PCI began operations in Zambia in 1996, and quickly established a strong reputation for integrated, community-based programming. We build the capacity of civil society organizations and other networks to address multi-sectoral needs such as health, nutrition, livelihoods, education, and gender inequities.
According to UNAIDS, 1.2 million Zambi¬ans are living with HIV, out of a total popu¬lation of only 17 million people. Zambia has made progress in recent years with a decrease in AIDS-related deaths and a decrease in the number of new HIV infections. However, women in Zambia remain disproportionally affected by HIV and account for 58% of current infections. The vast majority of those infected are people in the prime of life and their income and roles as parents are critical to the survival of families and society. The loss of so many parents has left an estimated 400,000 children orphaned.
Zambia also has one of the highest rates of cervical cancer in the world. Efforts on behalf of the Zambian Ministry of Health and the U.S. President’s Emergency Fund for AIDS Relief (PEPFAR) have brought services for cervical cancer screening and treatment to many facilities in urban areas, but access in rural areas remains extremely low.
PCI began operations in Zambia in 1996 and quickly established a strong reputation for integrated, community-based programming focused on strengthening local capacity. Through a community-led and client-centered approach, PCI works with community-based organizations, faith based organizations, and the local government to cohesively and sustainably respond to the health and socioeconomic needs of People Living with HIV/AIDS (PLHIV), vulnerable children, adolescents, caregivers, and households. PCI strengthens community and primary health systems so that communities are prepared to prevent and respond to HIV and related health issues, co-morbidities and pandemics as they emerge, such as COVID-19. Over the years, PCI has integrated nutrition, maternal, neonatal and child health (MNCH), tuberculosis (TB), cervical cancer screening, and family planning interventions into its HIV/AIDS programs. Additionally, through women’s empowerment and livelihood programs, PCI is mobilizing communities to be resilient to shocks and socioeconomic vulnerabilities, while also raising awareness about harmful gender and cultural norms.
Preventing Cervical Cancer in Women Living with HIV/AIDS
Women living with HIV are at least five times more likely to develop cervical cancer than their HIV-negative peers, and they are twice as likely to die from invasive cervical cancer within three years. In Zambia, the national HIV prevalence is 12.1% – a rate which doubles when looking exclusively at the military population. Since 2011, with support from PEPFAR and Pink Ribbon Red Ribbon Initiative, and in partnership with the U.S. Department of Defense HIV/AIDS Prevention Program, PCI has been strengthening the primary health care system of the Defence Forces of Zambia (DFZ) to integrate cervical cancer screening services into routine clinical care for women living with HIV. Military nurse-midwives and doctors are now using the “screen and treat” approach to reach HIV-positive women with lifesaving cervical cancer screening and treatment services. Through this low-cost/low-tech approach, the DFZ has expanded cervical cancer screening services to reach over 35,000 women living in the remotest parts of Zambia and has strengthened referral systems between screening facilities and hospitals.
Laboratory and Supply Chain Systems Strengthening
PCI is also working with the Defence Forces of Zambia to strengthen laboratory quality management systems and HIV commodity supply chain management systems in 45 primary health centers. Through this program, primary health systems are strengthened to ensure reliability and accuracy of HIV diagnostic and related tests including viral load, CD 4 count, hematology, chemistry, and TB testing. PCI has also supported the development of an automated supply chain management system in over 30 primary health centers so that they can provide an uninterrupted supply of lifesaving HIV/AIDS treatment and prophylactic drugs to PLHIV.
Strengthening Local Capacity to Care for Vulnerable Children and Adolescents
Since 2004, PCI has strengthened local organizations, community schools, health centers, and government institutions to empower communities to more effectively care for vulnerable children and adolescents (VCA). Through a bottom-up approach, PCI has networked and strengthened the capacity of over 200 CBOs and affiliated primary care centers and government welfare committees and trained over 500 case workers to provide frontline integrated HIV and social services that strategically prioritize community key health and socioeconomic needs. Most recently, PCI’s DHAPP-funded Integrated Community HIV/AIDS Program reached over 40,000 PLHIV and 10,000 VCA and their caregivers with integrated HIV/AIDS, prevention of mother to child transmission, TB, MNCH, and nutrition services across all ten provinces in Zambia. With strengthened capacity to target identification of new HIV cases, Community Health Workers identified over 3,000 HIV-exposed infants who were provided with community-based early infant diagnosis.
Women’s Empowerment and Economic Strengthening
To further support households with VCA, PCI provides linkages to savings groups, loans and short-term cash incentives through PCI’s Women Empowered Savings Group model and the Government/European Union-supported social cash transfer program. To date, PCI has supported Zambian women to form 363 Women Empowered savings and lending groups (representing 7,776 members) who have collectively saved approximately $7 million US dollars.
Recent Program Highlights
Partnering with Churches to Reduce HIV/AIDS Transmission:
With funding from the US Centers for Disease Control and Prevention (2010-2015), PCI partnered with church communities in Southern and Western Provinces to decrease HIV transmission. The project demonstrated that effective church-led community mobilization and provision of capacity building and mentoring to church leaders is an effective and sustainable HIV prevention strategy – reaching nearly 20,000 individuals with HIV prevention messages, as well as referrals, testing and counseling.
Saving Mothers, Giving Life:
As part of the global initiative Saving Mothers, Giving Life, PCI strengthened the capacity of seven primary health centers located in districts in Zambia with high neonatal and maternal mortality rates and mobilized community-based Safe Motherhood Action Groups to deliver a continuum of quality facility- and community-based MNCH services. As a result of the program, which ended in 2015, the number of deliveries in the targeted areas with access to skilled personnel nearly tripled and the number of women receiving antenatal care increased from 134 to 670.
Local Capacity Strengthening to Combat Malnutrition:
PCI strengthened the capacity of 15 community-based organizations in Kitwe District to provide critical, life-saving support to adults living with HIV and VCA suffering from acute malnutrition. As part of a district-wide Nutrition Assessment Counseling and Support (NACS) program (2013-2015), PCI trained over 150 community nutrition supporters to identify malnourished HIV-positive pregnant and lactating women, PLHIV, and children and link them to facility-based therapeutic treatment services.
Globally, one woman dies of cervical cancer every two minutes. [...]