According to UNAIDS, 1,200,00 Zambians are living with HIV, out of a total population of only 15 million people. The vast majority of those infected are people in the prime of life, whose income and roles as parents are critical to the survival of families and society. The loss of so many parents has left an estimated 310,000-450,000 children orphaned. Even when extended family members will take them in, many of these children are at risk for neglect and often turn to the streets to support themselves and their families.
Additionally, WHO/UNICEF reports that 68% of Zambians do not have access to clean water and almost half of the population lacks access to proper sanitation facilities. Floods and droughts worsen sanitation as well as food insecurity problems, leading to higher morbidity and mortality.
PCI began operations in Zambia in 1996, and quickly established a strong reputation for integrated, community-based programming. PCI builds the capacity of civil society organizations and network to reach vulnerable and hard-to-reach groups, including street children and the military, to address multi-sectoral needs such as health, nutrition, livelihoods, education, and gender inequities. By leveraging strategic partnerships with church networks and existing community structures, PCI and partners are building local capacity to sustain a long-term response to HIV/AIDS. Additionally, through social and economic empowerment opportunities, PCI is equipping individuals with the resources and skills they need to support their families and better serve their communities. In addition, PCI is mobilizing communities, local NGOs, and the government to better prepare for, and respond to, natural disasters such as drought and floods. PCI currently implements activities in all 10 provinces of Zambia.
HIV/AIDS PREVENTION, CARE AND SUPPORT
Through support from the U.S. Department of Defense HIV/AIDS Prevention Program, PCI launched a groundbreaking program in 2003 to build the capacity of the Zambian Defense Force (ZDF) to design, implement and evaluate HIV/AIDS behavior change and care activities for its 30,000 uniformed personnel, their family members and surrounding communities. PCI provides technical assistance to the ZDF Medical Services to utilize innovative, evidence-based prevention methods such as theater, music, workshops, and educational materials to promote behavior change and create awareness about HIV prevention, treatment, care and support among this high risk group. Through these activities, the project provides its target population with key linkages to facility-based post-exposure prophylaxis, paralegal services with the Victim Support Unit under the Zambia Police, and counseling services.
In recent years, PCI’s work has taken an increasingly clinical focus. In addition to supporting ZDF in conducting integrated mobile HIV testing and counseling, rapid diagnostic testing, gonorrhea and chlamydia screening and treatment services, PCI enhances facility-based PMTCT services by training, mentoring and supervising health workers. PCI and ZDF have also integrated a cervical cancer screening, treatment and referral program – the “screen-and-treat” model of the Cervical Cancer Prevention Program in Zambia – into ZDF’s mobile home and community-based treatment program. Over the past five years, PCI has screened over 16,000 service women and civilians for cervical cancer and treated nearly 700 women. Since the beginning of the project nearly 15 years ago, PCI has reached over 71,000 individuals with HIV prevention messages and tested over 48,000 for HIV through mobile counseling and testing at military camps.
HIV CLINICAL LABORATORY SERVICES SCALE-UP
With funding from the U.S. Department of Defense HIV/AIDS Prevention Program, PCI is strengthening the military clinical laboratory system to deliver high quality, accessible HIV testing and treatment monitoring services. ZDF in turn will significantly impact the lives of program beneficiaries through high quality HIV testing, linkage to care, ART uptake, patient monitoring for viral suppression, and other combination prevention.In order to facilitate diagnosis and patient monitoring in health centers that provide anti-retroviral therapy; PCI is helping ZDF to: (1) increase in the competency and capacity of laboratory staff competency and capacity; and (2) establish and manage laboratory quality policy and processes;. PCI is also strengthening the health commodity supply chain system and processes in ZDF health facilities. The program’s capacity building and sustainability approaches will foster a culture of quality, transfer of competencies, systems strengthening, and the transition of program leadership, management and ownership to ZDF for sustained, need-driven implementation.
RECENT PROGRAM HIGHLIGHTS
Church Partnership for Positive Change, 2010-2015: Under this project, funded by the US Centers for Disease Control and Prevention (CDC), PCI strengthened the capacity of church communities in Southern and Western Provinces to decrease HIV transmission. Through partnership with two national church membership organizations – the Evangelical Fellowships of Zambia and Zambia Episcopal Conference – the project established agreements with 26 churches in eight districts to lead HIV prevention activities. Using church structures, the project reached church members with HIV prevention services, including door-to-door HTC, and stimulated local ownership and solutions for reducing HIV transmission. This resulted in increased participation of church leaders and members in HIV prevention activities, increased demand for and referral to HIV services, and increased male involvement in antenatal and prevention of mother to child transmission programs. 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. The project reached 19,743 individuals with HIV prevention messages through church-based discussions. The project also reached 3,057 individuals with testing and counseling, and 7,988 women completed referrals for prevention of mother-to-child transmission (PMTCT) services.
Sustainable Health and Agriculture for Resilient Populations (SHARP), 2013-2015: Funded by USAID’s Office of Foreign Disaster Assistance (OFDA), SHARP strengthened resilience in disaster-prone communities in Southern and Western Zambia by: (1) promoting the adoption of food security practices that reduced vulnerability to climate change risks; (2) fostering improved nutrition uptake through waterborne disease mitigation; and (3) areducing the impact of natural disasters through community-based disaster risk reduction. It also supported and mentored Zambian communities, government entities, and NGOs to ensure sustainable improvements in adaptive capacity.
BELONG, 2004-2010: Through its USAID-funded BELONG project, PCI strengthened 200 community schools, 15 local organizations, and established 210 women’s savings groups in order to empower communities to more effectively care for orphans and vulnerable children. Over the life of the project, PCI and partners provided direct services to over 111,250 orphans and vulnerable children and over 5,000 caregivers. This target was reached by using a cascade approach to quickly build capacity at scale, which involved establishing centers of excellence within select partner CBOs/NGOs which then served to build the capacity of other groups.