A day in the life of treatment support workers and treatment mobilisers
The Zambian government’s national implementation plan for scaling up anti-retroviral (ARV) treatment states “communities can make major contributions to anti-retroviral treatment programmes”. One of the key principles of the government’s plan to effectively scale up anti-retroviral treatment is to promote partnerships between government, private sector, civil society and communities. Here Mauld Malia Inaka, Miriam Banda, Ruth Siabwacha, Harry Sakanya, Paul Yengwe and Eric Nachibanga – treatment mobilisers and treatment support workers – share their thoughts on their role and its impact.
A daily diary
The treatment mobilisers and treatment support workers keep a daily diary, recording what they do during a normal working day. The following extracts highlight how their work benefits the community, the health system and themselves:
- Mauld Maila Inaka’s account shows how community members and health care workers can work alongside each other in a supportive, productive manner.
- The peer support Miriam Banda receives from her colleague helps her deal with the emotional impact of her role as a treatment support worker.
- Paul Yengwe sees his role as important because he offers confidential, non-judgemental support to people who may experience stigma and discrimination elsewhere.
- Harry Sakanya’s account highlights the wide range of issues and questions people bring to the ARV clinic and the sort of in-depth knowledge required of the treatment support workers.
- Eric Mweemba Nachibanga relishes the opportunity to challenge the stigma people encounter from family members, transforming discrimination into acceptance.
- Ruth Siabwacha’s account reveals the many responsibilities she has as a treatment mobiliser. The large numbers of people accessing ARV treatment since the beginning of the project clearly indicate the urgent need for access to treatment in the community and impact of her role.
The extracts highlight how treatment support workers and treatment mobilisers raise awareness and increase treatment literacy within communities, which helps to reduce stigma and discrimination around HIV and ARV treatment. They provide necessary support in starting and remaining on treatment, lifetime adherence to treatment, positive living, prevention, psychological support and meeting economic and social needs. And they contribute to a functional referral system between the ARV clinic, other health facilities and community groups providing care, support and prevention services.
They are powerful advocates for living positively with HIV and the right to access ARV treatment.
The ACER project
The ACER project in Zambia is providing an important example of an effective community-driven and -led ARV treatment programme. The overall aim of the ACER project is to improve health-seeking behaviour, prevention, equity of access and adherence to anti-retroviral treatment for people living with HIV. It does this through community education and referral, with the participation of people living with HIV and other community stakeholders. A further aim of the project is to build and strengthen treatment and prevention-friendly communities.
The ACER project currently employs four treatment support workers and two treatment mobilisers. All have been living openly with HIV for a number of years. The treatment support workers support people visiting the clinics by listening and offering advice on issues related to ARV treatment. They have strong relationships with community organisations and health services, to which they refer clients for further care, support and prevention. The treatment mobilisers’ work involves raising awareness of HIV/AIDS and ARV treatment, increasing treatment literacy and linking communities with the treatment support workers in the ARV clinics. They co-ordinate community education and referral activities, reaching over 80,000 people with intensive, ongoing activities.
Conclusions of 'A day in the life of treatment support workers and treatment mobilisers.'
