With holistic case management, a family in Tanzania breaks the cycle of poverty, HIV risk

Eva Mwaka Twimanye hasn’t had an easy childhood. She is one of five children, and both of her parents are HIV-positive. The income they make as small-scale gold miners in Bukombe District, in northern Tanzania, is rarely enough to make ends meet. Now 16, Eva was in grade five when she decided to drop out of school to work for local food vendors to help support herself and her family. She felt the small amount of money she made was better than nothing, and she had little hope for her future. 

A path out of poverty began to emerge when Eva’s family got connected with a local nonprofit organization called NELICO. NELICO receives PEPFAR funding through Pact and USAID’s Kizazi Kipya project. Kizazi Kipya, or New Generation, is working to sustainably improve the lives of vulnerable Tanzanian children, particularly those affected by HIV. NELICO, one of many of Pact’s local partners in the effort, uses a social welfare case-management approach to assist families like Eva’s to break the cycle of poverty and HIV risk. NELICO staff began by assessing the needs of each member of Eva’s family. Her case worker found that the nature of Eva’s work put her in close contact with a large community of older men. Combined with the income disparity between her and the men, this greatly increased her risk for sexual violence and exposure to HIV.

NELICO offered Eva a three-month scholarship to a vocational training school. She saw it as the opportunity she needed for a better future and enrolled in a tailoring course. It was the first time she’d ever traveled outside of Bukombe and the first time in a long time that she’d felt hope.

During the vocational training, Eva also attended educational sessions on sexual and reproductive health aimed at safeguarding adolescent girls from unplanned pregnancies and HIV and other sexually transmitted infections. She says the knowledge she gained has given her determination to protect her HIV-negative status and confidence to strongly say no to men who approach her.

After finishing vocational school, Eva returned home and started an apprenticeship with a local senior tailor. There, she is honing her skills and earning significantly more money than she did as a food vendor. Pact is supplying her with a tailor’s start-up kit so she can launch her own small business after her apprenticeship ends.

Her family continues to receive comprehensive social welfare services from NELICO. They are now connected to much-needed health services, and the family took part in a Kizazi Kipya course on positive parent-child relationships that enables parents to reduce adolescents’ risk of exposure to violence and HIV. Eva’s father has also joined a Pact savings and lending group, giving him access to low-interest community loans so he too can start a small business.

“My family’s life has been transformed greatly,” he says.