Detailed Mechanism Funding and Narrative

Years of mechanism: 2008 2009

Details for Mechanism ID: 1031
Country/Region: Zambia
Year: 2009
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: $0

Funding for Sexual Prevention: Abstinence/Be Faithful (HVAB): $0

ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:

The narrative reflects project closeout for the last three months of Health Communication Partnership's

(HCP) project life. There will be no new activities in the field, only financial and logistical close out.

Activity Narrative:

This activity linked with the HCP's other activities. HCP's Abstinence/Be faithful activities also supported

both Zambian and the PEPFAR goals through a comprehensive approach that promotes better health

seeking behavior. HCP worked 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 AIDS Council,

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

units.

HCP used 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 continued through FY 2008, consisted 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 included 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 reached 38,000 individuals with messages promoting HIV/AIDS prevention through abstinence

and/or being faithful.

HCP also continued 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 continued to support Creative HEART, a community-

based contest that promotes positive adult-child communication through mentoring relationships. HCP

expanded its coverage of the HEART program in districts where it was already working. Communities

provided in-kind contributions of food, venue, transport, and lodging for contestants. Creative HEART was

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 worked extensively 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 2008 trained drama groups reached over 32,000 adults

and 20,000 children. In FY 2008, dramas focused 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 non-government organizations (NGOs), United Nations (UN)

agencies, and government organizations.

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

held 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 also built on the comprehensive multi-media campaign initiated in

FY 2008 (with Plus-Up funds) for TV, radio, and print which promotes reduction of multiple concurrent

partnerships through raising risk awareness. This campaign increased self-efficacy in avoiding risk and will

have reached 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 provided leadership to ensure that this multi-media campaign and other

prevention campaigns are in full support of the national prevention strategy, which was developed in

collaboration with the National HIV/AIDS/STI/TB Council (NAC) and other local United States Government

(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 supported the HIV Talkline through FY 2008 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 abstinence and being faithful

(AB), counseling and testing (CT), male circumcision (MC), positive living, discordant couples, and

treatment adherence and options. With PEPFAR funding, HCP continued to promote HIV Talkline services

through radio and television spots and outreach activities, which led to a steady increase in caller demand.

In FY 2008, 42,000 individuals were reached with messages promoting HIV/AIDS prevention through

Activity Narrative: abstinence and/or being faithful and information on HIV services. Messages focused on confidential

information and services offered through HIV Talkline. Outreach activities placed an emphasis on

increasing the number of callers from rural areas, specifically targeting the general adult population,

PLWHA, and caregivers.

HCP has been committed to building Zambian capacity and improving the sustainability of the activities

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 are implemented is

community-driven, not imposed by HCP. In addition, the activities required community commitment through

in-kind support. HCP found 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

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 dissemination of the National Prevention Strategy.

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

Programmes (ZCCP), a local health communication NGO. HCP supported ZCCP's developing their

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

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

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

and provincial plans, ensuring ownership and sustainability.

HCP conducted an end-of-project survey in FY 2009, 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 was employed to qualitatively evaluate the project by involving the

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

All FY 2008-funded targets will have been reached by September 30, 2009.

New/Continuing Activity: Continuing Activity

Continuing Activity: 14406

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

14406 3539.08 U.S. Agency for Johns Hopkins 6823 1031.08 Health $2,937,016

International University Center Communication

Development for Communication Partnership

Programs

8905 3539.07 U.S. Agency for Johns Hopkins 4979 1031.07 Health $2,672,016

International University Center Communication

Development for Communication Partnership

Programs

3539 3539.06 U.S. Agency for Johns Hopkins 2911 1031.06 Health $1,080,000

International University Center Communication

Development for Communication Partnership

Programs

Emphasis Areas

Gender

* Addressing male norms and behaviors

* Increasing gender equity in HIV/AIDS programs

* Reducing violence and coercion

Health-related Wraparound Programs

* Child Survival Activities

* Family Planning

* Malaria (PMI)

* Safe Motherhood

Human Capacity Development

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.02:

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $0

ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:

•The narrative reflects project closeout for the last three months of Health Communication Partnership's

(HCP) project life. There will be no new activities in the field, only financial and logistical close out.

Activity Narrative:

This activity linked with the HCP's activities in Abstinence/Be faithful (AB), Palliative Care, Orphans and

Vulnerable Children (OVC), Counseling and Testing (HVCT) and ARV Services. It also supported 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 used 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, provided a comprehensive

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

HCP drew 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 has also been 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 facilitated 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 promoted HIV prevention through a balanced Abstinence, Being faithful, correct and consistent

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

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

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

leaders. These activities reached families of uniformed personnel and emphasized 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 were implemented for people

who are incarcerated. In FY 2008, HCP reached 6,400 individuals with HIV prevention messages.

HCP built on the comprehensive multi-media campaign initiated in FY 2008 (with Plus-Up funds) for

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

awareness. This campaign was designed to increase self-efficacy in avoiding risk and reached 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 provided leadership to ensure the multi-media campaign and other prevention campaigns

were conducted in full support of the national prevention strategy which was 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 were complemented with in-depth

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

men and women. Influential leaders were 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 continued to perform scripted drama and facilitated discussions

on partner reduction, knowledge of HIV status, and stigma reduction, reaching at least 13,200 people. In FY

2008, HCP focused 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.

In FY 2008, HCP continued 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 2008 to support culturally appropriate interventions and messaging about the risks of

alcohol abuse as related to HIV/AIDS. HCP continued to ensure that issues related to alcohol abuse were

integrated in communication interventions.

HCP expanded 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 promoted risk reduction through reduction in concurrent partners, knowing one's status,

using condoms correctly and consistently, and male circumcision. HCP continued 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 developed a high profile, national event with

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

traditional leaders, HCP built 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 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 designed activities that supported 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 implemented were not only chosen by

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

HCP continued 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 continued to work with the Zambia

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

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

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

HCP also facilitated 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 conducted an end-of-project survey to measure impact of all of the above mentioned

activities. The Participatory Ethnographic Evaluation and Research (PEER) method was also employed to

qualitatively evaluate the project by involving the community members in the design, implementation, and

execution of the evaluation exercise.

All FY 2008-funded targets will have been reached by September 30, 2009.

New/Continuing Activity: Continuing Activity

Continuing Activity: 14407

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

14407 3538.08 U.S. Agency for Johns Hopkins 6823 1031.08 Health $1,100,000

International University Center Communication

Development for Communication Partnership

Programs

8904 3538.07 U.S. Agency for Johns Hopkins 4979 1031.07 Health $630,000

International University Center Communication

Development for Communication Partnership

Programs

3538 3538.06 U.S. Agency for Johns Hopkins 2911 1031.06 Health $540,000

International University Center Communication

Development for Communication Partnership

Programs

Emphasis Areas

Gender

* Addressing male norms and behaviors

* Increasing gender equity in HIV/AIDS programs

* Reducing violence and coercion

Health-related Wraparound Programs

* Child Survival Activities

* Family Planning

* Malaria (PMI)

* Safe Motherhood

Human Capacity Development

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.03:

Funding for Care: Adult Care and Support (HBHC): $0

ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:

•The narrative reflects project closeout for the last three months of Health Communication Partnership's

(HCP) project life. There will be no new activities in the field, only financial and logistical close out.

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.

Activity Narrative: 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

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.

New/Continuing Activity: Continuing Activity

Continuing Activity: 14408

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

14408 3536.08 U.S. Agency for Johns Hopkins 6823 1031.08 Health $335,000

International University Center Communication

Development for Communication Partnership

Programs

8902 3536.07 U.S. Agency for Johns Hopkins 4979 1031.07 Health $335,000

International University Center Communication

Development for Communication Partnership

Programs

3536 3536.06 U.S. Agency for Johns Hopkins 2911 1031.06 Health $335,000

International University Center Communication

Development for Communication Partnership

Programs

Emphasis Areas

Gender

* Addressing male norms and behaviors

* Increasing gender equity in HIV/AIDS programs

* Reducing violence and coercion

Health-related Wraparound Programs

* Child Survival Activities

* Family Planning

* Malaria (PMI)

* Safe Motherhood

Human Capacity Development

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.08:

Funding for Treatment: Adult Treatment (HTXS): $0

ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:

•The narrative reflects project closeout for the last three months of Health Communication Partnership's

(HCP) project life. There will be no new activities in the field, only financial and logistical close out.

Activity Narrative

This activity linked with the HCP and other 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 supported 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 used President's Emergency Plan For AIDS Relief (PEPFAR) and Child Survival funds so that more

than 900 communities could 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 drew 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 1,500 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 continued 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 also included more messages on treatment adherence and HCP focused on

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

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

HCP helped develop a comprehensive national communication strategy for children and HIV. Based on

this strategy, interventions were developed 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 improved parents and caregiver's knowledge to connect more parents/caregivers and HIV-

positive children to treatment programs, to improve treatment adherence, to improve the disclosure of

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

own HIV positive status.

HCP also worked to help older children and adolescents cope after learning of their HIV status through

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

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

settings. The materials specifically addressed 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 needed 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. In FY 2009, HCP built on these materials to ensure wider

distribution, coverage, and use.

These HCP activities, along with those described elsewhere, began 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 continued 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 five years, HCP has continued to mentor and work closely with dB Studio in radio

Activity Narrative: programming, Prime Images and LACO 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 has been 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 2009, HCP conducted 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-funded targets will have been reached by September 30, 2009.

New/Continuing Activity: Continuing Activity

Continuing Activity: 14411

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

14411 3534.08 U.S. Agency for Johns Hopkins 6823 1031.08 Health $455,000

International University Center Communication

Development for Communication Partnership

Programs

8901 3534.07 U.S. Agency for Johns Hopkins 4979 1031.07 Health $455,000

International University Center Communication

Development for Communication Partnership

Programs

3534 3534.06 U.S. Agency for Johns Hopkins 2911 1031.06 Health $455,000

International University Center Communication

Development for Communication Partnership

Programs

Emphasis Areas

Gender

* Addressing male norms and behaviors

* Increasing gender equity in HIV/AIDS programs

* Reducing violence and coercion

Health-related Wraparound Programs

* Child Survival Activities

* Family Planning

* Malaria (PMI)

* Safe Motherhood

Human Capacity Development

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.09:

Funding for Care: Orphans and Vulnerable Children (HKID): $0

ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:

•The narrative reflects project closeout for the last three months of the Health Communication Partnership's

(HCP) project life. There will be no new activities in the field, only financial and logistical close out.

Activity Narrative

This activity is linked with the HCP other activities in Abstinence/Be faithful, Other Prevention, Palliative

Care, Counseling and Testing, and Treatment/ARV Services. It also support the U.S. Government (USG)

partners providing orphan and vulnerable children (OVC) care and support services, and addressed 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 used PEPFAR and Child Survival funds so that more than 900 communities benefited 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,

provided a comprehensive approach that promoted better health-seeking behavior through the support for

and promotion of OVC services throughout the country. HCP drew 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 has continued to be 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 continued to disseminate

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

provinces.

In FY 2008, HCP continued 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 developed 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 2009, HCP consolidated the best of the programs

broadcasted during the past three years and HCP held a one week workshop for community radio stations

on the use of this package. The workshop also consolidated the skills of community radio stations in

developing their own programs on local HIV/AIDS issues. HCP district staff continued 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 continued to

work with local communities, Neighborhood Health Committees (NHCs), and the Ministry of Health on these

activities. These organizations will assume leadership and ownership of the activities while linking with

other support organizations to ensure sustainability.

HCP continued 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 continued to be

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

For example, HCP supported 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

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

HCP has continued 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 were also integrated into district and

provincial plans, ensuring ownership and continuity of activities.

In FY 2009, HCP conducted an end-of-project survey to measure impact of all of the activities mentioned

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

All FY 2008-funded targets will have been reached by September 30, 2010.

New/Continuing Activity: Continuing Activity

Continuing Activity: 14409

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

14409 3537.08 U.S. Agency for Johns Hopkins 6823 1031.08 Health $290,000

International University Center Communication

Development for Communication Partnership

Programs

8903 3537.07 U.S. Agency for Johns Hopkins 4979 1031.07 Health $290,000

International University Center Communication

Development for Communication Partnership

Programs

3537 3537.06 U.S. Agency for Johns Hopkins 2911 1031.06 Health $290,000

International University Center Communication

Development for Communication Partnership

Programs

Emphasis Areas

Gender

* Addressing male norms and behaviors

* Increasing gender equity in HIV/AIDS programs

* Reducing violence and coercion

Health-related Wraparound Programs

* Child Survival Activities

* Family Planning

* Malaria (PMI)

* Safe Motherhood

Human Capacity Development

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.13:

Funding for Prevention: HIV Testing and Counseling (HVCT): $0

The narrative reflects project closeout for the last three months of Health Communication Partnership's

(HCP) project life. There will be no new activities in the field, only financial and logistical close out.

This activity linked with the HCP's activities. This activity also directly supported 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 supported the

Ministry of Health (MOH), National HIV/AIDS/STI/TB Council (NAC), and USG implementing partner

counseling and testing (CT) activities. HCP has also been 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 used 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, provided a comprehensive

approach to promoting counseling and testing services throughout the country. HCP drew 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,

developed in conjunction with ZCCP, for service providers to use in pre- and post-circumcision counseling

for clients seeking MC services.

In FY 2008, HCP also developed a short video on the basic information around MC, 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. This video, in seven national languages, was aired for 16 weeks, twice per

day, on ZNBC television, and ZNBC Radio 1 and Radio 2, with at the relevant language slots. 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 2009, HCP built on the information campaign to support MC services and HCP addressed specific

behavioral issues that emerged from FY 2008 and will continue to emerge throughout FY 2009. HCP will

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

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

In FY 2009, HCP staff continued to strengthen community links to MC services, working with partners in

service delivery (JHPIEGO, PSI/SFH and MOH) to orient counselors to the male reproductive health

handbook. Safe motherhood action groups continued to promote knowing one's HIV status. These action

groups also promoted 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 continued 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,

continued to be used at a community level and at 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 have continued to be focused on developing the skills and capacity of

individuals, Neighborhood Health Committees (NHCs), and community-based organizations (CBOs). HCP

has continued to promote self-reliance and build sustainable programs. HCP continued 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 continued 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 facilitated 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

Activity Narrative: ownership and continuity of activities.

In FY 2009, HCP conducted an end-of-project survey to measure impact of the activities mentioned above,

along with activities listed elsewhere in the COP.

All FY 2008-funded targets will have been reached by September 30, 2009.

New/Continuing Activity: Continuing Activity

Continuing Activity: 14410

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

14410 12529.08 U.S. Agency for Johns Hopkins 6823 1031.08 Health $330,000

International University Center Communication

Development for Communication Partnership

Programs

12529 12529.07 U.S. Agency for Johns Hopkins 4979 1031.07 Health $330,000

International University Center Communication

Development for Communication Partnership

Programs

Emphasis Areas

Gender

* Addressing male norms and behaviors

* Increasing gender equity in HIV/AIDS programs

* Reducing violence and coercion

Health-related Wraparound Programs

* Child Survival Activities

* Family Planning

* Malaria (PMI)

* Safe Motherhood

Human Capacity Development

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.14:

Subpartners Total: $0
Comprehensive HIV/AIDS Management Program: NA
Save the Children: NA
International HIV/AIDS Alliance: NA
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