Zambia at 20: Celebrating Lifesaving Partnerships on World AIDS Day

Here at PCI, we envision an AIDS-free generation and an end to the AIDS epidemic. And this World AIDS Day, we’re celebrating the significant progress made to end HIV/AIDS worldwide – and specifically highlighting our impact in Zambia.

Since the early 1990s, we’ve been active in the HIV/AIDS response and our work spans the range of prevention, care, treatment and support interventions in several countries around the world including three in sub-Saharan Africa. PCI began working in Zambia in 1996, and quickly established a strong reputation for integrated, community-based programming. PCI-Zambia builds the capacity of civil society organizations, government institutions and communities to address needs in health, nutrition, livelihood, education, and gender inequities particularly in vulnerable and hard-to-reach groups.

Working with existing networks and community structures, PCI and partners build local capacity in the fight against HIV/AIDS and support individuals with resources and skills to empower their families and better serve their communities.

We are equipped now more than ever to fight AIDS and to empower individuals and families to live healthier and more hopeful lives.

Highlights from our Zambia HIV/AIDS Programs for over 20 Years:

Capacity Strengthening of Local NGOs and Networks to Prevent the Spread of HIV/AIDS
In 1996, USAID funded PCI to implement an HIV Capacity Strengthening program in four urban and one rural high prevalence districts. PCI formed the first ever District AIDS Task Forces in Kitwe, Ndola, Lusaka, Nchelenge, and Kabwe to coordinate multi sector responses to the pandemic. These structures were later adopted by the National AIDS Council and remain the district level coordinating structures operating in all districts today. PCI also launched the Zambia Interfaith Network Organization (ZINGO), a network of different faith groups in Zambia working collaboratively to plan and coordinate faith-based HIV prevention, care and support interventions. In 2000, HIV/AIDS was devastating Zambia. With funding from USAID PCI launched BEACON (Building Effective AIDS Coalitions, Organizations and Networks) to enable local NGOs to strengthen their capacity to manage themselves, access resources, and become more effective and sustainable in delivering HIV/AIDS services. These local coalitions played a critical role in stemming the tide of the epidemic reaching over 11,000 People Living with HIV (PLHIV) and Orphans and Vulnerable Children (OVCs) with care and support services in Lusaka and Nchelenge Districts. PCI also developed the Integrated System for Assessment and Transformational Results (I-STAR) to measure the success of the programs.

Empowering girls in Botswana

Home-based Care for People Living with HIV/AIDS
In 2000 with Community Reach, PCI took the fight against HIV/AIDS to communities and PLHIV in their homes. Between 2002 and 2005, PCI partnered with PACT, JHPIEGO, and the Bwafwano Community Home-based Care Organization to more than triple the number of PLHIV receiving care in their homes. Bwafwano became a model for community based organizations providing home based care to people living with HIV/AIDS, and the program extended their reach beyond Lusaka district to Lusaka province and Central province. More than 100 caregivers were trained in quality home-based care services, and the first ever national standardized home based care training materials were developed for national use. The program also resulted in a nearly seven-fold increase in the treatment of Tuberculosis patients.

Adherence and Nutritional Support for Clients on HIV/AIDS Treatment Program
In 2004, with funding from the U.S. Center for Disease Control and Prevention (CDC) and the World Food Program, PCI implemented the ART Adherence and Nutritional Support program with the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) and the Centre for Infectious Disease Research in Zambia (CIDRZ) in Lusaka and Western provinces. The Project adapted and integrated the home based care DOTS model into ART programs in all main primary health centers in Lusaka and Mongu districts. Coupled with nutritional support for the food insecure ART patients, the program improved both adherence to therapy and care of clients enrolled by 90 percent.

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Fighting HIV/AIDS and Cervical Cancer within the Military
PCI has partnered with the Zambia Defense Force with U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) funding through the U.S. Department of Defense in support of HIV/AIDS prevention and care programs with the Zambia Defense Force and the surrounding civilian communities for more than a decade in all ten provinces. Through peer education and community mobilization, PCI has reached over 71,000 individuals with HIV prevention messages and tested over 48,000 for HIV through mobile counseling and testing in military camps and surrounding communities. Interventions address gender and cultural norms that drive HIV transmission and Gender Based Violence. Using the index client HIV testing approach, PCI extends HIV prevention, care, and treatment services to OVCs and children of ART clients. PCI also support Orphans & Vulnerable Children through caregivers with social protection, psychosocial support, nutrition screening, counseling and support, and linkages to facility-based HIV treatment, care and support services. Through the DHAPP program, PCI received plus-up funding from USAID in 2009 to develop “Say and Play”, a model that focuses on reaching children under five years of age with psychosocial support services. PCI developed “Say and Play” training and counseling guidelines. PCI’s work under this project has taken on an increasingly clinical focus. As women with HIV are five times more likely to develop cervical cancer, PCI is working to provide cervical cancer screening and treatment in some of the most remote corners of the country through mobile clinic services. Over the past five years, PCI has screened more than 16,000 women for cervical cancer and treated nearly 700 women, ensuring their children have mothers to continue caring for them. PCI works through community volunteers in Safe Motherhood Action Groups (SMAGs) to ensure pregnant women are tested for HIV and those who are positive and “lost to follow up” are traced in the community to ensure they access PMTCT services. PCI has recently been awarded a new four-year project to strengthen laboratories and supply chain management with the Zambian Defense Force to enhance ZDFs ability to contribute towards Zambia reaching the UNAIDS 90:90:90 targets on HIV.

Educating a Healthy New Generation of Orphans and Vulnerable Children
In 2004, under PEPFAR with funding from USAID, PCI implemented BELONG (Better Education and Life Opportunities for Vulnerable Children through Networking and Organizational Growth) in the Western and Lusaka provinces to educate OVCs through school and home-based care about good nutrition and health. The program reached over 250,000 children and nearly 16,000 caregivers with direct services in nutrition, education, psycho-social support, child protection, and health. To ensure these programs would continue to grow, PCI’s work strengthened over 500 local community and faith-based organizations, 200 schools, and 15 existing local organizations. PCI trained community school teachers in Early Childhood Development methodologies and provided caregivers and older OVCs with economic empowerment opportunities. More than 200 women’s savings groups were formed so mothers could create businesses and better care for their families.

Photo by Jeffrey Lamont Brown

Providing a Safety Net for Kids Living on the Street
In 2001 with a grant from NetAid, PCI worked with local partners to tackle the growing problem of street children and orphans. In the beginning, more than 2,000 children received food, shelter, health care, and opportunities for education and vocational training. The success of this model established PCI’s Africa KidSAFE (Shelter, Advocacy, Food and Education) initiative with support from USAID’s Displaced Children’s and Orphans Fund (DCOF). PCI led a network of 18 local organizations to coordinate and improve the provision of street and facility-based services for more than 10,000 OVCs involving both public and private support and advocated for this highly vulnerable group. Together the coalition carried out activities including mobile health clinics, street outreach programs, and economic empowerment activities targeting vulnerable households, and reuniting street children with their families when possible. Together, KidSAFE partners successfully advocated for the establishment of Zambia’s first professional association for child care workers and national legislation for children’s rights.

Partnering with Churches to Stop HIV/AIDS
HIV/AIDS is a highly sensitive topic, and churches play a critical part in curbing the epidemic. Through CDC, PCI worked with the Evangelical Fellowships of Zambia (EFZ) and Zambia Episcopal Conference (ZEC) in 26 churches in eight districts in Southern and Western provinces to lead HIV prevention activities and strengthen linkages between communities and HIV care and treatment facilities under the Church Partnerships for Positive Change (CPPC) project. The project reached nearly 20,000 individuals with HIV prevention messages with over 3,000 individuals in testing and counseling and 8,000 women completing referrals for Prevention of Mother to Child Transmission (PMTCT) services. Group incentives were highly effective in motivating Church communities to reach their targets. One unexpected outcome was that many church members and leaders disclosed they were living with HIV/AIDS and encouraged others to be tested.