Background: Zimbabwe National Network of People living with HIV (ZNNP+) is implementing a project entitled Amplified Voices in Scaling up Short-course Preventive Therapy for TB in Zimbabwe. The main thrust of the project is to increase demand and uptake of TPT for PLHIV and children under the age of 5 years and to monitor the accessibility, availability, availability and acceptability of TPT services targeting urban areas of Harare and Midlands Provinces in Zimbabwe.
Methods: ZNNP+ and JHWO is working so closely with communities and utilizing their well established and functional community supporting structures and systems. Such structures include Community Health Advocates, Community Based Organizations (CBOs), peer educators, Differentiated Service Delivery (DSD) models, support groups of PLHIV, mentor mothers, expert patient model among others. Such structures embrace community involvement in advocating for the improvement of TPT uptake and other health related services. These community structures and systems also improve the linkage between the community and the health facility`
Results: Integration of TB/HIV services paved way for using some of community supporting systems like DSD models in improving uptake of TPT amongst PLHIV. After creating demand for TPT in different communities, PLHIV acknowledged that DSDs like Community ART Refill Groups (CARGs), Adherence groups and support groups which are used in HIV response, will improve TPT adherence monitoring amongst PLHIV and distribution of TPT medicines can be done using DSD models to those eligible for it. Directly-observed therapy (weekly doses) of 3HP can be done using DSDs. TB screening can be done at community level using some of the DSDs models like CARGs and Family ART Refill Group (CARG) and TB presumptive can be referred to health facility for further management at the earliest convenient time.
Conclusions: Meaningful involvement of Communities and working closely with their supporting systems will help in improving the uptake of health related services. TPT can be integrated in DSD models to enhance TPT adherence and completion rate to receipients of care intiated on the preventive therapy.