Community-based Approaches to Reinforce the National Response to Reducing HIV and TB Incidence and Mortality in Mozambique
Mozambique’s HIV-prevalence rate is among the highest in the world at 12.1%1, with up to 25% of adults infected in some provinces. The World Health Organization (WHO) estimates the risk of developing tuberculosis (TB) to be up to 27 times greater in people living with HIV than among those without HIV, and TB is the leading cause of death among people living with HIV; yet TB often goes undiagnosed and untreated in people living with HIV, contributing to preventable deaths. From 2018 to 2020, Pathfinder International implemented the community-based Reinforcement of Adherence & Retention of Patients in Antiretroviral Therapy (ART) & Screening for TB (RARE) project in Mozambique. Funded by the Global Fund to Fight AIDS, Tuberculosis, and Malaria through the Center for Collaboration in Health, RARE-HIV-TB worked in Gaza, Manica, and Sofala provinces to reduce both HIV and TB incidence and mortality. This brief documents the project’s community-level interventions with community health workers (CHWs) to improve ART adherence, retention, and care. The brief shares lessons and recommendations for replication, adaptation, and expansion of these approaches.