Abstract
The NAMWEZA intervention was implemented, using a ten-session group format, to build skills targeting psychosocial vulnerabilities and enhancing HIV prevention among people living with HIV (PLH) and their social networks. The overall goal of this intervention is to improve psychological wellbeing and reduce HIV risk behaviours. These analyses aim to describe the barriers and facilitators of implementing the NAMWEZA intervention from the perspective of participants and trained peer group facilitators. Twenty-four in-depth interviews were conducted with NAMWEZA participants, and 50 pooled peer facilitator self-assessment reports were obtained from 16 trained peers. Participants identified personal and structural barriers, including fear of inadvertent HIV status disclosure, time constraints, level of participant reimbursements, and limited space available for group sessions. Factors facilitating effective implementation included perceived benefits of the program, such as reduction in HIV-related risk behaviours, increased self-esteem, and improvement in confidence in HIV prevention communications. Scaling up the NAMWEZA intervention to other areas of Tanzania or regionally should take into account these facilitators and barriers to implementation.
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Data Availability and Code Availability
Data are available upon request to skaaya@gmail.com or mksfawzi@msn.com.
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This study was funded by the US Centers for Disease Control and Prevention (CDC) (Grant no. TZ/UG.08.0147).
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MS designed the study, explored the literature, interpreted the findings and manuscript writing; SK, HS participated in study design, interpreted the findings and manuscript writing; DA managed field works and interpreted findings; KO, EM, KM, and JT assisted in designing the study and interpreted the findings; IA, AS assisted in guiding the project activities in the field; SM, NM collected data in the field; SH advised on the design and interpreted the findings; MSF guided the design, data management, and final manuscript writing. All authors have contributed to and approved the final version of the manuscript.
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According to the principles of 1964 Declaration of Helsinki, this study was approved by the National Institute for Medical Research (NIMR), Muhimbili University of Health and Allied Sciences (MUHAS) in Tanzania, and the Institutional Review Board (IRB) at the Harvard T.H. Chan School of Public Health (HSPH).
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Somba, M., Kaaya, S., Siril, H. et al. Barriers and Facilitators to Effective Implementation of the NAMWEZA Intervention in Dar es Salaam, Tanzania. Prev Sci 22, 940–949 (2021). https://doi.org/10.1007/s11121-021-01230-x
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DOI: https://doi.org/10.1007/s11121-021-01230-x