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CELEBRATING ROYAL APPROVAL FOR OUR LONG-TERM PARTNER CHIVA UK

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Dr Karyn Moshal is Chair and Founder of CHIVA Africa and a consultant in Paediatric Infectious Diseases at Great Ormond Street Hospital for Children.

We are delighted that CHIVA UK has been recognised for its great work by being chosen as a recipient of donations for the wedding of Prince Harry and Meghan Markle. It was a wonderful gesture by the Duke and Duchess of Sussex to help raise the profile of their important HIV work.

Our work in South Africa commenced as a CHIVA UK project in 2004 with CHIVA UK members volunteering to work alongside colleagues in South Africa to mentor and teach them as South Africa introduced ART and got to grips with the challenges of treating children living with HIV.

Over the years that followed, and our subsequent formation as a separate entity, our bond with CHIVA UK remained strong with 20+ teams of volunteers travelling to, and working in, South Africa over many years. This work has been recognised by the South African Department of Health

The Sub-Districts benefited tremendously from CHIVA South Africa team visits. It is evident that through targeted interventions, as identified by your team, there has been improvement in the management of our Paediatric HIV programme. The Health Professionals respond particularly well to the mentoring and coaching approach which your team employs. The fact that you provide this support on site is another benefit to the system, in that our health professionals are not removed as in the case of training, but are empowered in their personal practice, whilst rendering care to the community.”

Dr Kathy Randeree, North West Province Department of Health

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With these strong foundations, we have built an organisation in South Africa that has grown and continues to this day. Last year, our South African based teams helped to strengthen health services provided to children and adolescents in more than 40 communities. It is testament to our ethos and achievements with building skills in South African health workers that last year all programmes were delivered by South African staff only.

One of our staff team, Sizakele Ndlovu, shares her experience with CHIVA South Africa below:-

“Before I joined CHIVA South Africa I worked as a counsellor in the hospital that was specialising in HIV care. My area of expertise was with children with virological failure and resistance to ART and assisting caregivers to disclose HIV status to their children.

As a volunteer with the CHIVA S.A team I learned a lot from the UK and SA volunteers that I worked with.  The skills attained from my volunteering experience helped me a lot when I joined the staff team, especially to make a positive impact in the clinics.  I have increased my skills in areas such as giving presentations, clinical mentoring and promoting a multidisciplinary model of working.”

Sizakele Ndlovu, Paediatric Programme Coordinator, CHIVA South Africa

We are proud of the history we have with CHIVA UK and congratulate them on the Royal recognition their work has received.

IT’S TIME TO TALK ABOUT SEX

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Sonto Sikhosana is an AYFS Coordinator and joined CHIVA South Africa team six years ago. In her latest blog she tells us about her work and why she thinks it is important.

It is never easy to talk openly about sexual health. For young people in South Africa, fear of judgement and lack of confidentiality are huge barriers that shut down the conversation before it has begun. It’s a silence that can costs lives. This discussion is one that needs to happen if they are to have the information and skills they need to protect themselves from HIV, sexually transmitted infections and unplanned pregnancies.

We see the same situation in so many clinics. When young people – mostly girls – come for help, they have little choice but to take time, sometimes whole days, out of school. Their partners often don’t accompany them and many will wait hours to see a health worker. With communication challenges between healthcare workers and young people, it can be hard for young girls to ask questions and talk openly about safer sex, family planning, or the risks of HIV and STIs.

In South Africa, HIV is an epidemic of youth. That’s why the Department of Health has set a series of 10 ‘Adolescent and Youth Friendly Services’ (AYFS) standards to make sure that clinic services are meeting the needs of the country’s young population.Condom Demonstration

As supporting partners, CHIVA SA works directly with all staff in clinics in KwaZulu-Natal as they work towards achieving AYFS status. Delivered through monthly support visits and tailored one-to-one mentoring, we provide the guidance, resources and skills each team will need to achieve accreditation. Through analysis of feedback from young people using the clinics, we help make sure that the voices of their young clients are heard.  Promoting youth-focused initiatives – whether through the fast-tracking of school-aged attendees, offering ‘Happy Hour’ health education and consultation sessions, or school-based outreach – encourages young people to attend for services that now meet their needs and preferences.   One of our jobs is to break down communication barriers so that young people know they can discuss their concerns in a welcoming, confidential and non-judgemental environment.

It can take time. But having worked with CHIVA SA for six years and seen over 50 clinics ‘graduate’, I can tell you that our mentoring works. Together with our clinic partners we are starting a conversation that empowers young people to become involved in decisions that affect their health and say, ‘Yes. I need this. This is good for me’.

‘There’s such passion here, it’s contagious!’

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“We work with people, and I am proud to part of an organisation I know will make a difference to their lives.”

Sheena Lott joined our South Africa team in November as the new Deputy Country Director. In her first blog she tells us what she’s enjoying about being part of the team and how our work is making a difference.

It wasn’t until I worked with a local hospital that I saw what HIV really meant for South Africa. I had seen it from afar of course… young people were often withdrawn from our education programmes because of illness. But it was a shock to see the actual impact. Too many people were dying – especially children.

South Africa was country in denial, and I soon found myself involved in advocacy work. That’s where I met CHIVA South Africa. We delivered a number of projects together. I knew them, and I believed in their approach.

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I love being part of the CHIVA SA team, especially working to build the capacity of local clinic staff. It’s the right approach. I know that if we can build people’s skills, we can create change at community level, roll-out new projects, and work from the bottom, up. The challenge is making sure that everyone – clinic staff, communities – is on the same page. But there’s such passion here, it’s contagious!

I saw it in my first week, when our teams helped diagnose a young boy presenting with TB. If CHIVA SA hadn’t been there, he would never have known his HIV status. That’s when it hit me. There are so many cases that are being missed – and so many others at risk.

The government is taking South Africa’s youth-epidemic seriously, and we are not afraid to lead the way. CHIVA SA has great ambition for 2018, and I look forward to seeing the change – from beginning to end, and everything in-between. I am particularly excited to see our Adolescent and Youth Friendly Services (AYFS) grow, and I believe that by aligning ourselves with national priorities, this year will be CHIVA SA’s chance to shine: our work is all encompassing. If you have a youth-friendly clinic, you’re going to address prevention, you’re going to address treatment, and you’re going to address long-term care.

That’s why our work matters. We don’t just deal with numbers, statistics or caseloads. We work with people, and I am proud to part of an organisation I know will make a difference to their lives.

THE RIGHT TO HEALTH FOR ADOLESCENTS AND YOUNG PEOPLE

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Over the past 25 years the global development community has invested $105.34 billion in the health of the world’s poorest. Of this, 23% ($105 billion) has been spent on the prevention, management and treatment of HIV/AIDS. And not without results: with peaks in 2004 and 2006, the number of AIDS-related mortalities have halved and the total number of new infections has dropped by more than a third. No longer the death sentence it once was, today almost 50% of people living with HIV receive ART – a combination therapy so effective that life-expectancy rates can equal those living without HIV in the same communities.

But take a closer look at the statistics and you will notice a group that goes uncounted. Falling between the lines of child and adult case management, today 2.1 million (6%) of those living with HIV are young people aged between 15-19 years. Where all other age-groups have seen a decrease in mortality rates, for those in their teenage years, mortality rates are increasing. It’s a very real threat, with AIDS-related fatalities now the world’s second leading cause of death amongst adolescents. For the 83% that live in Africa, it’s the first.

IMG_20160720_083639For these young people, infection is most often a result of mother-to-child transmission. Many do not know their status, and they enter adolescence with little access to age-specific services or healthcare support.  This is something we are working hard to change.

With 15% of the world’s adolescent HIV cases occurring in South Africa, our teams are determined to address this by providing tailored mentoring and support in clinics across KwaZulu-Natal.  Our Nurse Clinicians and Youth Mentors are working with local partners to build a network of accredited Adolescent and Youth Friendly Services (AYFS) that cover a full spectrum of care. From education and prevention, to diagnosis and treatment – with 35 clinics accredited this year, we are working step-by-step to empower young people in South Africa to realise their right to health.

The fight to control HIV is far from over. And if the current trend toward reduced morality is to continue, then the time has come to focus on the needs of adolescents and youth. Theirs is a voice that needs to be heard.

Only then can we be sure that #Everybodycounts.

To support this work and strengthen health services for adolescents and young people please donate today by clicking https://secure.thebiggive.org.uk/project/28088. Every donation received before midday on December 5th will be doubled through the Big Give Christmas Challenge.

 

 

Combining Efforts to Strengthen Adolescent & Youth Friendly Services (AYFS)

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Juliet Houghton is Country Director for CHIVA South Africa. In her latest blog she writes about our partnership with UNFPA.

Adolescence is always going to be a difficult time. But for the young people of South Africa’s uThukela district, issues of poverty, rurality, and a lack of access to high-quality healthcare and education make these years even harder. Add HIV and gender inequality into the mix, and it is no surprise to see those aged between 15 and 24 carrying the largest burden of HIV.

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With so many issues, it can be hard to know where to start. But as I return from KwaZulu-Natal, where CHIVA South Africa is currently working with UNFPA to provide on-site mentoring and support to 20 clinics in the uThukela district, I can’t help but feel optimistic. Why? Because I know we’re not doing it alone.

Here, the programme’s greatest strengths are its partnerships – at every level. From the bottom-up, our team is taking care to work closely with local communities and the young people within them. Bringing together representatives from across sectors and services, we enable communities to address concerns and work together through challenges. It is our job to empower others, make sure that each voice is heard, and that programme clinics are supported to deliver services that meet the needs of adolescents and youth.

At the other end of the scale, I am proud to see our team working in close collaboration with the District Health Management Team. By working to shared values and objectives, together we are implementing improvements that are guided and sustained by strong leadership and engaged management.

Halfway through the project timeframe and already over half of the 20 clinics are on track to become accredited Adolescent & Youth Friendly services. There is still work to be done – but when the programme comes to an end this November, our shared momentum will continue to drive the development of AYFS across the region.

The young people of uThukela might face numerous challenges, but through our combined efforts, access to quality healthcare need not be one of them.

Breaking the trend. Pinetown clinic sets the pace for positive change.

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Across the world it is estimated that 10.3 million young people aged 15-24 are living with HIV. Today 50% of all new infections occur in young people specifically. Most don’t know their HIV status.

It’s a trend that the Adolescent and Youth Friendly Services (AYFS) Team at CHIVA South Africa are determined to break. Partnering with 35 health facilities in KwaZulu-Natal province, we are proud to see Pinetown clinic set the pace. With an interim assessment score of 98%, the clinic team are now delivering AYFS services well above the required 80%, within the first five months of our mentoring.

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CHIVA South Africa’s dedicated teams work closely with clinics like Pinetown to embed a culture of appropriate, accessible, and high-quality care and treatment, in order to improve the quality of comprehensive Sexual and Reproductive Health (SRH) services to young people. Ensuring that the focus is as much on education, prevention and support, as it is on diagnosis and treatment.

Living positively as an adolescent with HIV poses immense challenges. For some, this is the first time they have access to a service that has been designed with their needs in mind. ‘The love, care and support I got here is unbelievable’ one 16 year old client explains. ‘They never judged me… I accepted myself. I’m not HIV-positive, I’m living with HIV’. For the youth in KwaZulu-Natal, our work sends an important message: your lives matter.

It’s a message that makes all the difference. At CHIVA South Africa, we believe that building self-esteem alongside knowledge and skills is critical to the overall well-being of young people living with HIV in South Africa. That’s why we work to ensure that all adolescents can receive quality SRH services that not only educate, prevent and treat, but that also empower individuals to reach their potential.

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Our adolescent client sums it up perfectly: ‘I’m happy with the new me. I thought it (HIV) was going to break me, but it built me.’

All clinics are assessed against a series of 240 questions to meet 10 standards. It’s not easy, but with their sights set on a perfect 100%, Pinetown is a model of positive change for young people across the region.

Finalists in the third sector excellence awards!

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We are delighted to announce that our ‘Our Youth Our Future’ programme has been nominated as a finalist in the Big Impact Award category in the Third Sector Excellence Awards. The annual Third Sector Awards are prestigious awards run in the UK by Third Sector, the UK’s leading media outlet for the non-profit sector.

TSA_finalist17Since 2014, when we started the programme, we have supported the Department of Health in South Africa to strengthen health services for adolescents and young people across 23 health facilities, working with each facility for a whole year. In 2017 we are working with 43 facilities.

The award is particularly focused on our work in the past year. During this time our teams worked alongside approximately 450 healthcare professionals in 15 health facilities. These facilities had a catchment of more than 205,000 young people. Through targeted mentoring and teaching we supported teams to transform services available to all young people in their communities.

By measuring performance throughout the programme against 10 Department of Health standards and 244 indicators we could track progress and identify areas to improve. At baseline, the average score across all facilities was 51%. At the end, the average was 97%. Behind these scores are new, targeted activities which transform health services for adolescents.

We are very proud that our work has been recognised. To be finalists in these awards is a credit to our team in South Africa who carry out this work with total commitment every day. They are, together with the health workers we work alongside, excited and re-energised to work together to build a better future for adolescents and youth in South Africa. We would also like to extend our thanks to the Department of Health in KwaZulu-Natal, and all of our partners and funders who are important partners in enabling us to improve health outcomes for adolescents and youth in South Africa.

CATS in Zimbabwe

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Juliet Houghton is Country Director for CHIVA South Africa. In her latest blog she writes about her recent visit to learn more about the Zvandiri Programme in Zimbabwe.

This time last week I was in Zimbabwe, where I spent a few days with colleagues from NGO partners (MatCH, Zoe Life, Anova Health, HIV SA and Right to Care) visiting the Zvandiri programme for children and adolescents.

IMG-20170315-WA0000Zvandiri is a community based programme which provides prevention, treatment, care and support services read more

Our Youth, Our Future

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Manqoba Mthembu (AYFS Coordinator) and Nomfundo Gcina Mbatha (AYFS Peer Educator) from one of our new teams working on ‘Our Youth, Our Future’ programme. This is their latest update from Zululand where they are working throughout 2016.

“It is important to have as much information as you possibly can as a young person. It helps to hear about others’ experiences. It is very helpful to know that there is a supportive system like this within the clinic.” A.C. Zulu, Zululand

our youth our futureSince we started working with the staff in a health facility in Zululand they have been committed to reaching out to the young people in their community. Throughout our year-long Our Youth Our Future’ programme, our team works alongside healthcare staff, mentoring, teaching and supporting them to transform their clinic to meet Government Standards for Adolescent and Youth Friendly Services.

One step the team at the health facility has taken is to start a youth group – this not only creates an environment where young people can share their experiences, but also builds dialogue, cooperation and accountability between the clinic staff and the young people they serve.

“The youth group health care workers have assisted adolescents to overcome difficulties and help me make informed decisions.” N. Khumalo, Zululand

Supporting health workers to reach out to young people is crucial in getting young people to come to clinic and take control of decisions in their life. By building the skills of healthcare professionals on-site, in their community, enabling them to make the changes required, ensures this is sustainable and is why our approach works.

“I changed my perception about life in general, the youth is a team. My peer educator (in the clinic) shared the views that within a team everybody can have a goal to strive for. The programme of forming the youth group helps us to have more knowledge and take decisive steps towards our lives, health and future.” M. Khumalo, Zululand.

This is a key part of our programme which will help to build sustainability and successful health outcomes long after our programme.

 

Transforming health facilities with The Mercury Phoenix Trust

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“Six months in and some clinics have already made amazing progress. It shows what can happen when staff learn new skills, are empowered and can see the impact straight away.” Juliet Houghton, Country Director, CHIVA South Africa.

MPT logo FMAt the beginning of this year, two of our Adolescent and Youth Friendly Services (AYFS) teams started working with ten facilities in eThekwini District, KwaZulu-Natal, to deliver our year-long ‘Our Youth Our Future’ programme. They are working alongside healthcare staff in these clinics; mentoring, teaching and supporting them to transform their clinic to meet ten Government Standards for AYFS.

The programme has been part funded by received funding from The Mercury Phoenix Trust, which was founded by Brian May, Roger Taylor and their manager Jim Beach in memory of rock band Queen’s iconic lead singer Freddie Mercury who died in 1991 from AIDS.

The teams have just finished the six-month assessments of each clinic – our method of monitoring progress against each of the ten standards using 240 set questions/criteria. We carry out the same process before and after the programme, with the Department of Health also assessing the clinics.

Six months in and there are already some great improvements in the clinic. In fact, Danganya Clinic has already met all ten of the Government Standards – in January none of these were met. They are rightly proud of their achievements and we are delighted to have assisted them.

So what does that actually mean? Building skills and knowledge in clinic teams to provide quality health services to adolescents and youth improves health outcomes and increases opportunities for prevention of illness

“I would like to thank CHIVA SA for helping us understand AYFS better. They have provided us with so much information for me as a youth champion to be able to give to staff. CHIVA SA also assisted us with the materials and forms and guidance on the programme. Thank you so much.”
– Sister L.E. Ntonbela, AYFS Champion
Molweni Clinic

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