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Social, Cultural, and Environmental Challenges Faced by Children on Antiretroviral Therapy in Zimbabwe: a
Margaret Macherera1, Lindani Moyo2, Mkhanyiseli Ncube3
1Department of Environmental Science and Health, National University of Science and Technology, Bulawayo, Zimbabwe; Africa Academy for Environmental Health, Sinoville, South Africa.
Insights
Children on antiretroviral therapy (ART) in rural Zimbabwe face numerous challenges, including caregiver knowledge gaps and inadequate resources, leading to non-adherence. Addressing these barriers is crucial for improving health outcomes.
Area of Science:
- Pediatric HIV/AIDS care
- Public health in developing countries
- Rural health challenges
Background:
- Antiretroviral therapy (ART) has advanced HIV/AIDS treatment, yet children in rural Zimbabwe remain vulnerable.
- Understanding specific challenges faced by children on ART in these settings is critical for effective interventions.
Purpose of the Study:
- To identify factors and challenges impacting children on antiretroviral therapy (ART) in the Brunapeg area of Mangwe District, Zimbabwe.
- To inform targeted interventions for improving ART adherence and outcomes in vulnerable pediatric populations.
Main Methods:
- A mixed-method approach was employed, combining interviewer-guided focus group discussions and semi-structured questionnaires.
- Data were collected from diverse key population groups and analyzed using content coding based on predetermined themes.
Main Results:
- Key challenges include limited caregiver knowledge of HIV/AIDS, caregiver drug diversion, inadequate caregiver age/capacity, and non-disclosure of OI clinic visits.
- Other significant barriers encompass insufficient access to healthcare, food, clean water, and sanitation, compounded by community stigma and discrimination.
- These multifaceted challenges collectively contribute to poor adherence to antiretroviral drugs among children.
Conclusions:
- Children on ART in rural Zimbabwe experience severe compromises requiring multi-intervention strategies at policy and programmatic levels.
- Establishing and implementing effective mitigating measures in rural communities is essential for the global elimination of HIV/AIDS.
Objectives:
Despite the advent of antiretroviral therapy (ART), many children, particularly in the rural communities of Zimbabwe, remain vulnerable. The purpose of this study was to determine the factors and challenges facing children on antiretroviral therapy (ART) in Brunapeg area of Mangwe District, Zimbabwe.
Methods:
A mixed-method approach involving interviewer-guided focus group discussions and piloted semi-structured questionnaires was utilized to collect data from different key population groups. The data obtained were analyzed through content coding procedures based on a set of predetermined themes of interest.
Results:
A number of challenges emerged as barriers to the success of antiretroviral therapy for children. Primary care givers were less informed about HIV and AIDS issues for people having direct impact on the success of antiretroviral therapy in children whilst some were found to be taking the antiretroviral drugs meant for the children. It also emerged that some primary care givers were either too young or too old to care for the children while others had failed to disclose to the children why they frequently visited the Opportunistic Infections (OI) clinic. Most primary care givers were not the biological parents of the affected children. Other challenges included inadequate access to health services, inadequate food and nutrition and lack of access to clean water, good hygiene and sanitation. The lack of community support and stigma and discrimination affected their school attendance and hospital visits. All these factors contributed to non-adherence to antiretroviral drugs.
Conclusions And Public Health Implications:
Children on ART in rural communities in Zimbabwe remain severely compromised and have unique problems that need multi-intervention strategies both at policy and programmatic levels. Effective mitigating measures must be fully established and implemented in rural communities of developing countries in the fight for universal elimination of HIV/AIDS.
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