Community case workers: The heart of Pact's support for children vulnerable to HIV

January 25, 2023
Timotheo. Credit: Aidan Tarimo/Pact

Although they were surviving, life was extremely difficult for Kinyamagoha and his grandmother. At 15, Kinyamagoha is HIV-positive. His grandmother can no longer walk and crawls to move around. They had little money to live on in their town in Southern Highlands, Tanzania. All they really had was each other.

That is, until they met Timotheo. Timotheo is a community case worker with the Pact-led ACHIEVE project. Funded by USAID, ACHIEVE is a five-year global project working to reach and sustain HIV epidemic control among pregnant and breastfeeding women, adolescents, infants and children. A key component of the project – and Pact's work to improve the lives of orphans and vulnerable children around the world – is home visits and case management for households in need of support. That work is carried about by volunteer community workers like Timotheo.

Once households are identified and enrolled in Pact programming, they are assigned a trained community case worker. Case workers assess families' needs, develop care plans and connect them with vital services, from parenting skills training and resources to boost their income to HIV testing and medication. Community case workers visit their households often to ensure families are getting and staying on track. Often it is their case worker who helps them turn their lives around.

In Tanzania alone, ACHIEVE supports more than 9,500 community case workers with training, ongoing technical support and tools and materials to do their work. At the national level, ACHIEVE works with the government of Tanzania to coordinate and formalize the community health volunteers cadre. ACHIEVE and other Pact health programs also support community case workers in Rwanda, South Africa, Eswatini and beyond.

When Timotheo began supporting Kinyamagoha (whose name is changed here for the sake of his privacy), he began by assessing the family's needs. He could immediately see that stable income would be the key to solving many of their challenges, from affording food and health care to keeping Kinyamagoha on antiretroviral medication for HIV.

Timotheo provided Kinyamagoha with an ACHIEVE income-generating start-up kit to begin making money as a mason. It included trowels, a wooden float, a plumb rule, a bob and a level. Timotheo also linked Kinyamagoha with seasoned masons to gain practical masonry construction skills through apprenticeships. Soon, Kinyamagoha had reliable income that he and his grandmother could count on. And when Kinyamagoha lapsed in his treatment, it was easy for him to bounce back because of Timotheo's close follow-up.

"Timotheo is like a brother I never had," Kinyamagoha says. "He is there for my grandmother and me. If he was not coming to visit us often, I think we would be in bad condition."

Timotheo meets with Kinyamagoha and his grandmother. Credit: Aidan Tarimo/Pact

At 27, Timotheo is among ACHIEVE's youngest community case workers. He serves seven households with 14 people – seven caregivers and seven young people. All the families have made strides in improving their lives, gaining income with Timotheo's support. During his visits, he links families with critical services and shares knowledge about HIV prevention and treatment, parenting, nutrition, hygiene and the importance of health care.

He says seeing families thrive is his biggest motivation.

"With every sunrise, I hit the ground with new vigor, knowing that I am doing something to empower and transform the lives of the most vulnerable people," he says.

"I do all this with support from ACHIEVE. They have provided me with training, tools and working gear – two t-shirts, a backpack, a bib, a raincoat and an umbrella. All this has given me confidence, motivation and identity as someone important in my community. Let it be the sun or the rain; I have the assurance to visit my households as planned."