Detailed Mechanism Funding and Narrative

Years of mechanism: 2008 2009

Details for Mechanism ID: 1031
Country/Region: Zambia
Year: 2008
Main Partner: Johns Hopkins University
Main Partner Program: Bloomberg School of Public Health Center for Communication Programs
Organizational Type: University
Funding Agency: USAID
Total Funding: $5,447,016

Funding for Sexual Prevention: Abstinence/Be Faithful (HVAB): $2,937,016

This activity links with the Health Communication Partnership's (HCP) other ongoing activities. HCP's

Abstinence/be faithful activities also support both Zambian and the PEPFAR goals through a

comprehensive approach that promotes better health seeking behavior. HCP is working in 22 districts in

nine provinces in close partnership with Peace Corps, PACT/Y-CHOICES, the International Youth

Foundation (IYF), Population Services International (PSI)/Society for Family Health (SFH), RAPIDS, and the

Zambian government (GRZ). HCP is also a key member of the information, education, and communication

(IEC) committees of the National Malaria Control Centre and the Ministry of Health's (MOH) child health and

reproductive health units.

HCP uses PEPFAR and Child Survival funds to benefit more than 900 communities with wrap around

behavior change communication (BCC) activities linking HIV/AIDS messages with those related to malaria,

family planning, reproductive health, safe motherhood, and child survival.

In 1999, HCP designed the "Helping Each Other Act Responsibly Together" (HEART) campaign (Creative

HEART and HEART Life Skills Toolkit) in collaboration with the Government of Zambia and youth. The

HEART campaign informs young people about abstinence and being faithful as means to prevent HIV/AIDS

transmission. HEART program activities, which will continue in FY 2008, consist of yearly drama, music, art

and poetry contests in school, on themes of the HEART program and peer education through the out of

school programs Topics include the value of abstinence, delayed sexual debut for youth, adult-to-child

communication, faithfulness, stigma and discrimination, the importance of knowing your status and getting

tested, and positive male role modeling. In FY 2008, HEART contests carried out at a zonal level in 22

districts will reach 38,000 individuals with messages promoting HIV/AIDS prevention through abstinence

and/or being faithful.

HCP will also continue to work with in- and out-of-school youth groups by engaging community-based

organizations and by using the HEART Life Skills Toolkit to promote open discussion about risky behaviors,

problem-solving skills, and to build self-esteem. HCP will also continue to support Creative HEART, a

community-based contest that promotes positive adult-child communication through mentoring

relationships. HCP will expand its coverage of the HEART program in districts where it is already working.

Communities provide in-kind contributions of food, venue, transport, and lodging for contestants. Creative

HEART is run jointly with the Ministry of Education and supported by diverse stakeholders including

National Association for Arts and Theatre in Zambia (NATAAZ), the Japanese International Cooperation

Agency (JICA), and other international and Zambian non-governmental organizations.

HCP also works with theatre groups. HCP trained 20 theater trainers in health promotion through a three-

week workshop in FY 2005, and they in turn trained theater groups in 21 districts in FY 2006. These

actors/trainers developed skills to work with local theater groups to write and perform powerful and pertinent

dramas promoting AB, and facilitate discussions after the shows. Central themes addressed by these

groups included rethinking gender norms, especially in regards to sexual violence and exploitation of young

girls, as well as stigma reduction. In FY 2007 trained drama groups reached over 32,000 adults and 20,000

children. In FY 2008, dramas will focus on peer pressure and delayed onset of sexual activity for youth,

fidelity and partner reduction for adults, and alcohol use as a contributing factor for risky behavior. The

drama trainers will continue to serve as a resource to other USG-funded projects such as PACT/Y-

CHOICES, PSI/SFH, and IYF as well as other NGOs, UN agencies, and government organizations.

As part of its exit strategy, HCP, in collaboration with local NGOs and relevant government departments, will

hold refresher trainings for the 440 youth peer leaders and drama groups to equip them with updated

information on HIV/AIDS, prevention strategies, skills, relevant tools and IEC materials, and to cement the

linkages with local organizations. HCP will also build on the comprehensive multi-media campaign

developed in FY 2007 (with Plus-Up funds) for TV, radio, and print which promotes reduction of multiple

concurrent partnerships through raising risk awareness. This campaign will increase self-efficacy in

avoiding risk and will reach over 1,000,000 men and women of reproductive age in HCP's 22 districts and

over 3,000,000 in the rest of Zambia. HCP will provide leadership to ensure that this multi-media campaign

and other prevention campaigns are in full support of the national prevention strategy, which will be

developed in collaboration with the National HIV/AIDS/STI/TB Council (NAC) and other local USG partners.

All HCP activities begin with formative research and are piloted with target populations before being

launched. For example, the Participatory Ethnographic Evaluation and Research (PEER) qualitative data

collection conducted in FY 2006 was used to design innovative, culturally appropriate "being faithful"

interventions and messaging for geographically-remote, less-educated populations; these interventions and

messaging were piloted in FY 2007. All activities also consider existing gender roles with the goals of

reducing violence, empowering young women to negotiate healthier choices, promoting partner

communication and mutual decision making, and male responsibility.

HCP will also continue to support the HIV Talkline which is implemented by the Comprehensive HIV/AIDS

Management Programme (CHAMP). HIV Talkline is a confidential, 24-hour, toll-free telephone line

available in all 72 districts that provides information, counseling, advice, and referral services to the public.

Full-time qualified nurse-counselors, all of whom are registered with the General Nursing Council, operate

the HIV Talkline. They provide counseling and disseminate information on AB, CT, male circumcision (MC),

positive living, discordant couples, and treatment adherence and options. With PEPFAR funding, HCP

continues to promote HIV Talkline services through radio and television spots and outreach activities, which

has led to a steady increase in caller demand. In FY 2008, 42,000 individuals will be reached with

messages promoting HIV/AIDS prevention through abstinence and/or being faithful and information on HIV

services. Messages will continue to focus on confidential information and services offered through HIV

Talkline. Outreach activities will place an emphasis on increasing the number of callers from rural areas,

specifically targeting the general adult population, PLWHA, and caregivers.

HCP will continue to be committed to building Zambian capacity and improving the sustainability of the

activities being implemented. For example, trainings in proposal writing, activity design, and monitoring

enable organizations to find local responses to local challenges. The choice of activities that will be

implemented is community-driven, not imposed by HCP. In addition, the activities require community

commitment through in-kind support. HCP finds that these two things cause communities to value the

activities more. Furthermore, youth have been trained to conduct most activities without assistance or

incentives beyond the materials needed for the activity.

Government ministries have also been actively engaged in HCP activities such as the development of

Activity Narrative: Creative HEART contests, and in some places, the government has institutionalized contests into their

yearly programs. HCP continues to play a key role on the National HIV/AIDS/STI/TB Council (NAC) by

collecting, harmonizing, and sharing national IEC materials. In FY 2006, HCP supported the development

of the NAC Resource Center by compiling a database of all HIV/AIDS IEC materials available in Zambia.

Technical assistance will be provided to the National AIDS Council, Government of the Republic of Zambia

in the development and dissemintation of the National Prevention Strategy.

HCP continues to work in a technical advisory capacity with the Zambia Centre for Communication

Programmes (ZCCP), a local health communication NGO. HCP will support ZCCP to develop their

strategic approaches to AB and build their ability to design high quality BCC interventions. Supporting USG

partners, HCP facilitates the adaptation and reproduction of IEC materials for partners' programs and plays

a key role in promoting collaboration and coordination. HCP work plans are integrated into district and

provincial plans, ensuring ownership and sustainability.

HCP will conduct an end-of-project survey in FY 2008, to measure the impact of activities mentioned above,

as well as other HCP activities elsewhere in the COP. The Participatory Ethnographic Evaluation and

Research (PEER) methodology will be employed to qualitatively evaluate the project by involving the

community members in the design, implementation, and execution of the evaluation exercise.

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $1,100,000

This activity links with the Health Communication Partnership's (HCP) activities in Abstinence/be faithful

(AB), Palliative Care, Orphans and Vulnerable children (OVC), Counseling and Testing (HVCT) and ARV

Services. It also supports both the Zambian and the President's Emergency Fund for AIDS Relief

(PEPFAR) goals for appropriately targeting most at-risk populations (MARPs) with interventions promoting

partner-reduction and condom use.

HCP uses PEPFAR and Child Survival funds to benefit more than 900 with wrap around behavior change

communication (BCC) activities linking HIV/AIDS messages with those related to malaria, family planning,

reproductive health, safe motherhood, and child survival.

Community mobilization and BCC, the foundation of HCP's strategy in Zambia, provide a comprehensive

approach to promote better health-seeking behavior through interventions targeting MARPs in 22 districts.

HCP draws on Johns Hopkins University Center for Communication Programs' (JHU/CCP) worldwide

expertise in formative research and evaluations of these programs. For example, the 2003 study of

Language Competency in Zambia has informed all HCP printed materials while the BRIDGE project

baseline survey in Malawi provided valuable reference for building community efficacy in similar rural

communities.

HCP is also a key member of the information, education, and communication (IEC) committees of the

National Malaria Control Centre and the Ministry of Health's (MOH) child health and reproductive health

units. At the same time, HCP facilitates synergistic networks among community organizations and the

involvement of community leadership structures to ensure that activities are responsive to local needs.

Working within these community structures in close partnership with other US Government (USG) partners,

HCP will promote HIV prevention through a balanced Abstinence, Being faithful, correct and consistent

Condom use (ABC) approach. Part of HCP's mandate in FY 2008, will be to focus on communications on

partner reduction, correct and consistent condom use, and promotion of knowing one's HIV status.

In FY 2008, HCP will continue to provide technical support for ongoing activities organized by trained peer

leaders. These activities will reach families of uniformed personnel and will emphasize knowledge of HIV

status, correct and consistent condom use, provision of social support to those who are ill, anti-stigma

messaging, and reduction of concurrent partners. At prisons, similar activities will be implemented for

people who are incarcerated. In FY 2008, HCP will also reach 6,400 individuals with HIV prevention

messages.

As part of its exit strategy, HCP, in collaboration with local non-governmental organizations and relevant

government departments, will hold refresher workshops for the active uniformed services peer leaders. The

refresher workshops will equip peer leaders with updated HIV/AIDS information, behavior change strategies

for prevention and information on male circumcision. Relevant tools and IEC materials will also be provided

and HCP will also help cement linkages with local organizations and other service providers.

HCP will build on the comprehensive multi-media campaign developed in FY 2007 (with Plus-Up funds) for

television, radio, and print which promotes reduction of concurrent partnerships through raising risk

awareness. This campaign will increase self-efficacy in avoiding risk and will reach over 1,000,000 men

and women of reproductive age in HCP's 22 districts and over 3,000,000 in the rest of Zambia. HCP will

provide leadership to ensure the multi-media campaign and other prevention campaigns are conducted in

full support of the national prevention strategy; which will be developed in collaboration with the National

HIV/AIDS/STI/TB Council (NAC) and other local partners.

Furthermore, program messages on correct and consistent condom use, will be complemented with in-

depth information on behavior change and the development of respectful, gender-equitable relationships

between men and women. Influential leaders will be encouraged to serve as role models for men in order

to affect change in the male norms and behaviors that undermine risk avoidance efforts. HCP-trained

community drama groups in remote, rural communities will continue to perform scripted drama and facilitate

discussions on partner reduction, knowledge of HIV status, and stigma reduction, reaching at least 13,200

people. In FY 2008, HCP will focus on ensuring strong links between drama groups and individual

communities, and zonal and district structures to facilitate maximum use of this resource after the end of

project.

As in FY 2007, HCP will continue to encourage peer leaders to conduct local screenings and facilitate

discussions around four key videos: "Tikambe" (an anti-stigma video), "Mwana Wanga" (prevention of

mother to child transmission video), "The Road to Hope"(video on anti-retroviral therapy), and "Our Family

Our Choice" (video on family planning/HIV). Available in three-to-seven Zambian languages, more than

3,500 copies have been distributed throughout Zambia to clinics, mobile video units, non-governmental

organizations (NGOs), and other stakeholders.

In order to better understand the risks around alcohol abuse and HIV/AIDS, in FY 2006, HCP conducted a

Participatory Ethnographic Evaluation and Research (PEER) qualitative data collection. The collected data

was used in FY 2007 to support culturally appropriate interventions and messaging about the risks of

alcohol abuse as related to HIV/AIDS. HCP will continue to ensure that issues related to alcohol abuse are

integrated in communication interventions.

HCP will expand activities initiated by the Public Affairs Office (PAO) with universities, the media, the

National Arts Council, and traditional leadership through linkages with above described activities. All of

these activities will promote risk reduction through reduction in concurrent partners, knowing one's status,

using condoms correctly and consistently, and male circumcision. HCP will continue to build capacity of

community radio stations to develop and broadcast locally relevant programs that address issues around

risk reduction. Together with the National Arts Council, HCP will develop a high profile, national events and

popular artists to promote HIV risk reduction. With the House of Chiefs, the coordinating body for Zambia's

traditional leaders, HCP will build on an existing relationship to promote their advocacy for HIV risk

reduction.

All HCP activities begin with formative research and are pre-tested with target populations before being

launched. They also consider existing gender roles with the goal of reducing violence, empowering women

to negotiate for healthier choices, promoting partner communication, mutual decision-making, and male

Activity Narrative: responsibility.

HCP's community mobilization efforts are focused on investing in the development of skills and capacity of

individuals, neighborhoods, and community-based organizations to promote positive health and social

development. HCP will design activities that support Zambian capacity, sustainability, self-reliance and the

development of public opinion and norms supporting prevention activities. For example, trainings in

proposal writing (for funds available locally), activity design, and monitoring can allow organizations to find

local answers to local problems. In addition, the activities that are implemented are not only chosen by

communities, they also require community commitment through in-kind support.

HCP continues to play a key role with the NAC by collecting, harmonizing, and sharing national IEC

materials. In FY 2006, HCP supported the development of the NAC Resource Center by compiling a

database of all HIV/AIDS IEC materials available in Zambia. HCP continues to work with the Zambia

Centre for Communication Programmes (ZCCP), a local health communication NGO in a technical advisory

capacity. HCP will support ZCCP in developing strategic approaches for preventing the sexual transmission

of HIV and will build ZCCP's ability to develop high quality, behavior change communications interventions.

HCP also facilitates the adaptation and reproduction of IEC materials for other USG supported programs,

playing a key role in promoting collaboration and coordination among USG partners.

In FY 2008, HCP will conduct an end-of-project survey to measure impact of all of the above mentioned

activities. The Participatory Ethnographic and Evaluation and Research (PEER) method will also be

employed to qualitatively evaluate the project by involving the community members in the design,

implementation, and execution of the evaluation exercise.

All FY 2008 targets will be reached by September 30, 2009.

Funding for Care: Adult Care and Support (HBHC): $335,000

This activity links with the Health Communication Partnership's (HCP) ongoing activities. It also supports

the overall U.S. Government (USG) effort in promoting palliative and community-based care services by

increasing the uptake of palliative care services. HCP's activities address both Zambian and the

President's Emergency Plan for AIDS Relief (PEPFAR) goals for increasing public information and

understanding of counseling and testing, palliative care and treatment, and improving the length and quality

of life for people living with HIV/AIDS (PLWHA). In FY 2008, HCP will continue to work closely with the

following USG palliative and home-based care service providers: Catholic Relief Services

(CRS)/SUCCESS, RAPIDS, Zambia Prevention, Care and Treatment Partnership (ZPCT), Support for the

HIV/AIDS Response in Zambia (SHARe), Peace Corps, national and international stakeholders, PLWHA

networks, faith-based organizations (FBOs), and other community groups.

HCP will use PEPFAR and Child Survival funds so that more than 900 communities can benefit from wrap

around behavior change communication (BCC) activities linking HIV/AIDS messages with those related to

malaria, family planning, reproductive health, safe motherhood, and child survival.

Community mobilization and BCC, the foundation of HCP's strategy in Zambia, provide a comprehensive

approach to promoting better health seeking behavior nationally and within the 22 HCP-supported districts

in Zambia's nine provinces. HCP is a key member of the information, education, and communication (IEC)

committees of the National Malaria Control Centre and the Ministry of Health's (MOH's) child health and

reproductive health units. HCP draws on the expertise of Johns Hopkins University Center for

Communications Programs' (JHU/CCP) worldwide experience including formative research and evaluations

of these programs. For example, the 2003 study of Language Competency in Zambia has informed all HCP

printed materials while the BRIDGE project baseline survey in Malawi provided valuable reference for

building community efficacy in similar rural communities.

In FY 2005 and FY 2006, HCP developed a PLWHA and caregivers distance radio program, "Living and

Loving," to communicate standardized messages to PLWHA, their families, and caregivers. The program is

broadcast in seven local languages in addition to English. The 26-episode series, which is aired on

Zambian National Broadcasting Corporation (ZNBC) and local radio stations, promotes discussion on a

wide range of topics including positive living and staying healthy, how men can be caregivers, ART, family

support, nutrition, treatment of opportunistic infections (OIs), money management, stigma and

discrimination, treating PLWHA with respect, etc. In FY 2008, HCP will consolidate the best of the

programs broadcast during the past three years and hold a one week workshop for community radio

stations on the use of this package as well as consolidate their skills to develop their own programs on local

HIV/AIDS issues. HCP district staff will continue to support listener groups (selected from PLWHA care and

support groups) to enable them to increase their reach to PLWHA and their caregivers in 22 districts. By

using HCP-produced program guides, group leaders will facilitate and head discussions on care, support,

and positive living. HCP will continue to work with local communities, Neighborhood Health Committees

(NHCs), and the MOH to assume leadership and ownership of this activity, linking these groups with other

support organizations to ensure sustainability.

In FY 2005, the Care and Compassion movement was developed and launched by the Zambia Interfaith

Networking Group (ZINGO) with technical support from HCP. Counseling and education kits for religious

and traditional leaders were adapted for use in Zambia. These kits enable leaders to initiate and implement

care and support activities in their congregations and communities and strengthen their counseling skills.

With HCP support, more than 600 religious and lay community leaders were trained in psychosocial

counseling by the end of FY 2007. In FY 2008, HCP will use the trained counselors to continue the Care

and Compassion movement that focuses on rural communities to ensure community-based action in

support of those infected/affected by HIV/AIDS. As part of its exit strategy, HCP will conduct refresher

trainings and skills updates for those previously trained.

HCP will continue to promote local screenings of educational films and will facilitate discussions to raise

awareness in four key areas: anti-stigma ("Tikambe"), prevention of mother to child transmission ("Mwana

Wanga-My Child"), antiretroviral therapy ("The Road to Hope"), and reproductive choices for those who are

HIV positive ("Our Family, Our Choice"). Available in three to seven Zambian languages (depending on the

film), more than 3,500 copies of these films were distributed throughout Zambia to clinics, mobile video

units, non-governmental organizations (NGOs), and other stakeholders.

At the end of FY 2005, approximately 59,000 copies of the Positive Living Handbook were produced and

distributed with a target audience of PLWHA, their caregivers, and OVC. This handbook is written for low

literacy audiences and designed to be the comprehensive and practical guide to positive living with HIV. It

has become a regional standard for informing and engaging PLWHA. In 2007, this handbook was updated

to reflect current drug regimens and additional treatment sites. The printing of the handbook was supported

by partners including the MOH.

All activities begin with formative research and are pre-tested with target populations before being launched.

The activities also take into account existing gender roles with the goal of reducing violence, empowering

women to negotiate for healthier choices, promoting partner communication, mutual decision-making and

male responsibility.

HCP will continue to be committed to building Zambian capacity and improving the sustainability of the

activities being implemented. HCP's community mobilization efforts focus on capacity development of

individuals, NHCs, and community-based organizations. For example, HCP will provide training in proposal

writing (for funds available locally), activity design, and monitoring enable organizations to find local

responses to local challenges. HCP work plans will be integrated into district and provincial plans, ensuring

ownership and sustainability.

HCP is also committed to the development of public opinion and norms supporting treatment and care.

"Living and Loving" empowers the listeners. Additionally, local radio personalities have been trained to

interview PLWHA so that they can produce future programs on their own. "Care and Compassion" groups

have emerged as a community response to a community problem. HCP will continue to play a key role on

the National HIV/AIDS/STI/TB Council (NAC) in the collection, harmonization, and sharing of national IEC

materials. In FY 2006, HCP supported the development of the NAC Resource Center by compiling a

database of all HIV/AIDS IEC materials available in Zambia. In concert with USG partners, HCP will

Activity Narrative: facilitate the adaptation and reproduction of IEC materials for its programs, playing a key role in promoting

collaboration and coordination among partners. Dramatically discounted air time on ZNBC and local radio

stations reflects the national and local ownership of "Living and Loving" and the Care and Compassion

movement.

In FY 2008, HCP will conduct an end of project survey to measure the impact of all of the activities

mentioned above, as well as other HCP activities described elsewhere in the COP.

All FY 2008 funded results will be reached by September 30, 2009.

Funding for Care: Orphans and Vulnerable Children (HKID): $290,000

This activity links with the Health Communication Partnership's (HCP) ongoing activities in Abstinence/be

faithful, Other Prevention, Palliative Care, Counseling and Testing, and Treatment/ARV Services. It also

supports the U.S. Government (USG) partners providing orphan and vulnerable children (OVC) care and

support services, and addresses both Zambian and the President's Emergency Plan for AIDS Relief

(PEPFAR) goals for increasing the number of orphans and vulnerable children receiving care through

community mobilization and the provision of quality information on educational, nutritional, and psychosocial

support.

HCP uses PEPFAR and Child Survival funds so that more than 900 communities will benefit from wrap

around behavior change communication (BCC) activities linking HIV/AIDS messages with those related to

malaria, family planning, reproductive health, safe motherhood, and child survival.

Community mobilization and behavior change communication, the foundation of HCP's strategy in Zambia,

provide a comprehensive approach that promotes better health-seeking behavior through the support for

and promotion of OVC services throughout the country. HCP draws on Johns Hopkins University Center for

Communication Programs' (JHU/CCP) worldwide expertise including formative research and evaluations of

these programs. For example, the 2003 study of Language Competency in Zambia has informed all HCP

printed materials while the BRIDGE project baseline survey in Malawi provided valuable reference for

building community efficacy in similar rural communities. HCP is also a key member of the information,

education, and communication (IEC) committees of the National Malaria Control Centre and the MOH's

child health and reproductive health units.

In FY 2007, HCP continued to take the lead in defining gaps in OVC materials and working with key

partners/stakeholders to develop appropriate IEC materials. In FY 2008, HCP will continue to disseminate

correct and consistent OVC information and referrals within the 22 HCP-supported districts in Zambia's nine

provinces.

In FY 2008, HCP will continue to take the lead in filling gaps in OVC IEC support materials, working in

collaboration with the Ministry of Sports, Youth, and Child Development and Ministry of Community

Development and Social Services, the National HIV/AIDS/STI/TB Council (NAC), and more than 15 different

USG activities implementing OVC support activities throughout the country. HCP will develop appropriate,

practical, and user-friendly IEC resources as requested by OVC forum and partners such as RAPIDS, with

the production and distribution coordinated by the requesting partner.

In FY 2005 and FY 2006, HCP developed a people living with HIV/AIDS (PLWHA) and caregivers radio

distance program, "Living and Loving," that was broadcasted in seven local languages in addition to

English. The series of 26 episodes promotes discussion on many topics pertaining to OVC and their

caregivers such as: psychosocial support, health and nutrition, income generation, stigma and

discrimination, education, and social inclusion. In FY 2008, HCP will consolidate the best of the programs

broadcasted during the past three years and HCP will hold a one week workshop for community radio

stations on the use of this package. The workshop will also consolidate the skills of community radio

stations in developing their own programs on local HIV/AIDS issues. HCP district staff will continue to

support listener groups (selected from PLWHA care and support groups) to increase their reach to PLWHA

and their caregivers in 22 districts. "Living and Loving" empowers the listeners with information and hope.

Local radio personalities have also been trained to interview PLWHA so that they can produce future

programs on their own. Discounted or free air time on both the Zambia National Broadcasting Corporation

(ZNBC) and community radio stations reflects the national and local ownership of "Living and Loving." HCP

will continue to work with local communities, Neighborhood Health Committees (NHCs), and the Ministry of

Health on these activities. These organizations will eventually assume leadership and ownership of the

activities while linking with other support organizations to ensure sustainability.

HCP will continue to promote local video screenings and facilitate discussions to raise awareness in four

key areas: anti-stigma ("Tikambe"), prevention of mother to child transmission ("Mwana Wanga"),

antiretroviral therapy ("The Road to Hope") and reproductive choices for those who are HIV positive ("our

Family, Our Choice"). Available in three to seven Zambian languages (depending on the series), more than

3,500 copies have been distributed throughout Zambia to government authorities (Ministries of Education,

Health, Youth, Sport and Child Development), clinics, mobile video units, non-governmental organizations

(NGOs), and other stakeholders.

All activities begin with formative research and are pre-tested with target populations before being launched.

They also consider existing gender roles with the goal of reducing violence, empowering women to

negotiate for healthier choices, and promoting partner communication/mutual decision-making, and male

responsibility.

To ensure sustainability and partner graduation from HCP support, HCP's community mobilization efforts

have focused on investing in the development of skills and capacity of individuals, NHCs, and community-

based organizations (CBOs), promoting self-reliance, and supporting sustainability. HCP will continue to be

committed to building Zambian capacity and improving the sustainability of the activities being implemented.

For example, HCP supports the development and implementation of community-level action plans that

promote positive health and social development, and inclusiveness of and support for those infected or

affected by HIV/AIDS. Training in proposal writing (for funds available locally), activity design, and

monitoring enable organizations to address local challenges with locally designed responses. Roughly 900

communities involved in this project have utilized these community-level capacity building trainings to

strengthen their response to their own OVC needs and issues. Training sessions for psychosocial

counselors have inspired many to use their own initiative in response to local needs.

HCP continues to play a key role with the NAC, collecting, harmonizing, and sharing national IEC materials.

In FY 2006, HCP supported the development of the NAC Resource Center by compiling a database of all

HIV/AIDS IEC materials available in Zambia. With USG partners, HCP facilitates the adaptation and

reproduction of IEC materials for their programs, playing a key role in promoting collaboration and

coordination among partners. HCP work plans are also integrated into district and provincial plans,

ensuring ownership and continuity of activities.

In FY 2008, HCP will conduct an end-of-project survey to measure impact of all of the activities mentioned

Activity Narrative: above, as well as other HCP activities mentioned elsewhere in the COP.

All FY 2008 targets will be reached by September 30, 2009.

Funding for Prevention: HIV Testing and Counseling (HVCT): $330,000

This activity links with the Health Communication Partnership's (HCP) activities. This activity also directly

supports Population Services International/Society for Family Health (PSI/SFH), JHPIEGO, and Partnership

for Supply Chain Management Systems (SCMS) male circumcision activities (MC). HCP's activities

indirectly support the Ministry of Health (MOH), National HIV/AIDS/STI/TB Council (NAC), and USG

implementing partner counseling and testing (CT) activities. HCP is also a key member of the information,

education, and communication (IEC) committees of the National Malaria Control Centre and the Ministry of

Health's (MOH) child health and reproductive health units.

HCP uses PEPFAR and Child Survival funds to benefit more than 900 communities with wrap around

behavior change communication (BCC) activities linking HIV/AIDS messages with those related to malaria,

family planning, reproductive health, safe motherhood, and child survival.

Community mobilization and BCC, the foundation of HCP's strategy in Zambia, provides a comprehensive

approach to promoting counseling and testing services throughout the country. HCP draws on Johns

Hopkins University Center for Communication Programs' (JHU/CCP) worldwide expertise including

formative research and evaluations of these programs. For example, the 2003 study of Language

Competency in Zambia has informed all HCP printed materials while the BRIDGE project baseline survey in

Malawi provided valuable reference for building community efficacy in similar rural communities.

In FY 2007, HCP supported JHPIEGO's and PSI/SFH's male circumcision (MC) initiatives with strategic

communication approaches. In FY 2007, HCP also assisted the MOH, the NAC, and MC service delivery

partners, in the development and implementation of a national MC awareness campaign that places CT as

a first step to MC. The awareness campaign also included messages regarding AB and

stigma/discrimination reduction. Materials for the campaign addressed risk-disinhibition and focused on the

importance of knowing one's HIV status, the necessity for consistent safe sex practices, and the need to

seek MC services from a trained professional with post-procedural care. The campaign placed MC and CT

in the greater context of reproductive health and ensures that clients receive clear counseling on how MC is

and is not protective in acquiring HIV; it also emphasized the importance of knowing one's HIV status. A

male reproductive health counseling kit was also developed for the campaign. This kit is a practical

counseling tool and is accompanied by a more technically detailed male reproductive health handbook for

service providers to use in pre- and post-circumcision counseling for clients seeking MC services. Simple

take-away brochures for use at CT and other sites for those who test HIV negative were included in the kits.

The take-away brochures described MC as a risk-reduction option that can be considered, but it

emphasized that MC is not 100% protective and safe behaviors must still be practiced (specifically:

abstinence, delayed sexual debut, partner reduction and condom use).

In FY 2007, HCP also developed three one-minute television and radio spots focusing on disinhibition, the

need to use a trained service provider, the importance of knowing one's HIV status, and the advisability of

MC for men who have tested negative. These spots, in seven national languages, were aired for 16 weeks,

twice per day, on ZNBC television, and ZNBC Radio 1 and Radio 2, with alternating languages and themes.

Local radio stations, that HCP has ongoing relationships with in all nine provinces, aired radio messages in

the appropriate language twice per day over 16 weeks.

In FY 2008, HCP will build on the information campaign to support MC services and HCP will address

specific behavioral issues that emerged from FY07 and will continue to emerge throughout FY 2008. HCP

will continue to work closely in with its collaborating partner, the Comprehensive HIV AIDS Management

Programme (CHAMP) HIV Talkline, to ensure counselors are fully prepared to respond to MC questions.

During FY 2007, HCP trained 25 staff, in 22 districts in all nine provinces, who are working in nearly 900

communities to raise awareness and to correctly convey information about MC, including continuing

practicing safer sex, being faithful, and knowing one's HIV status. In FY 2008, HCP staff will continue to

strengthen community links to MC services. Safe motherhood action groups will continue to promote

knowing one's HIV status. These action groups will also promote MC for men who have tested negative

and for male newborns.

Traditional leaders play a key role in all of HCP community-based activities. In provinces that implement

MC as a traditional practice, HCP will continue to actively engage traditional initiators to promote CT and

safe and sterile MC. This work will complement the training efforts of JHPIEGO, PSI/SFH, and the MOH.

Community health education flipcharts, developed by HCP in FY 2007, which include MC information, will

continue to be used at a community and rural health centers to raise awareness of MC.

All activities begin with formative research and are pre-tested with target populations before being launched.

They also consider existing gender roles with the goal of reducing violence, empowering women to

negotiate for healthier choices, promoting partner communication/mutual decision-making, and male

responsibility.

HCP's community mobilization efforts are and will continue to be focused on developing the skills and

capacity of individuals, Neighborhood Health Committees (NHCs), and community-based organizations

(CBOs). HCP will continue to promoting self-reliance and build sustainable programs. HCP continues to be

committed to building Zambian capacity and improving the sustainability of the activities being implemented.

Trainings in proposal writing (for funds available locally), activity design, and monitoring, enable

organizations to find local responses to local challenges. All of the over 900 communities involved in this

project have utilized these community-level capacity building trainings to promote and mobilize CT at a

grassroots level. Training sessions for psychosocial counselors have inspired many to use their own

initiative in response to local needs.

HCP continues to play a key role with the NAC, collecting, harmonizing, and sharing national IEC materials.

In FY 2006, HCP supported the development of the NAC Resource Center by compiling a database of all

HIV/AIDS IEC materials available in Zambia. With USG partners, HCP facilitates the adaptation and

reproduction of IEC materials for their programs, playing a key role in promoting collaboration and

coordination among partners. HCP work plans are integrated into district and provincial plans, ensuring

ownership and continuity of activities.

Activity Narrative: In FY 2008, HCP will conduct an end-of-project survey to measure impact of the activities mentioned

above, along with activities listed elsewhere in the COP.

All FY 2008 targets will be reached by September 30, 2009.

Funding for Treatment: Adult Treatment (HTXS): $455,000

This activity links with the Health Communication Partnership's (HCP) ongoing activities in Abstinence/be

faithful, Other Prevention, Palliative Care, Counseling and Testing, Orphans and Vulnerable Children, and it

links with National HIV/AIDS/STI/TB Council (NAC). It also supports the U.S. Government (USG) partners

providing HIV care and treatment services and addresses both Zambian and the PEPFAR goals of scaling-

up ART services by providing quality information on treatment, adherence, and positive living.

HCP uses PEPFAR and Child Survival funds so that more than 900 communities can benefit from wrap

around behavior change communication (BCC) activities linking HIV/AIDS messages with those related to

malaria, family planning, reproductive health, safe motherhood, and child survival.

Community mobilization and BCC, the foundation of HCP's strategy in Zambia, provides a comprehensive

approach that promotes better health-seeking behavior through the support for and promotion of ART

services throughout the country. HCP draws on Johns Hopkins University Center for Communication

Programs' (JHU/CCP) worldwide expertise including formative research and evaluations of these programs.

For example, the 2003 study of Language Competency in Zambia has informed all HCP printed materials.

HCP is also a key member of the information, education, and communication (IEC) committees of the

National Malaria Control Centre and the Ministry of Health's (MOH) child health and reproductive health

units.

Building on the national ART communication strategy that HCP helped the NAC in developing, HCP will

continue to assist the NAC in streamlining and produce quality communications relating to ART during.

HCP will take the lead in assessing nationwide gaps in ART literacy materials and where appropriate, HCP

will either develop new materials or it will utilize available materials to reach new audiences.

In FY 2005 and FY 2006, HCP produced a three-part PMTCT video issued in five languages entitled

"Mwana Wanga" (nearly 1500 copies), as well as the Positive Living Handbook (59,000 copies), an

antiretroviral video entitled "The Road to Hope", and a contraceptive choices when one is HIV positive video

entitled "Our Family, Our Choice". Demand for the Positive Living Handbook exceeded supply. In FY 2008,

HCP will continue in to broadcast excerpted segments of these videos on national radio and television to

promote messages of knowing one's HIV status, ART adherence, PMTCT, and contraceptive choices for

HIV positive people. HCP will also include more messages on treatment adherence and HCP will focus on

issues faced by people who have been on treatment for a long period of time.

Through a consultative process with relevant stakeholders and key roles played by the NAC and the MOH,

HCP developed communication interventions in FY 2007 to address the gaps in pediatric HIV education

communications. Parents and other caregivers face many difficult issues after finding out a child's HIV

status. HCP will improve parents and caregiver's knowledge to connect more parents/caregivers and HIV-

positive children to treatment programs, to improve treatment adherence, to improve the disclose children's

positive status in an age-appropriate way and to help children to cope with knowledge of their own HIV

positive status.

HCP is also working to help older children and adolescents cope after learning their HIV status through

materials that are produced for children's support groups. Communications geared for older children and

adolescents will help children and adolescents talk about their feelings more openly in support group

settings. The materials will specifically address managing medications, growing up with HIV (with age

appropriate information on sex and sexuality). All HCP-produced materials have been vetted by groups

consisting of the target audience and are pre-tested for effectiveness.

At the service delivery level, providers need support on how to best counsel parents to get children tested

and on treatment; counsel on adherence; prevent opportunistic illnesses; promote positive living; and how

to disclose positive status to their children. Materials addressing these issues were developed in

consultation with the MOH, the NAC, ART service delivery partners, PLWHA networks, the Centers for

Disease Control and Prevention (CDC), JHPIEGO, Zambia Prevention, Care, and Treatment Partnership

(ZPCT), Centre for Infectious Disease Research in Zambia (CIDRZ), Catholic Relief Services

(CRS/SUCCESS), and other stakeholders. HCP worked hard to reach a consensus with these partners on

appropriate and correct messages for providers to convey to families. In FY 2008, HCP will build on these

materials to ensure wider distribution, coverage, and use

These HCP activities, along with those described elsewhere, begin with formative research and are piloted

with target audiences before being launched. HCP's IEC materials also support greater gender equity with

a goal of empowering women to negotiate for healthier choices and promote partner communication, mutual

decision-making, and male responsibility.

HCP will continue to be committed to building Zambian capacity and improving the sustainability of the

activities being implemented. For example, as a result of the consultative and collaborative processes used

in their development, there is significant government ownership of materials produced by HCP in the

Ministry of Health and the NAC. Zambia National Broadcasting Corporation (ZNBC) has aired "Tikambe",

"Mwana Wanga", and "Road to Hope" in multiple languages on national television free of charge and has

significantly contributed to the airing of "Living and Loving," a radio program for PLWHA and their caregivers

aired on national radio stations since December 2005. As a result, ZNBC has become known for the airing

of health programs. HCP has also built a credible relationship with community radio stations around

Zambia who participate in the production of and contribute to the airing of HCP health radio programming.

Over the last four years, HCP has continued to mentor and work closely with dB Studio in radio

programming, Prime Images in the development of films, and the Zambia Centre for Communication

Programs in the development of behavior change communication strategies and programs. Part of HCP's

exit strategy is to leave sustainable capacity in developing quality ARV communication materials with local

productions companies that are then capable of developing additional communications on these important

messages.

In FY 2008, HCP will conduct an end-of-project population-based household and community survey to

measure impact of all of the activities mentioned above, as well as other HCP activities listed elsewhere in

the COP.

All FY 2008 targets will be reached by September 30, 2009.

Activity Narrative: This activity links with the Health Communication Partnership's (HCP) ongoing activities in Abstinence/be fai

Subpartners Total: $3,354,000
Comprehensive HIV/AIDS Management Program: NA
Save the Children: $2,420,000
International HIV/AIDS Alliance: $934,000
University of Zambia: NA
National Arts Council of Zambia: NA
Copperbelt University: NA
Zambia Interfaith Networking Group on HIV and AIDS: NA
Zambia Centre for Communication Programmes: NA