Evaluation of the paediatric human immunodeficiency virus care and treatment program in Bulawayo City, Zimbabwe, 2023

Introduction: HIV is a major public health priority with disparities in its response between adults and children. On review of the Demographic Health Information System data of Bulawayo City, ART initiation in newly HIV diagnosed children was below the target of 95%, with 80% in 2022 and 84% in 2020. Of the children who received viral load results,12% were virally unsuppressed. We therefore evaluated the pediatric HIV care and treatment program. Methods: We conducted a descriptive cross-sectional study. Fifty-six health workers and 30 caregivers of HIV positive children participated in the study. Interviewer-administered questionnaires, checklists and records reviews were used to collect data on knowledge of health workers on the program, reasons for low treatment initiation and viral load suppression, program inputs, processes, outputs and caregiver reasons for non-adherence. Epi Info 7 was used to analyze the data. Results: Health workers (83.9%) had good knowledge of HIV care and treatment in children. A shortage of nurses, counsellors and doctors was noted, with 61%, 50% and 72.8% of the expected available, respectively. Defaulter tracking was not done at the stipulated timelines. Of all children who tested HIV positive, 96 % were initiated on ART. Most children (93.9%) had viral load tests done. Of those, 12.2% had high viral loads, and 86.6% of them received enhanced adherence counselling. Reasons for non-adherence to treatment included forgetfulness and the child refusal to take medication. Conclusion: The pediatric HIV care and treatment program showed optimal treatment coverage with defaulter tracking and viral load monitoring, and management below target.