The Catholic Medical Mission Board (CMMB) is working in partnership with the Church Health Institutions

(CHIs) of the Church Health Association of Zambia (CHAZ) in the implementation of the Men Taking Action

Project (MTA). This objective of this activity is to increase the uptake of PMTCT through male involvement.

At the end of FY 2008, the MTA project will be operational at 31 CHIs as this three-year project, funded by

USAID under the New Partner's Initiative is concluded.

The funding for the MTA project for FY 2008 will go towards training CHI staff, community capacity-

building, and promotion of prevention of mother to child transmission (PMTCT) and counseling and testing

(CT). Through outreach programs CHIs will mobilize and educate community men, promoting positive

attitudes and behaviors so that men support their partners to enroll in PMTCT services and mother to child

transmission-Plus (MTCT- Plus) programs available in their catchment areas.

Building upon the MTA projects previous two years of successes, the project will continue addressing two

key factors to promote sustainability: integration and partnership. CMMB will promote sustainability by

encouraging the CHIs to continue integrating its project activities into their local health care system.

HIV/AIDS information, materials, and approaches developed under MTA will be integrated into routine

trainings of professional health staff (nurses, clinical officers and physicians at all CHIs), community health

workers (CHWs), network leaders, traditional healers and civic leaders. Further, it will also be integrated into

the regular outreach programs involving CHI staff and CHW.

CMMB will continue working closely with CHI management teams, to select MTA site coordinators and Men

Take Action Community Peer Educators (MTA- CPEs) to be trained as supervisors who will provide

frequent supervision for the implementation of the two-pronged approach in the execution of the MTA

program, as well as contribute significantly to monitoring and evaluation. CMMB shall gradually shift more

responsibility to the coordinators and community educators as part of their routine activities. By the end of

project, CHIs and MTA-CPEs will conduct a community education session with minimal CMMB support.

The MTA project will continue building and fostering strong partnerships with CHAZ, the CHIs, the District

Health Management Teams (DHMTs), and others to assure commitment to project activities and building of

local capacity is achieved. In addition, on a regular basis, the CMMB MTA team will continue sharing

lessons learned, literature, materials, and other resources with our partners with the aim of engaging them

in supporting the components of the MTA project.

With FY 2008 funding, CMMB will target ten CHI sites and respective catchment communities. Using the

results from the knowledge, attitudes, and practices study (KAP) which was executed in 2007 and

experience gained from implementing the MTA project in the previous two years, CMMB will train eight CHI

health staff at each of the ten targeted CHIs. As in the past, this training will be a review of the latest

HIV/AIDS information, the routine provision of PMTCT and general CT, and an orientation into the MTA

program.

CMMB will also train ten CHWs at each site as MTA-CPEs to mobilize and educate men to change

behaviors in order to increase PMTCT uptake and antenatal care (ANC) visits, testing, and counseling of

men. The selection of CHW to be trained as MTA-CPEs will follow the same pattern as in the past: the

CHWs to be trained will include traditional healers, chiefs, headmen, indunas, the clergy, civic leaders, and

other influential members in the various targeted communities.

CMMB will support CHI staff and CHWs to mobilize and conduct education sessions focused on men in the

communities and those with pregnant partners/wives attending ANC at CHIs to increase their support for

PMTCT services. With CMMB's support, each of the ten CHIs will conduct ten men's education sessions to

approximately 100 men per each session in the general population. In addition, each CHI will conduct ten

education sessions to approximately 50 men per session who are partners to pregnant women attending

ANC. Concurrently the previous 21 CHIs where the MTA program is active will conduct the MTA education

sessions in the general population once per quarter and on a monthly basis to husbands of pregnant

women attending ANC. At these 21 sites most of the men would already have been exposed to MTA

education campaigns; it is expected that only about 25 men who are husbands to pregnant women

attending ANC will be totally ignorant about MTA.

A total of 33,100 adult men will be reached in FY 2008. These activities will accomplish the following: A total

of 14,080 pregnant women will test for HIV and receive their test results due to influence from their

husbands, and 98% of those who will test positive will be supported by their husbands to obtain ARVs and

adhere to the PMTCT package.

The CMMB MTA team will continue conducting performance assessment and providing the technical

support to both old and new sites. During this fiscal year, we shall also conduct the final project evaluation,

and disseminate the lessons learnt, challenges, and way forward to the stakeholders.

The Catholic Medical Mission Board (CMMB) is working in partnership with Church Health Institutions

(CHIs) in the implementation of the Men Taking Action (MTA) Project. The MTA project is a New Partner

Initiative project funded through USAID for three years which will be concluded at the end of this fiscal year.

The major underpinning for this project is the fact that Zambian men exert significant control and influence

at community and household level in the health seeking behaviors of people and have the potential to

positively change the tide of HIV transmission and demand for HIV care and prevention services, including

counseling and testing (CT) and prevention of mother to child (PMTCT) services.

The CMMB MTA team will continue training, supervising, and supporting the CHIs. As in the last two years,

through outreach programs CHIs will mobilize and educate community men and promote positive attitudes

and behaviors so that men can significantly contribute to stigma reduction related to HIV/AIDS and adapt

and maintain behaviors that protect them and their partners from HIV/AIDS. In FY 2008, the funding for the

MTA project will build upon the programs previous years' successes by continuing to support the training of

CHI staff, community capacity-building, and promotion of CT. In those areas without CT capabilities, the

funding will establish CT facilities.

FY 2008, CMMB will target ten CHI sites and respective catchment's communities. Using the results from

the knowledge, attitudes, and practices study (KAP) and lessons learnt so far, CMMB will train eight CHI

health staff at each of the ten targeted sites involved, for a total of 80 CHIs. This training will include review

of the latest HIV/AIDS information, the routine provision of PMTCT and general VCT, and an orientation into

the MTA program. CMMB will also train ten community health workers (CHW) at each site (for a total of

100 CHWs) to mobilize and educate men to change behaviors in order to increase PMTCT uptake, ANC

visits, testing, and counseling of men. The community leaders to be trained will include CHWs, traditional

healers, chiefs, headmen, indunas, the clergy, civic leaders, and other influential members in the various

targeted communities, and will function as the MTA-CPEs.

CMMB will support CHI staff and CHWs to mobilize and conduct education sessions focused on men in the

communities. Those with pregnant partners/wives attending antenatal care (ANC) at CHIs will increase

their knowledge of HIV/AIDS and support for PMTCT services, and be encouraged to go for CT. With

CMMB' assistance, each of the ten CHIs will conduct ten men's education sessions to approximately 100

men per each session in the general population. In addition, each CHI will conduct ten education sessions

to approximately 50 men per session who are partners to pregnant women attending ANC. Education

sessions will continue to be conducted at the other 21 sites actively engaged in the MTA project. MTA

education sessions will continue being conducted on quarterly basis to 100 men per session as well as ten

special sessions at CHIs to reach 25 men who are husbands to pregnant women attending ANC. Therefore

a total of 27,500 adult men will be reached by end of the year in 2009. We estimate at this stage of project

implementation, 80% of men reached through these education campaigns will accept HIV testing and

receive their results.

After the training sessions, CMMB will visit each new site monthly and each old site (those 21 trained in

2007 and 2008) quarterly to help conduct community sessions and to monitor the progress of the CHWs

and CHI staff. CMMB will review the progress of each site—including tracking data, ensuring that each CHI

monitors the attitudinal change that results in increases in CT and accessing treatment and care—with the

CHI staff during each of these visits.

CMMB has identified three sites where counseling and testing services are not available in the general

population or are too inconvenient to access. In these sites the project will institute mobile testing in close

collaboration with CHAZ and CHI management teams. The CMMB-MTA program will assist the CHI, in

close collaboration with CHAZ, to train professional health staff (a total of nine) and commission the

provision of general CT services. This will ensure availability of testing and counseling of men after a MTA

education meeting in the general community. CMMB will leverage the services of existing organizations

where feasible, particularly with organizations providing mobile testing.

During FY 2008, CMMB will also focus on assisting the CHIs and their partner network organization

involved in HIV care and prevention programs to sustain the good practices learnt so far in the MTA

program. The project will continue addressing two key factors to promote sustainability: integration and

partnership. We shall closely monitor, and where necessary, provide technical support to ensure that

HIV/AIDS information, materials, and approaches developed are integrated into routine in-service trainings

of professional health staff (Nurses, Clinical Officers and physicians), CHWs, network leaders, traditional

healers, and civic leaders. Further, we shall assist the CHIs to integrate the social mobilization and

education campaigns related to the MTA project into the regular outreach programs involving CHI staff and

CHW. By the end of FY 2008, all CHIs and MTA-CPEs will conduct community education sessions and

ensure that the testing and counseling sessions happen according to the CHI's MTA action plan with

minimal CMMB support only.

During this period, CMMB will also prepare the final project evaluation, and disseminate the lessons learnt,

challenges, and way forward to the stakeholders. It is our hope that because the CMMB MTA team will work

with partners to develop their capacity to engage donors, communities and others, the good practices

demonstrated in this project will be sustained after project completion. As the program is centered at the

existing CHIs, and employs existing staff, MTA trainings/orientation workshops, regular support

supervisions, systems development and other inputs will help sustain the capacity of the CHIs.

All targets will be reached by September 30, 2009.