Even before the COVID-19 pandemic, adolescents in Africa faced the greatest burden of health challenges in the world, including HIV, gender-based violence, and maternal death from teenage pregnancy. Now they face additional threats to their wellbeing: the knock-on effects of COVID-19 and the necessary lockdowns have been severe throughout southern Africa, and there are already regions where health clinics and services are harder to access, rates of rape and other forms of gender-based violence are up, teen pregnancies have increased, and girls’ access to education has dropped.
Whenever access to critical health services has been threatened, we’ve seen our teams mobilize time and time again on behalf of adolescents. Grassroot Soccer (GRS) recognizes the impact of partnerships, and there’s never been a more powerful moment to call upon the power of collective action at a community level. This International Women’s Day, Grassroot Soccer celebrates changemakers like Margaret Phiri and Tandose Banda who Choose to Challenge systemic barriers that can prevent youth from living their healthiest lives.
With support from Bohemian, GRS Zambia and Chisomo Community Programme (CCP) worked in concert with Neighbourhood Health Committees (NHCs) to champion the creation of community-based adherence clubs for adolescents and living with HIV (ALHIV).
Margret Phiri, 55, lives in Katete district of Eastern Province. As an
NHC chairperson, Margaret saw a community-based need for greater support for ALHIV. Heeding the call, Margaret supported NHC in a partnership with CCP to create an enabling environment for ALHIV across the nine sections (villages) she oversees. “Through my attachment to the clinic as a trained adherence promoter and NHC chairperson, I was invited to attend a meeting in the health facility which was organised by GRS through Chisomo to orient NHC Chairpersons on SKILLZ Plus. [We] supported them to come up with community-based support clubs in our NHCs.”
Following this meeting, Margret Phiri engaged nine section chairpersons who helped to support the formation of a community-based club for ALHIV. “I visited each section chairman in my zone, and I shared the idea of a community support group,” Margaret says. “They later helped me to mobilize participants who also helped to bring their fellow friends along.” The idea caught on. “Because of this meeting, Tandose Banda–a former SKILLZ Plus participant–was able to start up the club at her house. Following her dedication and her previous participation in the SKILLZ Plus program and the very fact she comes from my community, I supported her to also bring more of her friends to the club. There are now 12 ALHIV who meet from her home.”
Tandose Banda, a Lead Mentor running the community club at her home, explains the role Margaret played in creating a club for ALHIV in her NHC. ‘’Amai Nkhoma [as she is often called by the community members] helped us to start up the club after our SKILLZ Plus interventions came to an end.” Maraget’s support didn’t stop there. “She helped me follow up on [others] that were living with HIV that I did not know from my community.” Young people living with HIV are at particular risk for feeling isolated in their experience, and Tandose saw the ways in which the meetings provided safe spaces. “On my own, I saw that starting the community club helped make ALHIV feel free to share their feelings and discuss issues that affected them like on adherence and reminding each other to taking medication. Some of my friends were shy to come to the Youth Friendly Corner meetings at the clinic, because we have both young people living with HIV and those not living HIV mixing.”
Margret Phiri, believes that role of the NHCs in responding to issues of non-adherence and community support for ALHIV is now strengthened through community-based clubs. “We are the drivers and links between the community and health facility because we oversee all health-related issues including those affecting ALHIV. Community clubs have helped to build relationships for ALHIV since it enables them to communicate freely with others being able to open up on issues around non-adherence.”
She feels strongly that once well managed, community-based adherence clubs have the potential to act as access points for HIV treatment and adherence services. She sees particular opportunity for community members to act as both advocates and community health workers, partnering with local health facility staff. “Group members can identify one trusted leader who can help to link them to health services, especially for those that are unable to get their medication.” The goal? Increased access and safer spaces for adolescents living with HIV.