The premise
People living with HIV in Zimbabwe frequently need sexual and reproductive health (SRH) services too — family planning, cervical screening, STI care, maternal health support. In many clinics, these run as entirely separate services, on separate days, sometimes in separate buildings.
TSIME — formally “Integrating Sexual and Reproductive Health into Clinic-Based HIV Services in Zimbabwe: An Experience-Based Co-Design Approach” — sets out to change that. Rather than designing an integrated service in a boardroom and rolling it out, the study uses Experience-Based Co-Design (EBCD) to build the model together with the people who will use and deliver it: patients living with HIV, nurses, clinicians, and district leadership.
The aim is to develop and pilot an integrated SRH-and-HIV package of services as a genuine proof of concept — evidence that could inform how integrated care is scaled up more widely across Zimbabwe.
At a glance
The launch
TSIME was formally launched on 27 March 2024 at the Mazowe Rural District Council Headquarters in Concession. Rather than a quiet start, the launch was a full interdisciplinary stakeholder meeting.
Principal Investigator Rumbi Gumbie and Assistant Study Coordinator Onismo Mufare presented the study to heads of department, health leaders and practitioners, traditional and church leaders, and community members — including an audience with Chief Makope, who shared his perspective on the health issues facing the district. A visiting LSHTM fellow, Lu Niu, also attended.
Stakeholders raised questions on everything from how clinics would be selected for the research to what shapes access to HIV care locally — the kind of grounded, sometimes uncomfortable input that EBCD is designed to surface early, before any service is redesigned.
Sharing perspectives on integrating sexual and reproductive health into HIV care, and on what it means to have research conducted in your own community.
Reflected discussion at the TSIME launch meeting, Mazowe RDC, March 2024
The setting
A largely rural district of around 35 wards in Mashonaland Central Province, Mazowe gives TSIME a realistic testing ground — the kind of setting where an integrated model of care needs to hold up.
Testing integration here means the model has to work without the infrastructure of a specialist urban HIV clinic.
Chiefs and church leaders sit alongside Ministry of Health officials at the table — reflecting how decisions actually get made locally.
What's learned and co-designed here is intended to inform larger-scale integrated HIV/SRH service delivery elsewhere in Zimbabwe.
The team
Rumbi is a Registered Nurse and Clinical Nurse Educator specialising in primary and acute medical-surgical care. Before her PhD, she worked with a Denver-based NGO on HIV/AIDS awareness, community-based rapid testing, cervical cancer screening and voluntary male medical circumcision programmes across Uganda and Rwanda, and supported midwives and community health workers at a maternal health centre.
She holds an MSc in Sexual & Reproductive Health Research from LSHTM and is currently a PhD Fellow with the CREATE PhD Programme (the Africa Health Research Training Programme), where her doctoral work — begun in September 2022 — is the academic backbone of the TSIME study.
Onismo works alongside Rumbi as Assistant Study Coordinator, supporting the day-to-day running of TSIME in Mazowe District. He was part of the team that presented the study at its official launch at the Mazowe Rural District Council Headquarters in March 2024, and continues to coordinate fieldwork and stakeholder engagement on the ground.
Funding
TSIME is carried out as part of a Wellcome Trust–funded PhD fellowship, delivered through the CREATE PhD Programme — the Africa Health Research Training Programme run in partnership with the London School of Hygiene & Tropical Medicine (LSHTM). CREATE is, in part, an evolution of the earlier Bloomsbury Centre / Wellcome Clinical PhD Programme in Global Health Research, and connects fellows across Zimbabwe, Uganda, Zambia, The Gambia and beyond working on HIV, TB, maternal and child health, and related global health research.
Institutional home
In Zimbabwe, the study is based at the Biomedical Research and Training Institute (BRTI), home to The Health Research Unit Zimbabwe (THRU-ZIM) — a multi-disciplinary research programme built around equitable partnerships and strengthening local research capacity. TSIME sits alongside other BRTI/THRU-ZIM studies in HIV, sexual and reproductive health, and adolescent wellbeing across Zimbabwe.
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