Tracking an Index Case Helps Locate a Demoralized Vulnerable Household for Intervention

An area of health management that still needs great attention in Nigeria is the Psychological aspect. People go for medical treatment with other burdens that can either be relieved or aggravated based on the care they receive, just like Mr. Archibong, who knew his status and received treatment at a local health facility till he was informed that his prescription of Antirethroviral drugs could not be refilled unless he had a CD4 count test, for which he had to pay N3,000.00. At the time, he did not have the required amount. Confused, distraught and demoralized, he stopped treatment and sought other options instead, till happenstance brought his family under the HIFASS-LOPIN 3 project radar.

His 12-year-old son was hawking snacks in their neighborhood and walked into a HIV Testing Service (HTS) venue where a HIFASS-LOPIN 3 (a project funded by PEPFAR through USAID) community outreach was taking place. The outreach was hosted by one of the Community Based Organizations (CBO) sub-granted by HIFASS-LOPIN 3, Neighbourhood Care-Well Foundation (NCF). His son tested positive and was followed up as an index case, so his family could be tested. A few days later, the parents and other siblings were tested, and both parents along with the 12-year-old index case were the only positive cases recorded in the family. The boy was still not aware of his status.

During counselling, Mr. Archibong disclosed that he had previously been treated for Tuberculosis (TB) but had stopped receiving Antirethroviral drugs for about two years. At the initial visits, he could barely walk and said he lacked strength to keep up with his laundry business which he wanted to continue at home because he was ejected from his shop when he could not pay for it. His wife who worked with him at the time, stayed home to help him, as he became physically dependent. They looked to friends and relatives for basic needs. Also, he was encouraged to disclose his son’s status to him and eventually, with proper counselling, he told the boy.

Both parents and their son have now been linked to trusted facilities where their prescriptions are refilled regularly. They have received adequate training in relevant areas like financial literacy, education, nutrition, gender norms and a lot more. They have also received nutritional support in the form of food items – rice, beans, plantain, seasoning. The project supported Mr. Archibong with a seed grant of N40,000 which he put into his business. He has resumed laundry services and also now sells bread. His wife was also empowered with another seed grant of N40,000.00 and she now runs a hairdressing business.

Since the husband resumed treatment, he has regained strength and is back to his regular activities. So his wife is free to run her own business. The most fascinating part of their story is the fact that they learnt how to make ‘Tom Brown’, a highly nutritious meal made from soybeans, groundnut and either corn, millet or guinea corn, at a food demonstration held in HIFASS-LOPIN 3 office, Calabar. Positive households are usually encouraged to take it because it contains the body’s required nutrients and is high in energy. Mr. Archibong now consumes it regularly with his family and they sell it as well to people in their community, educating them of its advantages.

Also, he attends caregivers’ meetings regularly, where they discuss relevant information regarding care for themselves and their families and is the secretary of Nka Uforo (meaning Prosperity group), a Savings and Internal Lending Community (SILC) formed after caregivers were trained in financial literacy. He is ecstatic about the whole experience and has this to say “…I was sick, but now I am strong, at least I’m going back to my laundry business, combining with the bread business…. I am made to understand it is the American people that sponsored the program, so I want to say a big thanks. I want to say that you guys have helped me to stand…. I may not have ability to reward you all, but I believe that God will reward you all. I want to say thank you very much”.



Disclaimer: This success story was made possible by the kind support from the American people delivered through the U.S. Agency for International Development (USAID). The contents are the responsibility of Health Initiatives for Safety and Stability in Africa (HIFASS) and do not necessarily reflect the opinion of USAID or the U.S. Government.


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