Population Services International

Zimbabwe was once considered the crown jewel of Africa, with rich mineral exports and productive farming. However, participation in the Congo war, rampant inflation and a lack of foreign investment has left the landlocked Southern African country economically ravaged. 1 Today, Zimbabwe’s health care system is in a state of collapse, unable to provide basic health services or protect its people from ongoing epidemics and sporadic outbreaks of infectious disease.

PSI/Zimbabwe (PSI/Z) began in 1996 in partnership with the Ministry of Health and Child Welfare (MOHCW) to prevent HIV and AIDS, control malaria and improve family planning practices. Its 280 employees promote and provide testing and counseling services and distribute Protector Plus male condoms, Care female condoms, long-lasting insecticide treated nets (LLINs) and multiple contraceptive products.

PSI/Z has expanded its programs several times, including:

  • 1999 – Affordable testing and counseling (T&C) services through a nationwide network of New Start sites.
  • 2003 – New Life post-test support services (PTSS) for people living with HIV (PLHIV).
  • 2008 – Hygiene promotion and home-based water treatment services in response to the cholera epidemic.
  • 2009 – Male circumcision services for HIV prevention.
  • 2009 – Dual protection promoting the use of condoms and another modern FP method
  1. 1. Source: “How the Loss of Property Rights Caused Zimbabwe's Collapse,” Cato Institute, November 2005.
Health Areas

Child Survival, Diarrheal Disease, HIV, Malaria, Reproductive Health

Health Impact

PSI/Zimbabwe estimates that in 2010, its products and services helped avert:

  • 299,920 HIV & TB DALYs1
  • 80,703 Reproductive Health DALYs
  • 332,174 Malaria Control DALYs
  • 11,419 Child Survival DALYs
    1. 1. Source: The DALY (Disability-Adjusted Life Year) is a widely-used, credible metric that was first developed by the World Bank and is now routinely relied upon in the public health community.
Health Interventions
Improving Health in Zimbabwe

Malaria

Since 2004, PSI/Z has partnered with MOHCW and received support from UNICEF and The Global Fund Round to distribute more than 450,000 LLINs to pregnant mothers, children under the age of 5 and PLHIV in high malaria districts. In 2009, PSI/Z is distributing 595,500 LLINs through district hospitals, rural health centers, antenatal clinics and other targeted sites. Peer education helps to promote correct and consistent net use.

Reproductive Health

The Royal Netherlands Embassy helps fund PSI/Z’s training for nurse counselors to integrate family planning (FP) with T&C and PTSS. PSI/Z currently works with the MOHCW and other local partners to expand the referral network for T&C and PTSS clients needing FP services. PSI/Z also distributes long-term (Jadelle and Petogen) and emergency contraceptives (Postinor2) through public- and private-sector providers. A new integrated communication strategy promotes dual protection – both condoms and another modern FP method – among women ages 15 to 29, HIV-positive women, and HIV-positive/discordant couples.

Diarrheal Diseases

With DFID support, PSI procured 2 million oral rehydration (ORS) sachets for public health facilities and cholera treatment centers across the country. ORS is part of a nationwide effort to reduce morbidity and mortality due to diarrheal diseases.

Safe Water/Child Surviva

In response to the cholera epidemic in Zimbabwe, PSI launched and distributed more than 20 million household water treatment tablets in 2008. It also developed mass media and interpersonal communications to promote hygienic practices and home-based water treatment. In 2009, PSI distributed 20 million water treatment tablets and more than 1 million PUR sachets with support from UNICEF, USAID, DFID, P&G, AmeriCares and The Coca Cola Africa Foundation (TCCAF). Also in 2009, PSI introduced WaterGuard water treatment solution with USAID support.

HIV

PSI/Zimbabwe takes several approaches toward helping empower Zimbabwean people to help curb the spread of HIV:

  • Testing & Counseling Services: Every month, more than 30,000 Zimbabweans are tested and counseled through a network of 19 static HIV testing and counseling centers and 23 mobile outreach teams. About 17% of New Start T&C clients are tested as couples, and 59% of all T&C clients are reached through mobile services. PSI/Z also goes door to door T&C services, which have been proven to be very effective in reaching people in very remote, rural areas.
  • Post Test Support Services: PSI/Z’s New Life program provides post-test support services to PLHIV at 15 static sites and 15 outreach teams. Additional services include: psychosocial counseling, support options to clients living with HIV/AIDS, and antiretroviral therapy (ART) adherence counseling. Nationwide, 50% of all New Life services are delivered via outreach teams that visit hospitals and clinics to help prevent mother-to-child transmission (PMTCT), and provide HIV treatment, including ART.
  • Male Circumcision: PSI/Z is collaborating with the MOHCW and other local partners to introduce Male Circumcision (MC) as an HIV prevention intervention in Zimbabwe. Results from four MC pilot sites and one national MC training centre will guide the scale up of future MC services and communications.
  • Condom Social Marketing: More than 4 million Protector Plus male condoms are sold every month through a network of over 12,500 retail outlets nationwide. PSI/Z uses annual population-based surveys and GIS mapping to identify areas of high-risk activities and those that are underserved. Branded mass media campaigns and interactive community-level events promote Protector Plus and encourage correct and consistent use of condoms. Each year, PSI/Z’s interpersonal communication activities with local partners reach more than 1 million people.
  • Peer education: Since 2001, PSI has trained female hair stylists from more than 1,500 salons in low-income areas to promote correct and consistent use of the care female condoms. In 2008, PSI distributed more than 3 million condoms through hair salons, support groups for PLHIV and tertiary colleges where young women may be involved in cross-generation sex.

Health Communications

PSI/Z also develops integrated campaigns to address HIV-related stigma/discrimination, concurrent sexual partnerships, TB and HIV co-infection, prevention of mother-to-child transmission (PMTCT), ART and Provider Initiated Testing & Counseling (PITC). PSI/Z works with local advertising agencies and community-based organizations to develop and implement mass media campaigns that are culturally appropriate and relevant to the target populations.

Target Populations

Sexually active men and women, high risk populations like migrant labor, truck drivers and commercial sex workers.

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