For Tanzanian families vulnerable to HIV, community case workers are a lifeline

Although HIV is one of the world’s most serious public health challenges, the fight to overcome the epidemic is personal – it happens day by day, household by household.

Across Tanzania, much of the work is done by community case workers, or CCWs. In partnership with local partners and Tanzania’s government, Pact’s USAID Kizazi Kipya project has mobilized more than 16,000 of them.

Kizazi Kipya, or New Generation, works to transform the lives of vulnerable Tanzanian children and their caregivers, especially those affected by HIV. The program is supported by PEPFAR. Once households are identified and enrolled in Kizazi Kipya, they are assigned a trained CCW. Often it is their CCW who helps them turn their lives around. CCWs assess families’ needs and connect them with sometimes lifesaving services, from parenting skills training to resources to boost their income to HIV testing and medication. CCWs visit their households as often as needed to ensure families are getting and staying on track.

Families like Lilian Mwita’s. After Lilian’s husband died because of HIV, she faced harsh discrimination from her neighbors in Dar es Salaam, and she struggled to earn enough money through casual labor to meet the needs of her two young children.

CCW Scholastica Mwandoa came into Lilian’s life a few years later. After assessing Lilian’s needs, Scholastica was concerned that Lilian and her children had been exposed to HIV. It took patience and persistence, but Scholastica eventually persuaded Lilian to overcome her fear and be tested. She was there to help Lilian process the pain that she was HIV-positive and the relief that her children were negative. With regular psychosocial support and counseling, Lilian was able to adhere to antiretroviral therapy, and she enrolled in a Pact WORTH group, which helped her save money and find new ways of earning income. Today, Lilian is healthy, has moved with her children into a bigger, better house, and has the money she needs to support them as they attend school.

“I’m very thankful to Scholastica,” Lilian says. “She never gave up on me.”

Sophia Kagemuro Jonas, a widow and single mother herself, has worked as a CCW in Muleba, in northern Tanzania, for three years. She serves a total of 10 households, six of which include people living with HIV.

Sophia Kagemuro Jonas (Photo: Kenneth Chima/Pact)
“It’s important to me to do the job to ensure antiretroviral therapy adherence.”

“During the afternoon, when a majority of community members are back home from the farms, I start my household visits,” Sophia explains. “I prioritize those living with HIV.”

She says the job can be challenging – just finding transportation to reach all of her families takes some doing – but she can see the impact she is making.

“Most of my community members who are HIV-positive do not like group counseling conducted at the health facility,” she says. “They prefer individual counseling because of the long distance to a health facility, and they are more comfortable talking with me.”

She says she has learned a lot from clients who have been on antiretroviral therapy for a long time, and she uses that to help others. “It’s important to me to do the job to ensure ART adherence.”

Pact’s Elizabeth Jere, who leads the Kizazi Kipya project, says CCW are the program’s lifeblood. “They are out there every day, doing everything they can to meet needs that in many cases are very serious. They’re some of the most dedicated, passionate people you’ll meet.”

Erasto Bashaya Eustace, a father of three, has been a CCW since 2017. He visits vulnerable households four days a week, helping them avoid HIV risks if they are negative and stay on treatment if they are living with HIV. He helps caregivers gain new skills for earning income, managing a household budget and connecting with their children.

Erasto Bashaya Eustace (Photo: Kenneth Chima/Pact)
“I think HIV cases will go down or even end completely in the future.”

“There is blessing that comes with service to children,” he says. “As I support communities, I have observed significant changes in the way parents interact with their children. I see more parents taking time, making meaningful conversations with their children.”

Erasto believes that slowly but steadily through education, testing, treatment and the work of CCWs, Tanzania will overcome HIV.

“I think HIV cases will go down or even end completely in the future.”


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