By Nutrition & HIV team, WFP Mozambique
Three times a week Adelaide Macamo, a community outreach worker for the World Food Programme (WFP), puts on her bright yellow vest, her backpack and the facemask and heads off to the community of Inchope, in Gondola district, along the Beira transport corridor, Mozambique. Her aim is to raise awareness about free services at the roadside wellness clinic, a container-like structure referred to as the ‘blue box’.
“What is important in this role is to build trust,” she says. “I need to speak to people clearly, with patience, to explain the importance of sexual and reproductive health, the benefits of testing for HIV and what services we provide at the clinic to help them decide to come and visit us”.
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This WFP-led initiative, implemented together with the NGO NorthStar Alliance and funded by UNAIDS, started in June amid the COVID-19 pandemic.
In Mozambique, one in 10 adults is HIV-positive, the eighth highest prevalence in the world.
Figures are disproportionately high among mobile populations and in those living along the transport corridors, such as truck drivers, sex workers, adolescent girls and young women.
The blue box project aims to support people living with HIV by preventing the spread of sexually transmitted infections (STIs) and increasing access to treatment among mobile populations and vulnerable groups in the surrounding communities.
The roadside wellness clinic is located on one of the main highways of central Mozambique — the Beira transport corridor.
Visitors have access to primary healthcare, HIV testing, antiretroviral therapy (ART), STI screening, TB screening, condoms and COVID-19 tests. The clinic raises awareness of sexual-reproductive health and rights, addressing gender-based violence through different social- and behaviour-change communication channels.
The health technicians at the blue box provide printed information and conduct focus group discussions on relevant topics with adolescent girls, boys and young women, sex workers and truck drivers.
HIV prevalence among long-distance truck drivers here is 15.4 percent — the national figure is 12.6 percent. This is due to connected factors such as the absence of appropriate accommodation and resting time, limited access to safe health services at key points along routes, as well as unprotected sex.
Tonderai is a truck driver from Zimbabwe who has been working along the Corridor since 2003. As assistant secretary-general of Zimbabwe’s Truck Driver Union, he explains that truck drivers have little time to stop on journeys. So mobile clinics like the blue box that are easily accessible provide fast services — an HIV test takes less than ten minutes.
Mary is a sex worker living in the community of Inchope, near the blue box, where she moved to from Zimbabwe with her son.
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She learned about the clinic from Adelaide and goes regularly. Adelaide frequently visits and calls Mary and other female sex workers in the community to check in on them and to remind them to get tested for STIs. Mary likes the dialogue groups targeted at female sex workers offered at the blue box.
At one of these, she learned she could be tested for HIV free of charge; now she goes every three months. Thanks to the intensive focus of the blue box around HIV prevention, Mary has access to condoms and has been taking Pre-Exposure Prophylaxis (PrEP), an HIV prevention medication, since it opened.
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“I used to go the hospital in Zimbabwe to get tested, but there I never heard about PrEP, here at the blue box I did,” she says. “It is thanks to PrEP medication that me and other female sex workers here we feel more protected from getting HIV. The blue box helps.”
Mary’s story testifies to the cross-country impact of this intervention, which is crucial due to the mobile nature of the target groups accessing the clinic.
After only four months of implementation and despite the challenges that the COVID-19 pandemic poses mobility, the number of people visiting the blue box has exceeded expectations.
This is thanks to additional awareness-raising efforts by lay counsellors, such as Adelaide, who play a key role in encouraging key target groups — truck drivers, female sex workers and adolescent girls — to access its services.
World Aids Day aims to bring attention to the HIV and AIDS epidemic affecting 38 million people worldwide and 2.2 million people in Mozambique alone. Projects like the blue box provide a platform to more effectively target key populations and vulnerable groups, ensuring that no one is left behind in the fight against HIV.
More results of the project can be found on this interactive M&E Tableau dashboard.