This activity is linked to EQUIPII CT (#8848) and will be implemented in an integrated approach with CT activities.

According to the most recent Ministry of Education (MOE) statistical bulletin over 800 teachers died in 2004. In a two year period (2002-2004), the number of deaths of teachers increased by 30%. Using current trends to project, it is estimated that by 2010, 5000 teachers will die annually. To mitigate this potential crisis, AED/EQUIP II provides technical support to the MOE and leverages World Bank ZANARA Project funding and DFID support for HIV/AIDS line ministry workplace activities to build a sustainable MOE HIV/AIDS Workplace Program. This activity is designed to both develop the capacity of the MOE to administer the HIV/AIDS Workplace Program and to provide direct AB messages. The MOE's workforce is critical in continuing education efforts, and includes over 61,000 employees in more than 8,000 schools across the country, some in remote, rural areas with fewer than five staff.

In FY 2005, EQUIP II expanded into the Central and Southern provinces. A total of 9,232 MOE staff attended HIV/AIDS sensitization workshops during this period with a total of 2,126 MOE staff undertaking CT. While these numbers are encouraging they are not reaching the numbers in the rural areas as they were in the first year of implementation in the urban areas. Geographical coverage for schools is extensive and transportation challenges in the rainy season increased in implementation costs, and the component was not fully mainstreamed into the MOE HIV workplace program's overall strategy and workplan. Due to these constraints, the project has worked with the MOE to revise the strategy for FY 2006 in order to reach more MOE employees with AB prevention activities complementing the EQUIP II CT program.

In FY 2007, EQUIP II will continue to reach teachers with AB prevention activities and using lessons learned from previous activities will adjust its strategy in order to meet targets. In order to restructure the program, the EQUIP II staff and MOE HIV/AIDS Unit devised a strategy to create a program within the existing MOE HIV/AIDS Work place program, which was officially launched in July, 2006.

The EQUIP II AB prevention activities will be implemented under the broader MOE program. As this effort includes coordinating activities (delineated below) among multiple partners, including three teachers unions, Society for Family Health, and CHAMP, a full-time staff person working on both AB and CT will be hired to ensure coordination and proper reporting. In addition, this person will work within the MOE offices to provide direct capacity building assistance to employees hired directly under the MOE HIV/AIDS Workplace program via their internal funding.

The position will also help to identify and source IEC materials related to AB for appropriate to MOE staff. The program will first use AB materials already created by MOE and the National HIV/AIDS/STI/TB Council (NAC), and where gaps in effective materials addressing AB messages are identified, new materials will be developed or sourced from other PEPFAR partners in Zambia. The program will also source IEC materials with particular emphasis on stigma and addressing gender variances and roles. In addition, positive teachers groups will be engaged to help raise levels of awareness and directly combat stigma in group-level activities.

Recognizing behavior change is a complex process that requires efforts from multiple fronts, Equip II will include strong education and messaging related to prevention supported by leadership in MOE, offering education, IEC materials and group counseling through easy access events (described below), and peer support for on-going behavior change.

To achieve targets, the program will implement quarterly "Teachers Health Day" in which community health clinics will offer a broad range of health services to teachers and their families. CT will be made available at these events. In addition, group counseling, individual counseling, distribution of IEC materials and education efforts related to AB will be conducted at the events. PEPFAR funds will be used exclusively for the HIV/AIDS related activities, with other funds and resources from ZANARA, MOE, and Ministry of Health leveraged to address broader the health agenda.

In FY 2007, Equip II will reach 20 clinics for Teacher Health days to start and then will add three additional districts each quarter, so that by the end of FY 2007, 32 Districts will be implementing Teachers Health Days on a quarterly basis. Activities will cover five Provinces and 39 out of the 72 districts. While events are proposed on a quarterly basis, it is not anticipated that the same teacher will take advantage of each quarterly event. Rather, it is hoped that teachers will be able to take advantage of one on an annual basis and that within one year at least 2500 individuals would be reached by these events alone. All events will be scheduled during school breaks to accommodate the highest levels of uptake possible.

The communications sent out before the events will come from high-level MOE officials, MOE officials, principals and other community leaders will be called on to reinforce these AB messages prior to an at events.

However, recognizing that sustained behavior change requires more than just support from leaders at one-time events, and should include peer-support and reinforced community norms throughout the year. Building on training activities for focal persons, an estimated 300 people will be trained by the end of FY 2006. EQUIPII will continue to work with these trained focal persons to build their capacity through training, regular communications, and provision of IEC materials to serve as peer-educators. Protocols and standards of effective AB prevention efforts for peer educators will be developed and used to track services provided. As history has shown some difficulty in follow-through and implementation by peer-counselors, a significant effort will be implemented by the program coordinator to continue on-going communications and monitoring of their efforts.

EQUIPII will also create a partnership between the three teachers' unions and MOE to bring HIV-prevention sessions and rallies to union. Educators from within the unions will be trained on providing AB information and counseling to serve as peer-educators and on-going prevention supporters, while events will include experts that will provide overall AB education and group counseling. All individuals will also be supplied with AB IEC materials for distribution at Union Events.

Finally, we will continue with our partnership with CHAMP to specifically bring AB education, HIV-sensitization and testing to schools in urban areas where many teachers can be reached at a single school.

The overall approach of EQUIPII focuses on a philosophy of sustainability. Rather than simply establishing a stand-alone program to meet PEPFAR Targets, our program will be fully integrated into the MOE. Specifically, staff will be housed within MOE offices and work side-by-side with direct MOE employees already engaged on a work-place program. Our staff member will seek not only to ensure tracking of services, but training of MOE staff in relation to PEPFAR indicators and methods for tracking. IEC materials, lesson plans, and strategies will be well documented and housed within MOE's own file systems. While some outside partners will be engaged, the primary partners working on this effort will be the unions and MOE itself, thereby ensuring that the activities are supported by organizations that can continue providing such services long-after funding under PEPFAR has ceased.

This activity is related to EQUIPII HVAB (#9712) and will be implemented in an integrated approach so that AB activities, information and sensitization will be provided to individuals reached for CT regardless of whether they choose to opt for CT.

According to the Ministry of Education (MOE), over 800 teachers died in 2004. Between 2002 and 2004, the number of deaths of teachers increased by 30%. Using current trends, it is estimated that by 2010, 5000 teachers will die annually. To mitigate this crisis, Academy for Educational Development's EQUIP II Project provides technical support to the MOE and leverages World Bank ZANARA Project funding and DFID support to build a sustainable MOE HIV/AIDS Workplace Program. This activity is designed to both develop the capacity of the MOE to administer the HIV/AIDS Workplace program and to provide direct CT services. The Ministry's workforce is critically important in continuing education efforts, and includes over 61,000 employees in more than 8,000 schools across the country, some of which are in remote, rural areas with fewer than five staff.

In FY 2005, EQUIPII expanded its program into the Central and Southern Provinces. A total of 9,232 MOE staff attended HIV/AIDS sensitization workshops with 2,126 undertaking CT (30%). While these numbers are encouraging, EQUIP II faced a number of challenges. It was not able to reach the numbers in the rural areas as they were in the first year of implementation in the urban areas. Geographical coverage for schools is extensive and transportation challenges in the rainy season increased implementation costs. The MOH did not fully mainstream this activity into its workplace program workplan. Due to these constraints, EQUIP II worked with the MOE to revise the strategy for FY 2006 in order to reach more MOE employees with CT and ensure linkages for a comprehensive approach.

With the lessons learned from previous years, EQUIP II, in collaboration with the MOE, has adjusted its strategy in order to meet targets. To achieve sustainable results, the program must be fully integrated into the MOE HIV/AIDS activities. In order to restructure the program to increase CT uptake, EQUIP II staff and the MOE HIV/AIDS Unit launched a new HIV/AIDS Workplace program strategy in July 2006. The new strategy will begin implementation under FY 2006 funds and extend to FY 2007.

This effort includes coordinating activities among multiple partners, including three teachers unions, Society for Family Health, and CHAMP. A full-time staff person working on CT and AB activities, will be hired and placed at the MOE to ensure coordination and proper reporting. This person will be responsible for mentoring and capacity building of MOE HIV/AIDS Workplace program staff.

To achieve targets, the MOE program will implement quarterly "Teachers Health Days" in which community health clinics will offer a broad range of health services (testing for diabetes, blood pressure, nutrition guidelines) to teachers and their families. This broader health approach will help de-link HIV-related stigma by emphasizing general health. CT will be offered in tents and mobile settings outside of the clinics in conjunction with the health days. PEPFAR funds will be used exclusively for the HIV/AIDS related services, with other funds and resources leveraged from ZANARA, MOE, and Ministry of Health used to address a broader health agenda.

EQUIP II partners will set up tents and mobile sites outside the health clinics to increase confidentiality. EQUIP II will continue its partnership with the three unions and MOE to help mobilize teachers in accessing the "Teachers Health Days" and will bring CT mobile services to union events.

The Teachers Health Days will begin in FY 2006 and is specifically proposed as a means for reaching MOE staff in remote and less densely populated districts. Activities will be implemented in the Lusaka, Copperbelt, Southern, Central and Eastern Provinces covering 39 districts.

During FY 2006, Teachers Health Days will be implemented in more than 50% of the districts in the five Provinces addressed by this program. With FY 2007 funds, EQUIP II will maintain the level of Teacher Health days reached, and plans to add three additional districts each quarter, so that by the end of FY 2007, 32 Districts should be implementing Teachers Health Days on a quarterly basis.

While events are proposed on a quarterly basis, it is not anticipated that the same teacher will take advantage of each quarterly event. Rather, it is hoped that of the three to four offerings a year, each teacher will be able to take advantage of one annually. All events will be scheduled during school breaks to accommodate the highest levels of uptake possible.

As the initiative for Teachers Health Days is only beginning during autumn of 2006, levels of turn-out are difficult to predict. However, based on funding provided to the unions for getting teachers to the events, coordinated efforts with mobilization agents/focal point people in each district, and clear messages sent from both the Permanent Secretary and Minister of Education marketing the events and their importance, an average event could pull in approximately 30 individuals. While it is not expected that all district health clinics will manage such events four times a year, it is estimated that 30 different district health clinics will each hold two to three quarterly health days for a total of seventy five clinic health days serving 2,250 individuals in remote locations. It is anticipated that at least half, or 1125, of those attending the clinics will opt for CT services.

CT will be offered to all individuals reached through the Teacher Health Days. In addition, and under the separate AB narrative, prevention activities and education will be supported at these events.

To further increase testing among employees of the MOE, EQUIP II will contract CHAMP, a local NGO, to bring mobile testing to the urban schools, and where possible, union events. The program will also partner with the Society for Family Health (SFH) New Start program to offer VCT vouchers to MOE staff and to utilize New Start Mobile sites in conjunction with the "Teachers Health Day," and union events where feasible. In addition, EQUIPII will continue to support on-going training for focal point persons to ensure strong linkages to the broad continuum of HIV/AIDS services required for a comprehensive approach.

In total, an estimated 3000 individuals will receive CT services and be provided with their test results.

The overall approach of EQUIPII focuses on a philosophy of sustainability. Rather than simply establishing a stand-alone program to meet PEPFAR Targets, this activity will be fully integrated into the MOE HIV/AIDS workplace program. Specifically, staff will be housed within MOE offices and work side-by-side with direct MOE employees already engaged on a workplace program. EQUIP II's staff will train MOE staff to collect, track, and report PEPFAR and national indicators. IEC materials, lesson plans, and strategies will be well documented and housed within MOE's own file systems. While some outside partners will be engaged, the primary partners working on this effort will be teacher unions and the MOE itself, thereby ensuring that the activities are supported by organizations that can continue providing such services long-after funding under PEPFAR has ceased.