Knocking on every door - Spotlight Tanzania
The family-centered approach to reaching every child living with HIV
About
This report examines the structural barriers impeding equitable access to HIV testing, treatment initiation and long-term adherence – essential elements for sustaining health and well-being for children, adolescents and young women. Rooted in socio-cultural norms, gender disparities and systemic inequalities, these barriers obstruct progress by perpetuating stigma, limiting healthcare access and destabilizing treatment continuity, stalling efforts toward the 10-10-106 and 95-95-957 targets.
A central theme emerging from the collected narratives is stigma, a pervasive barrier with entrenched biases impacting individuals, communities and health systems. Personal stories of children, adolescents and their caregivers within the report reveal how stigma manifests through fear of disclosure, social judgment and isolation, often deterring young mothers from seeking HIV testing for themselves and their children. In contrast, stories of resilience from community Treatment Advocates, or Wakili Tiba, offer a hopeful counterpoint. These advocates work to overcome the limited awareness and stigmatizing attitudes toward people living with HIV, promoting HIV testing for children and ensuring continuous treatment access.
The report is driven by a guiding vision that “virtually all paediatric HIV infections are preventable, and
no child should develop AIDS due to lack of access to testing and treatment.”8 It presents the Family- Centred Approach (FCA) to reaching children living with HIV who are unaware of their status in Tanzania as a promising model. The FCA is a community-based peer service delivery model that leverages the knowledge, communication expertise and deep understanding of the community and networks of people living with HIV to identify households with children and adolescents who may need HIV testing.
The community voices and insights in this report underscore the need for an inclusive, community-based healthcare system that is child-centred, stigma-informed and equipped to reach the most marginalized and vulnerable children, thereby advancing a more equitable HIV response.
