggestions on preparation needs. Dates are then set and community mobilization commences a week before the outreach dates. Community mobilization involves spreading the message by word of mouth using community agents, poster display, distribution of fliers and radio programs. At the end of the exercise a report is written and feedback given to collaborating organizations.

Lessons learned to date
•	There is need to screen the partner and potential demand carefully.
•	The service should be offered free wherever possible, since these populations tend to be very poor.
•	Active involvement of New Start staff during the community mobilization stage greatly improves chances for successful implementation.
•	In rural areas, there is a need to control or allocate client flow, either by village or kraal heads, so as to avoid overcrowding services resulting in long waiting times, turning away of clients, and counselor burnout.
•	There is need to investigate and establish that clients coming for the services are doing so voluntarily and not being coerced at any point. This risk tends to be higher, the smaller the community.
•	There is a need to assess the availability of post-test services in advance, and have a referral catalogue of these on hand during the outreach.

When compared with clients seen at static VCT sites, mobile outreach tends to attract more female clients, more clients above the age of 30, and significantly more HIV positive clients (30%-40% vs. 19% in static sites).

Because, outreach holds tremendous potential for broadening access and reaching high impact populations, PSI/Zimbabwe is beefing up its capacity to implement outreach at its free-standing sites, and training managers at integrated sites in this service provision modality. Our goal in 2003 is to see well over 6,000 clients via mobile outreach.

—Chuck Szymanski, Deputy Country Director, PSI/Zimbabwe

For more information:

• Visit the PSI/Zimbabwe page

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The success and value of PSI's New Start centers to Zimbabwean society is reflected in this postal stamp issued by the Posts and Telegraphs Department independent of any PSI activity or advocacy.