Description of Community Adolescent Treatment Supporters in the Africaid Zvandiri Program in Zimbabwe
| Who are CATS? | Adolescent and young adults living with HIV (18–24 years old) trained and mentored by MOHCC and Africaid as peer counselors |
| Who appoints CATS? | Health care facility staff identify PLHIV (18–24 years old) with the potential (willing, competent, and motivated) to be CATS and then appoint them in consultation with the authorities in the MOHCC and Africaid. CATS should have completed secondary school and must have consent from their caregivers to enroll. |
| How many CATS per health facility? | Although the number of CATS per health facility depends on the number of children, adolescents, and young adults living with HIV who need support, the aim is to at least have 1 male and 1 female CATS per health facility. Each CATS should support between 30 and 60 children, adolescents, and young adults living with HIV at any given point in time. |
| What training do they receive? | All CATS receive 2 weeks of MOHCC-endorsed training on knowledge related to pediatric and adolescent HIV (HIV, ART, adherence support, disclosure, sexual and reproductive health, protection, psychosocial support, and mental health) and skills in counseling and community outreach. The training combines theory and practical components, which includes hands-on mentorship (‘shadowing’) by senior CATS for a period of time before they are independently able to provide support. Training is participatory and uses case studies and role plays. They also receive technical support from district-based Zvandiri mentors employed by Africaid. This initial training is then followed by continued on-site training and mentorship. |
| What are their responsibilities? | Cofacilitate monthly support groups and ART refill groups Conduct home visits for counseling, monitoring, and support Send SMS reminders and phone calls for adherence and clinic visits and check-ins Provide counseling in clinic and link to other services as needed Refer children, adolescents, and young adults living with HIV (particularly severe cases) and link to other service providers including OI/ART, mental health, social protection, disability, SRHR, and PMTCT Perform community outreach visits in partnership with other cadres from health and social protection Cofacilitate caregiver workshops |
| Who supervises and mentors CATS? | A nurse or primary counselor at the clinic supervises CATS with additional supervision and mentorship by the district Zvandiri mentor. A district-level monthly meeting is conducted to mentor and review progress of CATS. |
| What remuneration and incentives do they receive? | Fixed allowance of US$20 per month Bicycles to facilitate home visits and/or reimbursement of bus fare Monthly airtime allowance for SMS reminders and calls |
Abbreviations: ART, antiretroviral therapy; CATS, community adolescent treatment supporter; MOHCC, Ministry of Health and Child Care; OI, opportunistic infection; PLHIV, people living with HIV; PMTCT, prevention of mother-to-child transmission of HIV; SMS, short messaging service; SRHR, sexual and reproductive health and rights.