Vulnerable people living with HIV in Zimbabwe are benefiting from an electronic voucher scheme being used to fight malnutrition among people on antiretroviral (ARV) therapy and their families by providing them with nutritious food.
The system, introduced by the UN World Food Programme (WFP) and implemented by the health ministry and NGOs, involves identifying malnourished patients who are then given electronic vouchers to buy food at specific shops.
The country's economic collapse in the past decade has significantly strained the ability of poor HIV-positive Zimbabweans to feed themselves and their families when on ARVs. An estimated 570,000 Zimbabweans are receiving the medication; HIV prevalence - one of the world's highest - is 13 percent.
Prices remain comparatively high for families with low incomes and little or no access to US dollars, despite the improved availability of food. The Zimbabwean dollar was discontinued in 2009 as a solution to hyperinflation, and replaced by currencies such as the US dollar, South African rand and Botswana pula, but unemployment levels are extremely high and many people do not have access to these currencies.
Two months ago, 42-year-old John Mugove of Rugare, a low-income suburb about 8km to the southwest of the capital Harare, collapsed while seeking medical attention at an opportunistic infections (OI) centre and had to be hospitalized for two weeks, leaving his four children to fend for themselves.
Mugove had long abandoned his small furniture-making business due to recurring illness, and could barely raise money to cover basic family essentials such as food and school fees. He has been looking after his children alone after his wife ran away when he became critically ill and tested HIV positive three years ago.
"Bringing food home is such a big headache. Debt collectors are also demanding the money that I owe the hospital,” Mugove told IRIN/PlusNews.
"My worry has not been to get nutritious food, but just any food that can fill our stomachs. My last-born son, like me, has been diagnosed HIV positive. He is malnourished and easily falls ill, partly because the food I give him is of poor quality," he added.
Mugove recently visited a clinic and was advised by the nurse to register for the e-voucher food assistance programme at Harare Hospital near low-income suburbs southwest of the capital.
The programme supports about 5,000 patients and their families with essential food items and is operating at seven health facilities in the capital and has been extended to the second-largest city, Bulawayo.
Catholic Relief Services (CRS) and Help from Germany (HfG) are the implementing NGO partners working with the health ministry.
|My worry has not been to get nutritious food, but just any food that can fill our stomachs|
Patients on ARVs or TB treatment who are malnourished are referred to register with the scheme.
During registration, adults’ weight and height are measured to determine body mass while children have their upper arm circumference measured to determine if they are malnourished. Beneficiaries then have to answer questions that help establish if their households are food insecure.
Patients are given vouchers, in the form of scratch cards similar to mobile phone airtime cards, which they take to designated retail outlets for specific rations that are “good for one month and for a maximum family size of five people”, in addition to 10kg of corn soya blend they receive at registration.
The rations comprise maize-meal, beans and vegetable oil and beneficiaries receive the food aid for six months but that period is extended if they are still malnourished.
"A big number of patients on ARVs come from poor and vulnerable households that cannot afford nutritious food and this makes the e-voucher system very essential," AIDS activist Martha Tholanah told IRIN/PlusNews.
"But there is a need to go beyond addressing current problems such as malnourishment and ensure that patients receive help that enables them to sustain themselves and their families through income-generating projects," she cautioned.