Mazowe District · Zimbabwe

Designing HIV care with the people who live it — not just for them.

TSIME is a research study integrating sexual and reproductive health services into clinic-based HIV care, built alongside patients, nurses and community leaders in Mazowe District using Experience-Based Co-Design.

2022 PhD fellowship began at LSHTM
Mar 2024 TSIME study launched in Mazowe
35 Wards across Mazowe District
EBCD Experience-based co-design method

The study

An integrated package of care, shaped by the people who use it.

Across Zimbabwe, people living with HIV often manage their care and their sexual and reproductive health through separate visits, separate queues and separate conversations. TSIME asks a simple question: what would it look like if clinics offered both, together, in a way that patients and staff actually helped design?

Formally titled “Integrating Sexual and Reproductive Health into Clinic-Based HIV Services in Zimbabwe: An Experience-Based Co-Design Approach,” the study is based in Mazowe District, Mashonaland Central, and is being carried out by the Biomedical Research and Training Institute (BRTI) / The Health Research Unit Zimbabwe, in partnership with the London School of Hygiene & Tropical Medicine (LSHTM).

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Why Mazowe

A rural district, a real testing ground

Mazowe is a largely rural district of roughly 35 wards where HIV care and sexual and reproductive health services have historically run on separate tracks. It gives the study a realistic, resource-constrained setting for testing whether an integrated model can actually work — and be sustained — outside of a specialist urban clinic.

Methodology

How Experience-Based Co-Design works

EBCD is a recognised approach — set within the Medical Research Council and National Institute for Health Research framework for developing and evaluating complex interventions — that treats patients and staff as equal partners in redesigning a service, rather than subjects of it.

01
Engage

Bringing the district in

Stakeholder meetings with district health leaders, traditional and church leaders, and community members establish trust and shared purpose before any service redesign begins.

02
Gather experience

Listening first

Patients living with HIV and the nurses and clinicians who care for them are interviewed about their real experiences of seeking SRH care alongside HIV treatment — the friction points, the workarounds, the moments that worked.

03
Feed back & prioritise

Naming what matters most

Findings are shared back with patients and staff together, who jointly identify the priority touchpoints worth redesigning first.

04
Co-design

Building it together

Joint working groups of patients and providers design practical changes to how integrated SRH and HIV services are delivered at clinic level.

05
Pilot & review

Testing the proof of concept

The co-designed package is piloted as a proof of concept for what a larger-scale, integrated model of care could look like across Zimbabwe.

Who's behind it

The study team

Meet the full team
RG
Rumbidzai “Rumbi” Anne Gumbie
Principal Investigator

Registered Nurse and Clinical Nurse Educator specialising in primary and acute care, pursuing her PhD at LSHTM through the CREATE PhD Programme, and leading TSIME on the ground in Mazowe.

OM
Onismo Mufare
Assistant Study Coordinator

Coordinates day-to-day study operations in Mazowe District — from stakeholder engagement to fieldwork logistics — keeping the co-design process moving on the ground.

Funding & partnership

Backed by a global health research community

TSIME is supported through a Wellcome Trust–funded fellowship, delivered via the CREATE PhD Programme — the Africa Health Research Training Programme run through the London School of Hygiene & Tropical Medicine — and hosted in Zimbabwe by the Biomedical Research and Training Institute.

Wellcome Trust London School of Hygiene & Tropical Medicine CREATE PhD Programme BRTI / THRU-ZIM Mazowe Rural District Council

Follow the study, or reach the team directly.

Whether you're a stakeholder in Mazowe, a fellow researcher, or simply curious about integrated HIV and SRH care — we'd like to hear from you.

Contact TSIME