NAC champions community-led HIV response in Bulawayo

The National Aids Council (NAC) is increasingly turning to communities as critical partners in the national response in an effort to sustain gains made in the fight against HIV and Aids.

In Bulawayo Metropolitan province, NAC has been exploring social contracting arrangements in its six districts, a move aimed at strengthening community-led HIV interventions and ensuring long-term sustainability.

Social contracting is an innovative financing and service delivery model that allows community-based organisations and civil society groups to provide HIV-related services through formal partnerships and funding arrangements.

The approach has gained prominence globally as countries seek to reduce dependence on donor funding while maintaining access to essential HIV prevention, treatment, care and support services.

For NAC, the model presents an opportunity to harness the strengths of local communities, which are often best placed to understand and respond to the unique challenges faced by people living with HIV and populations at risk.

The latest HIV estimates presented by NAC indicate that approximately 3,713 young people aged between 15 and 24 are currently living with HIV in Bulawayo.

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The burden remains disproportionately concentrated among adolescent girls and young women.

According to the data, girls aged between 15 and 19 years have HIV incidence rates 6.5 times higher than boys of the same age, while young women aged between 20 and 24 face infection rates 2.5 times higher than their male counterparts.

The figures have placed adolescent girls and young women among the highest priority groups for HIV prevention interventions in the province.

NAC’s district Aids coordinator for Magwegwe, Kenneth Ncube, said social contracting was helping bridge the gap between national HIV programming and community realities.

“The model allows us to leverage the strengths of community-based organisations that have direct access to the people we seek to serve,” he said.

“Communities understand their own challenges and are often best positioned to deliver tailored HIV prevention, treatment support, and awareness programmes.

“Through these intervention programmes, we are strengthening community ownership of the HIV response while ensuring accountability and quality service delivery.”

In high-density suburbs, community-based organisations have been engaged in HIV awareness campaigns, treatment adherence support and prevention programmes targeting young people and vulnerable groups.

Through social contracting arrangements, these organisations are increasingly becoming strategic partners in complementing NAC-led interventions.

NAC provincial manager for Bulawayo Sinatra Nyathi said NAC was strengthening prevention programmes and leveraging local resources to sustain the country’s HIV response.

She said the focus has shifted to high-impact, low-cost interventions, particularly prevention initiatives aimed at reducing new HIV infections and positive behavioural change.

“NAC is committed to sustainable HIV financing and community-led solutions,” Nyathi said.

“Our experiences demonstrate that when communities are empowered and adequately supported, they become effective partners in achieving epidemic control.

“Four decades into the epidemic, people have the information. What we now need is behaviour change,” she said.

Community leaders said the model has strengthened local participation and ownership of health programmes.

“For years, community volunteers have been at the forefront of disease awareness and support services,” said Ward 6 Bulawayo United Residents Association chairperson Modern Sibanda.

“Community involvement ensures that interventions are informed by our realities and that no one is left behind.”

Sibanda was speaking at a mobile healthcare clinic run by Zimbos Abantu Healthcare on Wheels in Cowdray Park.

The initiative is bringing medical services into communities, offering primary healthcare, child health service, HIV testing, non-communicable disease screening and health education.

Community structures have been at the forefront of the initiative over the last nine months, said Bathabile Mudzindiko, a programmes coordinator with Zimbos Abantu Healthcare on Wheels.

“Our programme is driven by community leaders and mobilisers who have been doing very well to mobilise the community,” she said.

“I would say we have been able to attend to close to 5 000 people over the last nine months and most of the patients that have been attended to suffer from non-communicable diseases.

“Young people also come to these clinics and they have been helped through our health education programmes.”

The story is similar in Pumula, one of Bulawayo’s oldest suburbs, where a local organisation, DotYouth and community volunteers have been supporting HIV education programmes, including the Brotha2Brotha model.

The Brotha2Brotha initiative is a peer-led mentorship and behavioral intervention aimed at reducing HIV infections and substance abuse among adolescent boys and young men (typically ages 10 to 24).

It utilises an “edutainment” approach, often pairing health education with sports or life skills, to mentor youths into responsible men.

DotYouth executive director Vezimpilo Ncube said the programme is community-led, fostering interventions that echo the lived certainties of youths.

“Brotha2Brotha seeks to empower adolescent boys and young men with knowledge on sexual and reproductive health rights, life skills and the capacity to navigate everyday challenges,” she said.

“We are intentionally working from within communities because that is where the real challenges and solutions exist.”

Vezimpilo said the programme has brought together community groups, healthcare workers, local authorities, and residents around a common goal.

Zimbabwe’s HIV response has long been recognised as one of Africa’s success stories, with significant reductions in new infections and Aids-related deaths over the years.