by Siyabonga Gema (Communications Officer)
One of the biggest challenges faced by the South African public health system is the issue of HIV prevalence among youth and adolescents. The ongoing unemployment crisis plaguing the youth makes them more vulnerable to HIV and other health challenges, including mental health. In response to this, Health Systems Trust (HST), in partnership with the Department of Health, provides psychosocial services to communities and deploys Peer Mentors who provide facility-based psychosocial support for paediatric and adolescent patients.
Let's first unpack the role of Peer Mentors
The key role of Peer Mentors is to provide adherence support to children living with HIV. They are responsible for patient education on HIV and antiretroviral therapy (ART): treatment literacy to children and caregivers; adherence counselling sessions; and basic psychosocial support to children on HIV medication. This support is intensified for children with an unsuppressed viral load, as Peer Mentors closely monitor the children's treatment journey. They identify social barriers that hinder viral load suppression and intervene through psychosocial assessment; refer patients to other partners/stakeholders within the facility and the community to ensure that they receive a comprehensive package of care; and offer enhanced adherence counselling. This holistic approach looks not only at the child but also at her or his family and community, as some factors that impede viral load suppression emanate from these structures. The Peer Mentors also support the implementation of support groups/adherence clubs and Family Care Days in the facilities. They ensure that paediatric and adolescent patients who come to the facility receive premium care through calling to remind them about their appointment dates; pre-pulling their files before they arrive; and fast-queueing them so that they don't wait in line longer than they have to.
HST's Peer Mentor based in eThekwini District, Nosipho Ngcobo, joined HST in February this year. Nosipho recently sat down with us and shed some light on her work.
Give us a brief description of what your job entails.
As a Peer Mentor, my job at the facility entails playing the role of a 'friend', 'coach' and 'companion' to the youth in my community who are living with HIV and other comorbidities. Realising the gap among the youth in adhering to treatment brought about the need for a peer or a 'buddy' who will encourage and support our youth to sticking to treatment. So as their 'friend', my duty is to provide treatment literacy and adherence support to them in the facility. Over and above this, my role as a Peer Mentor is to deliver psychosocial support to promote positive health-seeking behaviours, and to provide education on sexual and reproductive health (SRH). My role also extends to carrying out HIV Testing Services (HTS), tracking and tracing paediatric and adolescent patients and linking them back to care. Facilitating the HIV disclosure process to the 0‒24-year age group as well as facilitating adherence support groups are some of the very important duties that I have as a Peer Mentor. All of these tasks are aligned with the 95% cascade which is designed to ensure that 95% of people living with HIV and on treatment are virally suppressed.
What led you to taking up this profession?
I believe that having a Bachelor's Degree in Social Work was one of the advantages that afforded me the opportunity to be part of Youth Employment Services. Growing up in a community faced with various health, political and psychosocial issues fostered my desire and passion to enrol in a Social Work degree. Growing up, I wanted to be a change agent for vulnerable children who were and still are neglected, and to help them reconstruct their lives and advocate for a positive and healthy life. This mindset has helped me to become part of this year's Peer Mentor team.
What training did you have to undergo for this role?
Special thanks goes to my employer, HST, for providing us as Peer Mentors with the necessary skills and knowledge through training and certifications that are necessary to fulfil the duties of a Peer Mentor. We were provided with the following training and certification:
- Staying in Care for U=U (Undetectable = Untransmittable) Conversation Map Facilitators Training
- National RTCQI (Rapid Test Continuous Quality Improvement) course-quizzes and Assessment Certificate
- HIV Testing and Counselling Certificate
- Foundations of Working with Children, Disclosure, HTS and Adherence Certificate (the KidzAlive programme created by Zoë-Life).
- Kids Adherence Support Group Certificate (also part of the Zoë-Life KidzAlive programme).
How has this training assisted you in executing your tasks?
These trainings have been of enormous help in executing the daily tasks of a Peer Mentor in the facility. Firstly, the 'Staying in Care U=U Conversation Map' training for Facilitators helped us to understand the kind of communities that we as Peer Mentors would be exposed to and to understand how our role as Peer Mentors is aligned with the third 95 of the cascade. This training has also given us in the necessary skills for spreading the word of 'Undetectable = Untransmissable' (U=U). Secondly, the HIV Testing and Counselling Certificate has verified that we are competent to carry out HIV testing and counselling services in our facilities. Lastly, the 'Foundations of Working with Children' Certificate has equipped us with the necessary skills and knowledge for working with children who are living with HIV, and also the Zoë-Life KidzAlive Adherence Support Group training showed us how to facilitate an Adherence Support Group. I am grateful for the training provided by HST. This will open doors to new possibilities.
What more can be done to identify individuals or families in need of your services?
I believe that engaging more with the community can help in identifying individuals or families in need of our services. Awareness programmes, dialogues and educational talks in the community can help to bring our community closer to the facility, and a needs assessment can be done there to identify whether a person needs psychosocial support services, adherence support services, or referral to other stakeholders where needed.
What gives you motivation to render your services, even when you encounter challenges?
I have an unwavering passion for helping children to overcome even unthinkable circumstances. I believe that even on a tough day filled with hiccups, putting a smile on a child's face and leaving a positive mark on their lives is what motivates me to render these services.