Sizophila Project

The Desmond Tutu HIV Foundation initiated the Sizophila Therapeutic Counseling Project in 2002. It is run from the Hanan-Crusaid Centre in Guguletu, Cape Town. It provides Anti-Retroviral Treatment (ART) to more than 3000 people in the Nyanga District. The project was created to address the need for a strategy to ensure ART adherence and trained health care personnel in large clinics.

The Sizophila Project provides training to unemployed people from the community living with HIV and employs them as Therapeutic Counselors (TCs). The TCs conduct one-on-one counseling, education and support (including home-based support) to persons that have been diagnosed by the centre. Each patient is assigned a TC and support is given to the patient by means of on-going mentorship through home visitations. These assignments are geographical which minimizes the area TCs have to travel to visit patients. The project addresses the number of areas within ART provision that have specific needs. These are patients that include; adolescent and pediatric patients, co-infected TB patients, pregnant women with advanced HIV, sick non-ambulatory patients, mentally ill patients and general poor adherers. The partnership between the Desmond Tutu HIV Foundation, the Hanan-Crusaid Centre and the Provincial AIDS Directorate maintain the effectiveness of the Sizophila Project’s service delivery.

Innovation

The Sizophila model has proven highly successful in not only addressing poor ART adherence but also in providing employment for HIV-positive people in communities. By having TCs monitor and encourage HIV-positive patients, they are living proof that a meaningful, long and happy life is possible if you are HIV-positive.

Effectiveness

Presently there are 25 TCs that oversee 100 patients each in the Guguletu area. Their assistance significantly takes the pressure off the doctor and professional health staff at the Hanan-Crusaid Centre. They conducted a study involving the first 1 000 patients involved in the project. After 32 months, 96% of patients were still on the first-line regimen drugs, and showed no need to switch to second-line regiment. Maintaining 96% of patients on first-line regimens is more cost effective, as second regimens are more expensive, and illustrates Sizophila's effectiveness in stabilising the health of its patients.

Poverty Impact

TCs are employed at a monthly remuneration range of R1 800 per month for junior counselors and R2 000 per month for more senior counselors. The Sizophila Project ensures ART adherence and this success subsequently has an affect on individual health promoting patient employability and the maintenance of patient’s household income.

Sustainability

The total cost of the project is R600 000 per annum with half of the budget sponsored by the provincial AIDS directorate. The Heiser Foundation donates 17% of the funding, with the Freshlyground Band donating 3% and rest (30%) is sourced from PEPFAR. Patients are plagued with a range of other social problems and often additional funding is required to provide support like food parcels. Fundraising campaigns has helped to provide additional funding and funding has been secured for a further three years.

Replication

This project can be replicated in the many larger clinics that suffer from a poor ART adherence rate due to lack of capacity to deal with individualized HIV/ AIDS care and mentoring in South Africa.

Partnerships

Western Cape AIDS Directorate

Heiser Foundation
Freshlyground Band
PEPFAR

Sections