Zambia

Zambia-map

The Southern African nation of Zambia is home to 17.3 million people — 46 percent of whom are under the age of 15. Zambia’s population is small relative to the country’s area, and its growth rate is lower than that of many of its neighbors in sub-Saharan Africa. Large parts of the country are sparsely populated with much of the population concentrated in the country’s most developed area, known as the Line of Rail. The proportion of the population living in urban centers has risen steadily, and in the early 2000s more than one-third of the population was urban. While most of Zambia’s population is involved in subsistence agriculture, Zambia’s economy is heavily dependent on mining and manufacturing.

The country’s health system faces many challenges including being severely overstretched with a physician density of just 0.17 per 1,000 people. Consequently, improving Zambia’s health system — in part by increasing and strengthening the health workforce and finding ways to streamline care and prevention services — are of critical importance.

Although Zambia has made some significant gains in reducing maternal and child mortality over the past two decades, rates are still high, with 280 women out of 1,000 dying as a result pregnancy complications and 262 out of 1,000 children dying before they reach they reach the age of five. Life expectancy has also increased but is still below the global average and in line with most developing countries.

The country also has a very high rate of infectious diseases. With an HIV prevalence rate of 12.5 percent among people between the ages of 15 and 49, Zambia ranks seventh highest in the world, according to UNAIDS. Prevalence rates vary considerably within the country from a high of 18 percent in Copperbelt Province to a low of 6 percent in Muchinga. In 2018, 630,000 of the 1.1 million adults (aged 15 and over) living with HIV in Zambia were women. Infection rates are highest in cities and towns along major transportation routes, with young women, military personnel, commercial sex workers, truck drivers, and people who work in fisheries among the populations at greatest risk of contracting HIV.

AIHA has been active in Zambia for many years managing projects to increase health workforce capacity and to address HIV/AIDS. In 2020, AIHA initiated activities under the CDC1950 grant aimed at improving the capacity of local civil society organizations comprising and representing vulnerable and marginalized populations to address the pandemic in their communities. 

Click here for a printable overview of our work in Zambia.

Projects

Targeted Programmatic Support Across Countries (CDC1950)
(2020 – Present)

In September 2019, the U.S. Centers for Disease Control and Prevention (CDC) awarded AIHA a five-year grant, providing a vehicle by which AIHA can assist the CDC at the global and country level, in support of the President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria.

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AIHA initiated activities under the CDC1950 grant in Kenya (October 2019), Tanzania and Zambia, (April 2020), Nigeria (May 2020), Guatemala (July 2020), Haiti (October 2020), the Dominican Republic (October 2020), and the Philippines (2020) the goal of which is to strengthen Key Population (KP) and Civil Society (CSO) led organizations’ capacity to deliver services to vulnerable populations to stem the spread of HIV/AIDS through various prevention, care and treatment initiatives. The project also provides KP-led organization with the skills and abilities to enable them to operate as primary recipients (and sub-grantors) of US/PEPFAR and other donor funding. 

AIHA is conducting this work in collaboration with CDC/Atlanta and respective CDC Country Offices and National KP Consortia. 

CDC1950 also operated in Thailand and Laos where the primary focus of AIHA’s work was on index testing.

Once KP-led organizations in-country have been identified, the first step in the process is to conduct an assessment of organizational capacity. AIHA has used the Organizational Capacity Assessment (OCA tool), a self-assessment that each KP-led or KP-competent organization interested in participating in this project needs to complete to determine gaps and training needs. The OCA forms are analyzed and then shared along with recommendations with the national KP networks. This helps determine the list of KP-led CSOs to be included in the project and the input for the development of an organization-specific training plan. 

OCA analyses were completed for Zambia and 10 CSOs were selected for the project. The most common gaps identified were in Project, Finance, Human Resources and Organizational management. Due to the COVID19 pandemic, AIHA has been conducting trainings on priority areas via a set of webinars that are followed up by one-on-one mentorships. All CSOs are welcome to listen to webinars but one-on-one mentorship is being provided to 10-15 organizations per country selected for the project.

In April-May 2020, AIHA – in collaboration with the AVAC and CDC – arranged stakeholders’ consultations with the KP Consortium of Zambia to discuss the needs of KP-led organizations and identify priorities for training and mentorship. Taking into account training delivered by others in country, in Year 1 AIHA focused on on-line training in Strategic Planning, Governance and Advocacy that were delivered by AVAC and followed by mentorships.

Key results of Project Year 1 included:

  • Organizational Capacity Assessment completed;
  • 61 participants from 31 CSOs attended three trainings;
  • 116 mentorship hours were delivered by local mentors upon training completion.

In Project Year 2 AIHA focused on the following:

Objective 1: Strengthen financial resiliency through planning for diversified sources of revenue 

In accordance with gaps identified in Year 1, AIHA delivered a two week-long on-line training on Social Enterprise and diversified sources of revenue. All trainings were followed up with in-country based mentorship. Upon completion of the training on Social Enterprise, participants submitted draft business plans that included a social enterprise scheme (e.g. a profit-generating activity). 

Objective 2: Build capacity to implement and sustain social enterprise schemes

Small grants were provided to CSOs to address their capacity development needs followed by implementation of their social enterprise capacity development plans. A local consultant and AIHA supported selected organizations in each country to implement their social-enterprise scheme.

 

Key results:

Key Results of Phase 1 OCA-informed Training and Mentorship Programs:

  • Zambia participated in the following Capacity Building Trainings: Governance, Strategic Planning, Advocacy, and Social Enterprise
  • Organizational Capacity Assessments

Key Results of eligible CSOs’ Phase 2 Capacity Building Grants:

  • 7 Zambian KP-led CSOs awarded Organizational Capacity Grant
  • 7 of 7 KP-led CSOs successful completed their Organizational Capacity Project Grants
  • CSOs identified their greatest organizational need and submitted proposals to initiate their organizational development projects;
    • 3 CSOs developed their 1st Organizational Strategic Plans
    • 1 CSO developed its 1st Board Charter and provided Board Trainings
    • 1 CSO developed its 1st Advocacy and Communication Strategic Plans 
    • 1 CSO conducted a KP-Service Delivery Landscape Analysis Report 
    • 1 CSO created a Mental Health and Wellness Manual for KP-led CSOs Staff and Communities 

Key Results of Phase 3 Social Enterprise Initiative:

  • 9 of 10 eligible CSOs were trained in social enterprise
  • 7 CSOs submitted business plans for Social Enterprise mini-grants
  • 3 CSOs awarded Social Enterprise mini-grants 

 

Zambia CSOs will share their experiences, lessons learned and recommendations for follow-up in an on-line Learning Exchange Forum scheduled for November 2021.

The University Teaching Hospital – HIV/AIDS Program (UTH-HAP)
(2021 – 2023)

Over a two year period, AIHA supported the University Teaching Hospital in Zambia on its CDC funded HIV/AIDS program. The goal of the project is to support and build capacity of KP-led Civil Society Organizations (CSOs) in Zambia through the creation of  successful Social Enterprises (SE) initiatives so that they become more financially sustainable. KP-led CSOs were identified jointly with the Zambia KP consortium with whom AIHA partnered on another successful CDC supported KP HIV/AIDS project

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As a result of this innovative project, 9 KP-led CSOs completed several training courses on Social Enterprise and financial maturity, and 5 CSOs received additional mentorship and seed funding to open businesses.  3 CSOs work on micro-financing targeting vulnerable communities, one works on delivery service and one on chicken-rearing farming.

This innovative project empowered KP-led CSOs to run business enterprises and provide income and social benefits to vulnerable communities.

Historically Black Colleges and Universities (HBCU) Global Health Consortium
(2017 – 2019)

The Historically Black Colleges and Universities (HBCU) Global Health Consortium was launched by the Health Resources and Services Administration (HRSA), HIV/AIDS Bureau, Division of Global HIV Programs in February 2017 with funding from the Office of the U.S. Global AIDS Coordinator and Health Diplomacy. AIHA provided program and financial management, along with logistical, technical, and human resource support to ensure successful implementation of this PEPFAR project designed to transform HIV/AIDS clinical practice at four hospitals in Lusaka, Zambia.

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The HBCU Consortium’s key objective was to build the capacity of frontline health workers and hospital leadership to improve the quality of healthcare, clinic workflow, and teamwork as a way to improve health outcomes and support Zambia’s 95-95-95 strategy to achieve epidemic control.

Charles R. Drew University of Medicine and Science

CDU’s focus was on supporting and improving linkage and retention in children and adolescents in the Chawama Level 1 Hospital. Zambia’s PEPFAR Country Operational Plan (COP) 2017 outlined a plan to improve linkages to HIV testing, treatment and care for all age and sex bands, through improved connections with community partners, as well as enhanced referral and follow-up processes.

In support of this, CDU aimed to improve linkage to and retention in HIV care and treatment for 15-24-year-old HIV-positive females. Intervention activities included partnership with existing HIV testing and DREAMS agencies to implement youth friendly HIV peer navigation services that efficiently link newly diagnosed HIV-positives adolescent girls and young women (AGYW) to HIV care, treatment, and psychosocial support.

Howard University School of Medicine

With the Global Health Consortium, HU focused on supporting differentiated ART Care in the Matero Level 1 District Hospital. The COP for 2017 outlined a plan to scale-up differentiated models of HIV care for pediatric and adult patients across 86 districts with the goal of achieving a down-referral of at least 96,783 stable adult HIV-infected individuals and at least 10% of stable pediatric patients into community care and treatment by the end of 2018.

Howard sought to improve the quality of ART care for PLHIV by alleviating congestion through suitable differentiated care models and improving community-based ART services.

Differentiated delivery of ART services assist with decongesting the hospitals and free up more time and resources to initiate new patients and manage unstable patients and patients at risk of failing treatment.

Decongestion allows more enrollment and uptake of ART services contributing to the second 90. Improved and personalized adherence counseling of ART patients contributes to the third 90.

Meharry Medical College

Meharry focused on quality improvement (QI) planning- particularly rapid cycle quality improvement focusing on early diagnosis of infants and children with HIV in Chilenje Level 1 District Hospital.

The overall aim was to implement continuous QI in patient-centered care by assessing the timeliness, initiation of HIV testing, and ART for infants and children, and assessing the retention in care and viral load suppression of patients through quality improvement measures. Performance measures were established with clinic staff for QI in the clinic, especially for infants.

Quality improvement and practice transformation assist with identifying infants and children earlier in the care continuum and improve health outcome (first 90). By diagnosing infants within six weeks and improving the clinic flow for patients receiving ART, crowding will be decreased- giving way to an increase in uptake of ART services, which will contribute to the second 90. Improved and personalized adherence counseling for infants, children, and adult ART patients will contribute to the third 90.

Morehouse School of Medicine

During the initial phase of the Global Health Consortium project, MOSM’s focus was on optimizing HIV related clinical outcomes with better care coordination in the Kanyama Level 1 District Hospital’s ART Clinic.

MOSM sought to increase the 1st 90 for early initiation of ART and improve retention and care for 2nd and 3rd 90s. Also, to improve HIV testing rates, patient retention, anti-retroviral treatment and viral load testing/reporting through workflow re-design; as well as encourage better care coordination and improved integration and reliability of data management related to the SmartCare electronic health record system in Kanyama Hospital and Zambia District ART Clinics.

Improving the diagnosis, tracking, notification, and overall engagement of ART patients to increase the utilization of comprehensive ART services. Data collection and management will also be improved to enhance the care continuum for better care coordination and health outcomes.

To read more on this project, click here.

Certificate Program in Laboratory Leadership & Management
(2016 – 2019)

AIHA collaborated with the International Training and Education Center for Health (I-TECH) and the University of Washington (UW) to implement a 9-month project to strengthen the leadership and management skills of Zambian laboratory staff in management positions as a way to empower them to make meaningful improvements to their laboratory’s operations.

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In Zambia and many other low-resource countries around the world, insufficient leadership skills and lack of effective management practices among clinical and public health laboratory managers and directors represent major barriers to the effective provision of high-quality laboratory services. These critical health services underpin timely detection, surveillance, and response to infectious diseases, such as HIV and TB.

Under the Twinning Center program, AIHA began collaborating with the International Training and Education Center for Health (I-TECH) and the University of Washington in 2016 on a project to strengthen the leadership and management skills of Zambian lab staff currently in management positions as a way to empower them to make meaningful improvements to their laboratory’s operations.

The 16 individuals who each earned a Certificate in Laboratory Leadership and Management from the University of Washington in November 2016 were drawn from Ministry of Health public health laboratories earmarked for international accreditation. They enrolled in the course in March 2016 and spent nine months strengthening their skills in quality assurance practices; application of diagnostic technologies; data analyzation and interpretation; and communication of results and impacts. Developed and conducted by I-TECH, this program features a blend of distance learning and face-to-face training activities, along with targeted mentorship to foster professional growth. 

To read the final closeout report of AIHA’s Twinning Center Program, click here.

Building Capacity in Biomedical Technology to Improve Quality of Care
(2016 – 2019)

In collaboration with the Kenyan company, Biologics, we implemented a preliminary training on routine maintenance, repair, and calibration of non-automated laboratory equipment for 26 biomeds. AIHA procured and distributed toolkits to the 17 Ministry of Health labs seeking accreditation and conducted a study tour that brought three key biomedical personnel to our partner sites in Ethiopia as a way to expose them to more advanced biomedical engineering programs.

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Drawing on our experience implementing projects designed to strengthen local capacity in biomedical engineering and technology in Ethiopia, Kenya, and Uganda, AIHA began supporting efforts to ensure Zambia’s public health laboratories achieve accreditation in 2016.

In collaboration with the Kenyan company, Biologics, we implemented a preliminary training on routine maintenance, repair, and calibration of non-automated laboratory equipment for 26 biomeds. AIHA procured and distributed toolkits to the 17 Ministry of Health labs seeking accreditation and conducted a study tour that brought three key biomedical personnel to our partner sites in Ethiopia as a way to expose them to more advanced biomedical engineering programs.

This was an important learning experience that is supporting the development of strategies that will move the project forward. In the coming year, partners will continue training activities and work to create two calibration centers with the overarching goal of increasing the Ministry’s capacity to maintain and repair laboratory equipment critical for HIV testing, diagnosis, and treatment as the country works to attain global 90-90-90 targets. 

Chreso Ministries / University of South Carolina
(2015 – 2019)

Partners are working together to strengthen the capacity of Chreso Ministries to mitigate the impact of HIV/AIDS on key populations, including men who have sex with men (MSM); commercial sex workers (CSWs); people who inject drugs (PWID); and lesbian, gay, bisexual, and transgender (LGBT) individuals. Key objectives are to increase awareness and understanding among health and allied care providers as a way of improving access to health and social services and to reduce the stigma and discrimination experienced by these high-risk groups.

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According to UNAIDS, between 40-50 percent of all new HIV infections among adults worldwide occurred among key populations, including men who have sex with men (MSM), commercial sex workers (CSWs), people who inject drugs (PWID), and lesbian, gay, bisexual, and transgender (LGBT) individuals and their immediate partners.

In low-income countries, these key populations often face the additional burden of widespread stigma and discrimination in healthcare settings and criminalization of substance use, sex work, and same-sex sexual behaviors.

These social and structural realities create high-risk environments that undermine public health goals, violate human rights, and limit safe and effective provision of HIV prevention, care, and treatment services. With support from CDC/Zambia, AIHA’s Twinning Center launched a that linked Chreso Ministries with University of South Carolina to assess barriers to care and help mitigate them.

Together, partners met with members of key populations support groups and communities to gain a better understanding of their needs, as well as critical gaps in services they face on a day-to-day basis. They then conducted sensitivity training workshops for Chreso healthcare workers to strengthen their capacity to provide client-centered medical and psycho-social support services to these high-risk individuals.

A Chreso Ministries team traveled to South Carolina, where they learned about model psycho-social support services and HIV prevention, care, and treatment interventions their partners and other community-base organizations had in place to meet the unique needs key populations.

In 2016, partners developed a sensitivity training package adapted to the Zambian context and implemented a comprehensive schedule of training sessions based on Chreso’s needs. They also conducted onsite mentor- ing on the provision of quality, comprehensive, and client-centered care for key populations and worked to enhance responsiveness to their needs at Chreso Ministries sites through the creation and support of consumer advisory boards.

To read the final closeout report of AIHA’s Twinning Center Program, click here.

University Teaching Hospitals, Lusaka and Livingstone / Center for International Health
(2006 – 2019)

Partners are working to improve ART and related care for children living with HIV by training pharmacists at two Pediatric HIV/AIDS Centers of Excellence and better integrating them into HIV care teams. They are also building local capacity to implement ongoing professional development and training opportunities.

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With support from CDC/Zambia, AIHA began working with the University Teaching Hospital (UTH) in Lusaka and Livingstone Central Hospital (LCH) in 2006, linking them with the Milwaukee-based Center for International Health (CIH) to improve the quality of services provided by pharmacists at the Pediatric ART Centers of Excellence at both Zambian institutions. In 2014, AIHA graduated CIH upon successful completion of their technical assistance objectives and has since been providing direct support to UTH and LCH through our HIV/AIDS Twinning Center Program.

From day one, a key objective of this project has been to develop in-country training capacity that enables pharmacists to more effectively organize and manage pharmacy services as a way to better ensure high quality HIV-related treatment and care to mothers, infants, and children.

In support of this objective, partners have been continually working to better integrate pharmacists into multidisciplinary HIV/AIDS care teams at both hospitals. To this end, partners have established six satellite pharmacies — including a Pediatric ART Satellite Pharmacy at UTH — to improve access to both medications and expert advice in selected wards.

AIHA established Knowledge Management Centers (KMCs) at both institutions and facilitated training for pharmacists on evidence-based medicine, online resources, and searching techniques. We’ve also provided targeted training on the use of Lexicomp, an online database that provides clinical information, including drug usage guidelines that help health professionals make safer, faster care decisions.

In 2016, AIHA supported UTH and LCH as they shifted their focus to clinical mentorship, with both institutions serving as centers of excellence in delivering HIV/AIDS pharmaceutical care. Local experts trained in partnership with CIH continued to roll out training and mentorship activities for pharmacists and pharmacy assistants working at provincial level health sites throughout Zambia. Currently, partners are working to launch an adolescent disclosure project, as well as a therapeutic drug monitoring project with both pharmacies.

In response to local needs, LCH’s pharmacy team is also providing clinical pharmacy training and mentorships in all correctional facilities situated in Southern Province as a way to ensure the high-risk inmate populations have access to quality HIV and TB care and treatment. In particular, partners are working to develop the capacity of selected prison wardens and CHWs to act as trainers and mentors fully capable of assisting others with uptake of the system. They are also training a peer support network among specific inmate patient groups to strengthen treatment uptake and adherence, as well as working to assure continuity of care for prisoners who are on treatment and released.

To read the final report of AIHA’s Twinning Center Program, click here.

Zambian Defense Forces Learning Resource Center Initiative
(2005 – 2019)

Building on an existing relationship between the Zambian Defense Force and the US Department of Defense, this AIHA initiative is working to improve HIV treatment and care for military personnel and their families by improving access to evidence-based medical resources through information and communication technologies and telemedicine.

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AIHA has been collaborating with Zambian Defense Forces (ZDF) military medical personnel since 2005 with support from the US Department of Defense. We’ve been providing direct assistance since 2007 on a broad range of technical areas, including pre- and in-service training at the Defense School of Health Sciences in HIV care and treatment, injection safety, infection control, emergency medicine, and telemedicine, as well as targeted initiatives to improve rates of retention in care for PLHIV.

Supporting Telemedicine

ZDF oversees more than 50 clinical health sites, many situated in rural areas far from referral hospitals where specialized care can be accessed, so it is well-positioned to take the lead on telemedicine and other technology-driven health initiatives.

In underserved rural areas, telemedicine can greatly improve access to care, reduce morbidity and mortality rates, and improve quality of life for both the military and local civilian populations that ZDF clinics serve.

In 2014, AIHA and ZDF began collaborating with the Georgia-based Global Partnership for Telehealth on a groundbreak- ing locally-driven, locally-owned telemedicine program designed to improve access to quality care by linking clinics or care providers to central referral hospitals. Launched in September 2015, the ZDF telemedicine program links experts at Maina Soko Military Hospital in Lusaka with health staff at five sites across the country to improve the quality of diagnostics and treatment services at these military clinics.

Tracking Patients Lost to Follow-up and Reengaging Them in Care

In 2016, AIHA began working with ZDF’s HIV/AIDS Secretariat to implement another technology-driven project under PEPFAR’s Accelerated Childhood Treatment (ACT) Initiative. This intervention focuses on reducing loss to follow-up among children living with HIV and their mothers.

AIHA contracted US-based software company Zerion to assist with a needs assessment and create a mobile application to track patients. In September 2016, AIHA piloted the app — which enables health workers to input a patient’s national SmartCare identification number, address, demographic information, date of follow-up appointment, and name of the communi- ty health workers (CHW) assigned to the case — at ZDF sites in Kabwe, Lusaka, and Ndola.

CHWs receive an alert prior to a patient’s next appointment, so they can follow up with him or her as a reminder. The app also allows facility health workers to input the names and information of patients who are lost to follow-up (LTFU), so CHWs can redouble efforts to either bring them back into care or provide an explanation for why they are no longer on treatment.

Currently there is little data on loss to follow-up in Zambia. This mobile platform may help change that, while at the same time facilitating more effective monitoring, evaluation, and reporting. At present, health workers are manually linking patients tracked through the app to SmartCare, but in the coming months, AIHA and ZDF will work toward automated integration into the national SmartCare system.

Bolstering In-service Training Capacity

Over the course of our partnership with ZDF, AIHA has been working closely with the Defense School of Health Sciences and Zambia’s Ministry of Health on the development of training packages for a number of clinical disciplines, including developing a National Curriculum for Emergency Services, which is already being used. Similarly, AIHA supported the school’s efforts to draft curricula for injection safety and infection prevention, which are currently being implemented by faculty.

Strengthening Knowledge Management to Support Improved Health Outcomes

AIHA’s earliest collaboration with ZDF focused on establishing Knowledge Management Centers (KMCs) at clinical sites to empower healthcare personnel through access to a wealth of up-to-date clinical research, texts, case studies, protocols, and other evidenced-based resources that can guide their practice and improve quality of HIV-related care and treatment outcomes.

AIHA supported effective use and scale up of the 21 KMCs we established at ZDF sites by providing targeted training on evidence-based medicine, emergency medicine, proper research protocols, online resources, and other relevant topics both through workshops and distance learning courses.

In alignment with PEPFAR 3.0 goals and objectives, AIHA transitioned many KMCs into Monitoring and Evaluation Hubs to better support data-driven interventions and outcomes. This strategic shift is helping ensure effective use of resources for data management to enhance quality im- provement in HIV service delivery at the facility level. AIHA is providing focused training in data analysis, interpretation, and use to meet the daily needs of ZDF end-users, which addresses a serious gap in capacity to interpret and act on data to drive program surveillance and quality assurance processes. Other KMCs are being transitioned to adolescent- focused centers to support adherence and healthy lifestyles based on community needs.

To read the final closeout report of AIHA’s Twinning Center Program, click here.

 

Zambia Rising
(2013 – 2017)

AIHA was part of the USAID-supported Zambia Rising Project led by Save the Children. Zambia Rising worked in coordination with two other USAID projects (Data Rising and Community Rising); all three were designed to strengthen local systems and capacity to improve the quality of life for orphans and vulnerable children (OVC) living in Zambia.

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Lack of full access to health services, proper nutrition, and education, paired with high unemployment rates have threatened Zambia’s stability, putting far too many children at risk. UNAIDS estimated that there are 95,000 children in Zambia who are living with HIV.

AIHA supported institutionalization of the social work profession in Zambia by strengthening the Social Workers Association of Zambia (SWAZ). We worked closely with SWAZ staff to determine requirements for establishing a national office, engaging a Board of Directors, setting up a schedule of regular meetings, and other organizational capacity development activities. We also worked with SWAZ and the University of Zambia on educational requirements, continuing education, and other matters related to profession- al standards and accreditation. Collectively, these efforts supported SWAZ’s goal to build membership, advocate for the social work profession, and become a self-sufficient, self-sustaining association.

Zambia Institute of Mass Communication Educational Trust / University of Kentucky School of Journalism
(2008 – 2014)

Partners are working to build ZAMCOM’s capacity as a media training institution with the objective of increasing public awareness about HIV/AIDS through improved media coverage of the epidemic.

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AIHA first started working with the Zambia Institute of Mass Communication Educational Trust (ZAMCOM) in 2005, piloting training courses to improve local media coverage of HIV/AIDS-related topics.

In 2008, we partnered ZAMCOM with the University of Kentucky School of Journalism and Telecommunications with the goal of strengthening its organizational capacity to train journalists on HIV/AIDS reporting, as well as on reporting techniques and print and broadcast production.

Partners worked to improve training programs based on ZAMCOM’s strategic goals, training some 200 Zambian journalists on accurate HIV/AIDS reporting. They conducted a series of workshops in Chipata, Kitwe, and Livingstone to train community members to produce radio programs on HIV and other critical public health issues and provided training for staff at community radio stations throughout the country, along with targeted prevention messages that were translated into local languages.

In October 2011, the partners launched the “Newspaper in Education” project in close cooperation with Zambia’s Ministry of Education and the Zambia Daily Mail to improve classroom access to reading material and teaching resources — in particular on health topics and gender- based violence.

This partnership, which graduated in 2014, worked closely with another AIHA twinning partnership that linked ZAMCOM with the Media Institute of Southern Africa (MISA) in Botswana to implement a pan-African public HIV/AIDS awareness campaign called “Hearts & Minds.”

To read the final closeout report of AIHA’s Twinning Center Program, click here.

Palliative Care Alliance of Zambia / African Palliative Care Association
(2005 – 2014)

This south-south partnership worked to develop institutional and human resource capacity at PCAZ and position the organization as a leading advocate for national palliative care policies and standards throughout Zambia. In September 2010, PCAZ began receiving direct funding from AIHA’s Twinning Center to continue their efforts to strengthen palliative care throughout Zambia.

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Partners at the Palliative Care Alliance of Zambia (PCAZ) have emerged as a leading advocate for promoting national palliative care standards and policies in Zambia, thanks in part to an AIHA Twinning Center partnership with the Uganda- based African Palliative Care Association (APCA) that was funded from 2005 to 2010.

In September of 2010, AIHA began providing direct funding to PCAZ to support their efforts to strengthen palliative care throughout Zambia. To this end, we established a Knowledge Management Center (KMC) at PCAZ in 2011 to provide staff and other parties with access to a wide range of evidence-based resources, research, and other material that can help strengthen palliative care throughout Zambia.

The main objectives of this highly successful twinning partnership were to develop the organizational and human resource capacity of PCAZ and its staff; promote best practices in palliative care; and create broader awareness through expanded advocacy and information dissemination efforts.

Over the years, PCAZ ushered in many positive changes in the country. Key accomplishments include the development of a morphine fact book for Zambia and resource material on morphine use, as well as a chapter on pain management for the NAC Care Treatment and Prevention guidelines.

PCAZ spearheaded the development of the Palliative Care National Strategic Plan and co-authored an article on palliative care that appeared in both the Zambia Daily Mail and Times of Zambia, which coincided with the 10th African Growth and Opportunity Act.

In addition, PCAZ developed the country’s first draft Pediatric Palliative Care Curriculum, which was piloted through a training-of-trainers course for 15 health professionals. They also developed data quality management tools to strengthen their services to hospices, facilitated palliative care sensitization workshops for hospice and clinic workers, and finalized the Palliative Care National Strategic Plan.

In the final years of their participation in AIHA’s technical assistance program, PCAZ focused on providing strategic plan- ning and development trainings to enhance hospice capacities, as well as their own visibility through clearly documented plans. Another priority during their sustainability phase was economic strengthening through a pilot project that sought to ensure better recognition of palliative care providers, who are the unsung heroes of the health system.

To read the final report of AIHA’s Twinning Center Program, click here.

Zambia HIV/AIDS Media Initiative
(2005 – 2006)

In partnership with the Zambia Institute of Mass Communication Educational Trust, this innovative initiative focused on improving the accuracy, quality, and scope of HIV/AIDS-related coverage in mass media outlets throughout Zambia and other PEPFAR-supported countries by training journalists and editorial staff.

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HIV/AIDS media coverage in Zambia has long lacked the depth and innovation the subject matter demands. Many working reporters have no formal journalism training. Most reporters are unfamiliar with even basic information about HIV and its far-reaching implications for every sector of society.

In 2005-2006, with the support of PEPFAR and the US Embassy in Lusaka, AIHA collaborated with the Zambia Institute of Mass Communication Educational Trust (ZAMCOM) to build mass media capacity by training both print and broadcast journalists.

In July and August 2005, ZAMCOM brought 60 Zambian journalists to Lusaka for skills-based trainings facilitated by two experienced American journalists. The trainings were conducted in two 11-day sessions, each attended by 30 media professionals. This was the first time a media training of this type was held in Zambia.

These trainings consisted of presentations by physicians, policymakers, statisticians, economists, educators, civic leaders, and PLHIV. They also provided time in the field for gathering information and conducting interviews in two high-burden towns — Kafue and Kapiri-Mposhi — before returning to ZAMCOM campus to produce stories about the impact of HIV/AIDS in communities throughout Zambia.

Training materials and additional technical assistance for this project were provided by the Kaiser Family Foundation.

More than 80 stories were produced during the two workshops and published or broadcast. Some 30 more were subsequently produced. Various media outlets created HIV/AIDS desks and initiated new columns or programs as a result of this initiative and two participants received national recognition for producing the best HIV-related stories of 2005.

The way you feel charged up today is the way you must be every day. You must treat every day like World AIDS Day.”

— Chilufya Mwamba-Phiri, a long-time AIDS activist in Zambia, challenging journalists and editors to take their coverage of the epidemic more seriously during her presentation at ZAMCOM’s Editorial Leadership in HIV/AIDS Reporting for PEPFAR Countries workshop, in Lusaka, December 1, 2006.

Through the initial trainings and a follow-up meeting conducted in January 2006, a number of challenges that impede accurate and effective coverage of Zambia’s HIV/AIDS epidemic were identified, including:

  • Limited access to information, expert sources, and PLHIV who are willing to speak on the record about their situation;
  • Financial constraints and lack of necessary resources; and
  • Editors and other supervisors who claim the public has no interest in stories about HIV/AIDS.

As a result, people in Zambia do not always have access to potentially life-saving information about HIV-related prevention, treatment, and support services.

AIDS is a story that touches all sectors of society and must be covered as such. Mass media can — and should — work to shine a spotlight on the epidemic’s impact on society. Targeted training, professional development, and access to key information sources play a critical role in improving the quality and scope of HIV coverage by the mass media.

Combining journalism theory, practice, production, and ethics with expert sessions on HIV-related topics can build capacity among reporters and awareness among editors, thereby improving public access to accurate and useful information.

In addition, government officials, along with healthcare policymakers and providers, need to understand the value of the mass media for getting information about HIV prevention and treatment options disseminated to the public and forge mutually beneficial working relationships.

The training model used by ZAMCOM proved to be highly effective with both national and regional implications for improving media coverage of HIV/AIDS and other health-related stories.

The following two posters based on AIHA’s Zambia HIV/AIDS Media Initiative were accepted for presentation at the XVI International AIDS Conference held in August 2006 in Toronto, Canada:

In addition, PEPFAR included an article about the impact this groundbreaking initiative had on Ugandan journalist Elvis Basudde in its Stories of Hope series.