2. Programme Manager
Zimbabwe Association of Church Related
Hospitals(ZACH)
Email:nzou@zach.org.zw
Dr Chidz ew ere Nz ou
MB C hB , MSc. C linical Epidemiology
6. . ZACH has 135 mission institutions
. Mission hospitals make up to 25% of the 1,080 national
health facilities
. Mission hospitals contribute 38% of the 18,200 national
hospital bed capacity also contributing up to 68% of the
rural hospital bed capacity.
. 70% of Zimbabwe’s population lives in rural areas, these
mission health facilities play a key role in rural health
service provision
. Survey on “Causes of Treatment Interruptions among HIV
infected patients defaulting on anti-retroviral therapy in
Zimbabwe”
.Carried out at four mission hospitals which ZACH
members
8. • Cross sectional, exploratory study
• Questions were administered via phone
call and/or face to face
• Participants were adults HIV clients on ART
for a period of more than 6 months, who
have defaulted ART for more than 2 weeks.
• Systematic random probability sampling
method was used to allows each ART
defaulter to have an equal chance
9. • A total of 125 ART defaulters were recruited in the
study.
• The sample size was calculated based on the
following assumptions; 12% prevalence of non-
adherence among clients on ART (existing national
data), anticipating a standard error of 0.0378 and to
maintain a 95% confidence interval.
• Ethical approval was granted by Medical Research
Council of Zimbabwe
10. Name of Mission
Hospital
Bed
Capacit
y
Catchme
nt
Populati
on
Daily
OPD
Attendan
ce
Active
HIV
clients in
care
Activ
e ART
client
s
Defaulte
rs (Last 3
month)
Survey
participa
nts
St. Michaels
Mission Hospital
120 4529 50 869 839 40 32
Mt. St. Marys
Mission Hospital
130 74210 72 828 796 50 41
Nhowe Mission
Hospital
79 20489 30 1341 1290 35 28
St Pauls Musami
Mission Hospital
150 20758 70 2698 2639 30 24
TOTAL 479 119986 222 5736 5564 155
(2,7%)
125
11. Men , 2256 Men , 2266
Females , 3680 Females , 3698
5936 5964
0
1000
2000
3000
4000
5000
6000
7000
Clients In care Clients on ART
PLHIV in Care and ART
13. Demographic
characteristics
N/% Min Age
(Years)
Max Age
(Years)
Mean Age
Male 51(41%) 18 74 43 (SD 14)
Female 74(59%) 18 66 35 (SD11)
Totals 125 (100%) 38(SD 12)
Demographic characteristics of the respondents
14. Level of education of the respondents
Demographic
characteristics
Primary
Education
Secondary
Education
Tertiary
Education
Illiterate
Male 10 (8%) 30(24%) 5(4%) 6(4.8%)
Female 12(9.6%) 45(36%) 10(8%) 7(5.6%)
Totals 22(17.6%) 75(60%) 15(12%) 13(10.4%)
18. Medicines related factors
0
5
10
15
20
25
30
ARVs side effects Stopped treatment
as client not feel
better after taking
the ARVs
Had difficulties
swallowing
medicines
Felt depressed
because due to too
many medicines to
take daily
Frequency Males Females
20. Personal related factors
0
2
4
6
8
10
12
14
Talked to a faith
healer/preacher
/prophet who
prayed for the
client and
assured client
that was cured
by faith
A faith healer
/preacher /
prophet asked
client to stop
taking my
medicines
Shared
medicines with
another person
and stock run
out before next
clinic date
Was influenced
by other people
to stop taking
ARV medicines
Felt very ill that
could manage to
reach to the
clinic
Lost medicines Lack of time due
to school
Total Males Females
21. Personal related factors
0
5
10
15
20
25
30
35
Forgot to take
drugs
Too busy and
did not have
time to take
medicines
Did not want
anyone to know
that the client is
taking ARVs
Lack of time due
to work/job
Talked to a
traditional
healer/herbalist
or took some
traditional
medicine
A traditional
healer asked
client to stop
taking my
medicines
Total Males Females
23. Health facility related factors
0
10
20
30
40
50
60
Clinic hours are
not convenient
.Why are clinic
hours not
convenient?
Was not give
counsel
/sufficient
information at
the beginning of
treatment
lack of trust the
health care
professionals at
the clinic
The health
facility had run
out of drugs
It takes more
than 30 minutes
to get to the
health facility
It takes more
than 1 hour to
receive services
at the facility
Total Males Females
25. Socio-economic related factors
0
10
20
30
40
50
60
Changed
residence during
the period of
treatment
Had no support
or anyone to
encourage client
during
treatment
Unable to get to
clinic due to lack
of transport
Was drinking
alcohol or using
other drugs
during
treatment
period
Took ARVs on an
empty stomach/
did not have
enough food to
support my
treatment
Violence at
home
Total Males Females
27. > There is need for deliberate strategies among
the hospitals to offer men friendly services e.g.
. During weekends
. Times convenient to men e.g. after hours
. Efficient service without delays
> Sensitization on GBV
> There is need to have targeted interventions to
religions e.g. Apostolic Sect, prophets etc.
> Quality counselling must be provided at all
times
