PEPFAR's annual planning process is done either at the country (COP) or regional level (ROP).
PEPFAR's programs are implemented through implementing partners who apply for funding based on PEPFAR's published Requests for Applications.
Since 2010, PEPFAR COPs have grouped implementing partners according to an organizational type. We have retroactively applied these classifications to earlier years in the database as well.
Also called "Strategic Areas", these are general areas of HIV programming. Each program area has several corresponding budget codes.
Specific areas of HIV programming. Budget Codes are the lowest level of spending data available.
Expenditure Program Areas track general areas of PEPFAR expenditure.
Expenditure Sub-Program Areas track more specific PEPFAR expenditures.
Object classes provide highly specific ways that implementing partners are spending PEPFAR funds on programming.
Cross-cutting attributions are areas of PEPFAR programming that contribute across several program areas. They contain limited indicative information related to aspects such as human resources, health infrastructure, or key populations programming. However, they represent only a small proportion of the total funds that PEPFAR allocates through the COP process. Additionally, they have changed significantly over the years. As such, analysis and interpretation of these data should be approached carefully. Learn more
Beneficiary Expenditure data identify how PEPFAR programming is targeted at reaching different populations.
Sub-Beneficiary Expenditure data highlight more specific populations targeted for HIV prevention and treatment interventions.
PEPFAR sets targets using the Monitoring, Evaluation, and Reporting (MER) System - documentation for which can be found on PEPFAR's website at https://www.pepfar.gov/reports/guidance/. As with most data on this website, the targets here have been extracted from the COP documents. Targets are for the fiscal year following each COP year, such that selecting 2016 will access targets for FY2017. This feature is currently experimental and should be used for exploratory purposes only at present.
Years of mechanism: 2008 2009
This activity narrative is a draft and will be revised upon the award of the New United States Agency for
International Development HIV/AIDS Service Delivery Support Program in FY 2009. Targets will be
adjusted based on the actual starting date of the new project. It is envisioned that there will be a four month
overlap between the current and the new program so that services continue to be provided to new and
existing clients.
A new procurement on prevention mother-to-child transmission (PMTCT) to follow the Zambia Prevention,
Care, and Treatment Partnership (ZPCT) project is being developed. This activity will link to other project
program areas including: counseling and testing (CT), antiretroviral therapy (ART), tuberculosis (TB)/HIV,
Palliative Care, and Laboratory Support as well as the Government of the Republic of Zambia (GRZ)
strategic plans, and other United States Government (USG) partner activities as outlined below.
The new program will provide support to GRZ to strengthen and expand PMTCT services in the current 204
sites and an additional 12 facilities in 34 districts, many very remote, in Central, Copperbelt, Luapula,
Northern, and North-Western provinces, representing 80% of the population in these five provinces. The
program will expand its support to the remaining 8 districts in FY 2009 and beyond. In FY 2008, the current
program reached over 84,185 PMTCT clients over the 12 month target period, with 8,355 receiving ARV
prophylaxis. Since FY 2005, the current program has assessed and refurbished 204 PMTCT sites.
During 2009/2010, the new program will strengthen the expansion of current activities by providing technical
support, ensuring quality services, and building district capacity to manage HIV/AIDS services. The
program will support provision of accurate reporting and data collection (utilizing PMTCT Smart Care where
a computer and security is available), availability of basic medical equipment, and reliable supplies of ARV
prophylaxis. Commodity management will be coordinated with the GRZ, the United States Agency for
International Development | Deliver Project, and the Partnership for Supply Chain Management Systems
(SCMS).
The project will: 1) enhancing, strengthening, and promoting PMTCT service delivery; 2) increasing access
to CD4 testing services; 3) providing follow-up of HIV-infected and uninfected mothers and their children; 4)
expanding the integration of PMTCT with antenatal care, family planning and malaria (IPTp); and 5)
involving traditional birth attendants (TBAs) in PMTCT adherence support and follow-up at the community
level; and 6) increasing program sustainability with the GRZ.
The project will promote and strengthen PMTCT service delivery, by supporting at 216 PMTCT facilities in
the five provinces listed above. Approximately 85,000 women will be reached with PMTCT services, and
approximately 10,000 will receive a complete course of ARV prophylaxis. The project will monitor quality of
services in all facilities, and will include moderate renovations as needed. All sites will receive assistance to
improve quality of PMTCT services, including linkages to CT, ARV prophylaxis for mothers and infants, and
infant feeding counseling. Support will be provided to ensure accurate reporting and data collection,
availability of basic medical equipment, and reliable supplies ARV prophylaxis. Commodity management
will be coordinated with the GRZ, the United States Agency for International Development | Deliver Project,
and the Partnership for Supply Chain Management Systems (SCMS).
The project will provide technical support and training for health care workers (HCWs), TBAs, Adherence
support workers (ASWs), lay counselors, and supervisors. The project will provide training for at least 60
TBAs in PMTCT concepts, provision, and adherence support, and 300 health care workers, and will
continue to strengthen quality assurance, supervisory, and monitoring systems. At national level, the
project will provide technical assistance to the national PMTCT Technical Working Group in scale-up of
PMTCT services and support for the development, revision, and dissemination of PMTCT training materials,
protocols, standard operating procedures, and policies.
The project will increase access to CD4 testing services, and strengthening links between PMTCT and ART
services. In FY 2009, the project will fund transport of laboratory samples for CD4 testing from supported
facilities to sites with CD4 machines to ensure PMTCT and ART services are more accessible, and support
inter-facility sample referral.
The project will strengthen systems for follow-up of HIV-infected mothers and their infants after delivery.
Blood samples for exposed children will be taken as part of the PMTCT care package and couriered for
polymerase chain reaction (PCR) testing. Support will also include linking women with community groups
that provide nutritional, legal, and psychosocial support.
The project will promote PMTCT services by implementing an intensive strategy to reach pregnant women
with comprehensive PMTCT services. This approach includes strengthening universal counseling of
women in antenatal (ANC) clinics, establishing and/or strengthening outreach of ANC services to reach
women in more rural areas, and integration of PMTCT, counseling and testing (CT) (with emphasis on
reaching discordant couples), clinical palliative care, and ART services. The project will carry out
renovations were needed. The activity will support development and implementation of a USG/Zambia food
and nutrition strategy, as well as consider adopting a common technical approach to food and nutrition
support.
The project will identify and address gender disparities in access to PMTCT services by developing and
implementing gender related activities such as scaling up male involvement in PMTCT services; scaling-up
couple counseling to promote testing of men and to build their support for their female partners and efforts
in targeting families; promoting participation of male and female caregivers in community based activities;
promoting community participation in PMTCT services by working through community leaders including
Church leaders, community based caregivers and other community key stakeholders to encourage
pregnant women to access PMTCT services, and encourage partners and discordant couples to be
involved in couples counseling and testing for PMTCT; and developing indicators and reporting system for
gender integration activities.
The project will support community level mobilization activities that promote increased uptake of PMTCT
Activity Narrative: services. Reduction of stigma and discrimination, as well as equity of access to PMTCT and related
HIV/AIDS services, will be discussed and addressed with partners within a culturally-sensitive context.
In an effort to provide continuity of care, the project will also encourage follow-up services, referrals for
mothers, and integrated services. Women testing positive will be referred appropriately to malaria, family
planning, and ante-natal services or vice versa. Those who test negative will be referred to comprehensive
prevention activities. The program will also integrate HIV/AIDS services with Child survival related activities
to enhance early diagnosis and increased uptake of pediatric ART services. Traditional Birth Attendants
(TBAs) will provide PMTCT adherence support and follow-up at the community level to ensure pregnant
women know how to take their PMCT medications and when to return to the clinic to have their children
started on prophylaxis and undergo HIV testing.
The project will support evaluations of lessons learnt from PMTCT interventions to identify and scale up
best practices and to develop appropriate training and service delivery packages to increase access to
PMTCT services in public and private health facilities. The process of evaluation will include: identifying
critical activity areas that require evaluation and conducting evaluations as needed; substantive involvement
of policy makers, managers, service providers, and other stakeholders involved in the response to
HIV/AIDS including building sustainable links between key players, from identification of evaluation
questions, conducting training in evaluations, doing evaluations, and documenting, disseminating, and
utilizing evaluation results in program implementation. The evaluations will be conducted in close
collaboration with the provincial and district health offices to promote ownership of the results by the
government of Zambia and to strengthen the Health Management Information System (HMIS). The activity
will also participate and share best practices at President Emergency Plan for AIDS Relief (PEPFAR)
implementer's meetings, stakeholder meetings, and other fora.
The project will work closely with other partners - e.g., community based organizations, non-governmental
organizations, faith-based organizations, United Nations Population Fund, and other USG partners,
including: Behavior Change and Communications, Catholic Relief Services/SUCCESS, and RAPIDS.
The project will work with GRZ facilities, to establish a sustainable program by building program
management capacity through training of managers, and facilitating joint planning and budgeting including
estimating and costing human resources required to run HIV/AIDS programs; promoting active involvement
of key GRZ management officials in monitoring, supportive supervision and in quality assurance/quality
improvement (QA/QI) assessments; developing/improving strategic information and analytical tools to
enhance monitoring and evaluation (M&E) system strengthening, and data ownership and utilization by
PHOs, DHMTs, and health facilities to improve service provision; improving logistics management and
reporting; training health care workers; developing policies, standard protocols and guidelines;
strengthening physical and equipment infrastructures; and improving laboratory equipment and systems.
The project will gradually wean off well performing districts from project technical support over the five years
of the implementation period.
The program will, by 2010, develop public/private partnerships by providing technical support to privately
owned health facilities such as for the mines, to enhance provision of quality PMTCT services, and will link
these facilities to the government supply chain for provision of PMTCT ARV drugs, HIV test kits and PCR
dried blood spot reagents.
New/Continuing Activity: Continuing Activity
Continuing Activity: 14444
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
14444 14444.08 U.S. Agency for To Be Determined 6842 6842.08 ZPCT FOLLOW
International ON
Development
Emphasis Areas
Construction/Renovation
Gender
* Addressing male norms and behaviors
* Increasing gender equity in HIV/AIDS programs
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.01:
This activity narrative is a draft and will be revised upon the award of the New USAID HIV/AIDS Service
Delivery Support Program in FY 2009. Targets will be adjusted based on the actual starting date of the new
project. It is envisioned that there will be a four month overlap between the current and the new program so
that services continue to be provided to new and existing clients.
A new procurement on provision of clinical HIV/AIDS services to follow the Zambia Prevention, Care, and
Treatment Partnership (ZPCT) project is being developed. This activity is directly linked to Social Marketing,
Behaviour Change and Communications, Johns Hopkins Program for International Education in Gynecology
and Obstetrics (JHPIEGO), Partnership for Supply Chain Systems, and Elizabeth Glazier Pediatric AIDS
Foundation (EGPAF), as well as indirectly to Ministry of Health (MOH), National AIDS Council (NAC), and
United States Government (USG) implementing partners for AB activities. The project will also link with the
counselling and testing (CT), prevention of mother-to-children transmission (PMTCT) of HIV program area
activities and other health related areas that will increase demand for and access to MC services.
The project will establish and scale up male circumcision (CIRC) activities in health facilities in the five
provinces (Central, Northern, Copperbelt, Luapula and North-Western Provinces, to meet current demand
for CIRC services and to develop lessons learned regarding cost-effective, sustainable CIRC service
delivery models to rapidly scale-up CIRC services nationwide. To ensure maximum benefit, male
circumcision services will be part of a package of services that includes other HIV and STI prevention
services and counseling while promoting provision of quality surgical procedures to minimize complications.
The project will: 1) Conduct provincial, district, and facility-level orientations for management buy-in and
understanding of CIRC activities; 2) Integrate complete and evidence-based male circumcision services
with counseling and testing services and other HIV/AIDS related services, sexually transmitted infection
(STI) services, maternal and child health services to promote infant MC, and create linkages to male
circumcision services; 3) Integrate male circumcision information and services with other important male
reproductive health services; 4) Increase access to safe, high quality male circumcision services in program
operational sites where feasible; 5) Train CIRC providers using the international WHO materials in provision
of high quality CIRC services including performing the CIRC surgical procedure, and training CIRC
counselors using WHO supplemental counseling training materials; 6) Provide supportive supervision using
performance standards and a standards based management approach; 7) Strengthen health facilities to
provide quality CIRC services and to increase access to CIRC services by ensuring facilities get equipment
and commodities through the national system, and counseling and information, education, and
communication (IEC) materials; 8) Conduct operational research as needed that is cognizant of current
Office of the Global AIDS Coordinator (OGAC) guidance governing such activities, to improve CIRC
services; and 9) Strengthen reporting system for CIRC activities. The activity will increase gender equity in
HIV/AIDS prevention services by increasing the number of men accessing CIRC services.
The project will support evaluations of lessons learnt from male circumcision interventions to identify and
scale up best practices and to develop appropriate training and service delivery packages to increase
access to male circumcision services in public and private health facilities. The process of evaluation will
include: identifying critical activity areas that require evaluation and conducting evaluations as needed;
substantive involvement of policy makers, managers, service providers, and other stakeholders involved in
the response to HIV/AIDS including building sustainable links between key players, from identification of
evaluation questions, conducting training in evaluations, doing evaluations, and documenting,
disseminating, and utilizing evaluation results in program implementation. The evaluations will be
conducted in close collaboration with the provincial and district health offices to promote ownership of the
results by the government of Zambia and to strengthen the Health Management Information System
(HMIS). The activity will also participate and share best practices at President Emergency Plan for AIDS
Relief (PEPFAR) implementer's meetings, stakeholder meetings, and other fora.
At national level, the project will support the CIRC task force, the National AIDS Council (NAC) preventions
of sexual transmission (PST) working group and Ministry of Health (MOH) in developing policies, protocols,
guidelines, and training and education materials to enhance national scale-up of quality CIRC services. The
project will work with community groups including traditional leaders to create awareness and demand for
CIRC services, and will provide technical support to traditional circumcisers in North-Western province to
enhance provision of quality CIRC services.
The project will by 2010, develop public/private partnerships by providing technical support to privately
owned health facilities such as for the mines, to enhance provision of quality CIRC services. The program
will also link these facilities to the government supply chain for provision of CIRC equipment, commodities
and supplies.
The project will work with the Government of the Republic of Zambia (GRZ) facilities, to establish a
sustainable program by building program management capacity through training of managers, and
facilitating joint planning and budgeting including estimating and costing human resources required to run
HIV/AIDS programs; promoting active involvement of key GRZ management officials in monitoring,
supportive supervision and in quality assurance/quality improvement (QA/QI) assessments;
developing/improving strategic information and analytical tools to enhance monitoring and evaluation (M&E)
system strengthening, and data ownership and utilization by provincial health offices (PHOs), district health
management teams (DHMTs), and health facilities to improve service provision; improving logistics
management and reporting; training health care workers; developing policies, standard protocols and
guidelines; strengthening physical and equipment infrastructures; and improving laboratory equipment and
systems. The project will over the five years of the project gradually win off well performing districts from
project technical support.
New/Continuing Activity: New Activity
Continuing Activity:
Table 3.3.07:
This activity narrative is a draft and will be revised upon the award of the new USAID HIV/AIDS Service
A new adult care and support procurement is being developed to follow the ZPCT program. This activity
links with other program areas including: PMTCT, HTXS, PDTX, HVCT, HVTB, and HLAB activities as well
as with MSF-Spain, the Government of the Republic of Zambia (GRZ) and other US Government (USG)
partners. The activity will strengthen and expand clinical adult care services in Central, Copperbelt, and the
more remote Luapula, Northern, and North-Western provinces. In 2009/2010, 86,000 clients will receive
adult care in project supported facilities.
During FY 2009, the new activity will strengthen the expansion of current activities by providing technical
support, ensuring quality services, and building district capacity to manage HIV/AIDS services. Adult care
activities will include four components: 1) strengthening adult care services including management of
opportunistic infections and pain management within health facilities, and support moderate renovations as
needed; 2) increasing referral linkages within and between health facilities and communities working
through local community leaders and organizations; 3) participating in and assisting the Ministry of Health
(MOH) and the National HIV/AIDS/STI/TB Council (NAC) to develop strategy, guidelines, and standard
operating procedures; and 4) increasing program sustainability with the GRZ.
The project will strengthen adult care services within health facilities and support at least 228 health
facilities. In addition to ART/OI training, the project will train 250 health care workers, using the Government
of the Republic of Zambia (GRZ) approved curriculum, to provide cotrimoxazole prophylaxis, symptom and
pain assessment and management, patient and family education and counseling, management of adult and
pediatric HIV in the home setting, and provision of basic nursing services, all of which are part of the overall
package of adult care services. Pharmacy staff will be trained in data collection/reporting, ordering,
tracking, and forecasting of HIV-related commodities to ensure availability of critical medical supplies and
drugs. The project will liaise closely with the DELIVER project and the Partnership for Supply Chain
Management Systems on forecasting drug supply requirements.
The new activity will increase referral linkages within and between health facilities and communities,
building on Zambia's history of working with Faith-Based Organizations and Community-Based
Organizations that provide home-based care for people living with HIV/AIDS (PLWHA). These
organizations serve as critical partners for facility-based programs supported by the GRZ and USG. The
project will work closely with these established entities to strengthen referral networks linking clinical adult
care services with community-based programs. The project will also continue to work with the Ndola
Diocese home-based care program, and with other available Diocese home-based care programs in the
operational sites, and other USG supported home-based care partners such as, Catholic Relief
Services/SUCCESS and RAPIDS to better link clinical services to related community programs.
The project will work with existing community groups, such as Neighborhood Health Committees,
community-based care givers, traditional healers, and other key community leaders to increase community
involvement. It will also build community volunteers' capacity and involve PLWHA in adult care services at
the community level to reduce stigma and discrimination and thereby improve quality and efficiency of these
services. The project will use materials developed by or adapted from materials produced by the Behavior
Changes and Communications partner.
The new activity will participate and provide assistance to the USG Adult Care Forum as well as coordinate
with the Adult Care Association of Zambia and Ministry of Health (MOH) to develop a national adult care
strategy, guidelines, and standard operating procedures, including policy and advocacy activities supporting
scale-up of the use of Morphine for pain management. Through these efforts, the project will aim to
improve access to quality clinical adult care services; promote the use of evidence-based practices and
share lessons learned in project implementation; and support the revision of national adult care guidelines
and protocols in accordance with GRZ policies.
The project will support evaluations of lessons learnt form clinical palliative care interventions to identify and
access to palliative care services in public and private health facilities. The process of evaluation will
results by the government of Zambia and to strengthen the Health Management Information System (HMIS)
The activity will also participate and share best practices at President Emergency Plan for AIDS Relief
(PEPFAR) implementer's meetings, stakeholder meetings, and other fora.
The project will identify and address gender disparities and other gender issues that hinder access to
palliative care services by developing and implementing gender related activities such as scaling up male
involvement in palliative care services; scaling-up couple counseling to promote access to palliative care
services by couples, and efforts in targeting families including psychosocial and medication adherence
support; promoting participation of male and female caregivers in clinic and community based activities;
promoting community participation in HIV/AIDS activities by working through community leaders including
Church leaders, community based caregivers and other community key stakeholders to encourage couples
to access palliative care services, and developing indicators and reporting system for gender integration
activities.
Activity Narrative: The project will work with GRZ facilities to establish a sustainable program by building program
provincial health offices, district health management teams, and health facilities to improve service
provision; improving logistics management and reporting; training health care workers; developing policies,
standard protocols and guidelines; strengthening physical and equipment infrastructures; and improving
laboratory equipment and systems. Over the five years of the project implementation period, the project will
gradually wean off well performing districts from project technical support. Involvement of PLWHAs gives a
human face to the problem of HIV/AIDS, reinforces basic messages, and helps create a more supportive
environment. PLWHAs will be used as additional human resources for clinic and community level activities.
In addition to training, promoting active involvement of community leaders and key GRZ managers and
providers will also enhance program sustainability
owned health facilities such as for the mines, to enhance provision of quality CT services. The project will
also link these facilities to the government supply chain for provision of HIV test kits.
Continuing Activity: 14447
14447 14447.08 U.S. Agency for To Be Determined 6842 6842.08 ZPCT FOLLOW
Table 3.3.08:
Delivery Support Program in FY 2009. Targets will be adjusted based on the actual starting date of the
new project. It is envisioned that there will be a four month overlap between the current and the new
program so that services continue to be provided to new and existing clients.
A new procurement on Anti-Retroviral Therapy (ART) services to follow the Zambia Prevention, Care, and
Treatment Partnership (ZPCT) project is being developed. This activity will link to other project program
areas including HVCT, PMTCT, HVTB, HDCS, PDCS, and HLAB activities as well as the Government of
the Republic of Zambia (GRZ) and other US Government (USG) partners as outlined below. This activity
will strengthen and expand ART services in Central, Copperbelt, and the more remote Luapula, Northern,
and North-Western provinces.
During FY 2009, the new project will strengthen the expansion of current activities by providing technical
support, ensuring quality services, and building district capacity to manage adult and pediatric HIV/AIDS
treatment services. The activity will 1) provide comprehensive support to strengthen ART facilities and
services; 2) expand implementation of the ART outreach model; 3) strengthen referral linkages and improve
service integration to increase demand for ART services; 4) scale-up pediatric ART services; 5) participate
in and support the national ART Technical Working Group; and 6) increase program sustainability with the
GRZ.
The project will provide comprehensive support to strengthen ART facilities and services, and expand ART
services. In 2009/2010, the project will train about 250 health care workers (HCWs) in ART including
pediatric ART and opportunistic infection (OI) management. Additional courses will be offered in pain
management and refresher courses. In collaboration with the new Health Systems Strengthening activity,
the project will assist ART sites in developing quality assurance mechanisms and supportive supervision
systems. These systems will ensure the implementation, and utilization, of standard operating procedures
for ART case management and the linkage of ART patients and their families to ante-natal care, PMTCT,
TB, adult care, and other appropriate treatment and support services. The activity will conduct
refurbishments of ART rooms where needed to create an enabling environment for provision of ART
services. The project will also support pharmacy refurbishments to enhance proper storage and
distribution of ART drugs. In addition to refurbishments, the project will provide needed furniture and
equipment.
The project will consolidate expansion of the ART outreach model. Through this model, doctors trained in
ART case management travel to non-ART health centers on selected days, bringing with them mini-labs, to
train facility staff and to provide HIV/AIDS clinical services to patients who would not otherwise have access
to these quality ART services.
The project will work with other partners, such as Catholic Relief Services/SUCCESS, Elizabeth Glaser
Pediatric AIDS Foundation, Center for Infectious Disease Research in Zambia (CIDRZ), MSF-Spain,
Reaching HIV/AIDS Affected People with Integrated Development and Support, and the new social
marketing and behavior change activities to strengthen referral linkages and community outreach efforts
aimed at creating awareness of and demand for ART services and supporting treatment adherence among
ART patients. The project will collaborate with the GRZ, DELIVER, and Partnership for Supply Chain
Management Systems in the distribution of ARVs including pediatric formulas, and training of health facility
staff in logistics management to ensure timely ordering and uninterrupted supply of ARVs. The project will
also train approximately 100 adherence support workers (ASWs) in ART adherence counseling, treatment
support, and community outreach and 250 HCWs in ART. In 2009/2010 support will also further reduce
stigma and discrimination associated with ART by working with community leaders and key stakeholders
regarding the importance of CT and availability of ART.
The project will provide assistance to the GRZ in scaling-up ART services to serve at least 18,600 new
clients in FY 2009. The project will continue to provide technical assistance and mentoring to GRZ facilities
and staff in the five provinces to promote provision of quality HIV/AIDS services, with special attention to
routine or provider initiated CT, timely initiation of ART, and contrimoxazole prophylaxis.
The project will continue to integrate innovative approaches to ART case management, including mentoring,
on-site training, and strengthening basic ART/OI pediatric management. ASWs will continue to assist
families in addressing ART adherence and other challenges to effective ART case management.
The project will continue to strengthen linkages with PMTCT services to ensure that HIV positive pregnant
women who are eligible for treatment benefit from ART, those who have delivered are tracked to ensure
their babies have the Dried Blood Spot (DBS) DNA PCR test, and children who test positive are liked to HIV
care and treatment services. The project will also scale-up early childhood diagnosis through integration
with in and out patient child health services, couple and child counseling, and promotion of male
involvement in PMTCT services. The project will continue to strengthen the inter-facility sample referral
system to facilitate early diagnosis and initiation of ART, including referral for patient ART monitoring blood
samples.
The project will also work with partners to strengthen referral networks within and between facilities and
communities to expand access to HIV care, including tracking patients and providing adherence support
services. The project will work with churches and local community groups to reach families with
information and referrals for CT and ART services. The project will also support routine CT in TB and STI
clinics as additional entry points for ART services. Where appropriate the activity will collaborate with
OGAC and USG/Zambia on an effort to shift to a client focused food by prescription approach. The activity
will also support development and implementation of a USG/Zambia food and nutrition strategy, as well as
consider adopting a common technical approach to food and nutrition support.
At national level the project will continue providing technical assistance to the national ART Technical
Working Group for scaling-up ART services, focusing on developing, updating, and disseminating training
Activity Narrative: materials, protocols, and policies.
The project will identify and address gender disparities and other issues that hinder access to ART services
by developing and implementing gender related activities such as scaling up male involvement in HIV/AIDS
services; scaling-up couple counseling to promote testing of men and to build their support for their female
partners and efforts in targeting families; promoting participation of male and female caregivers in
community based activities; promoting community participation in HIV/AIDS services by working through
community leaders including Church leaders, community based caregivers and other community key
stakeholders to encourage couples to access ART services, and encourage partners and discordant
couples to be involved in couples counseling and testing; and developing indicators and a reporting system
for gender integration activities.
The project will support evaluations of lessons learnt from treatment interventions to identify and scale up
treatment services in public and private health facilities. The process of evaluation will include: identifying
Government of Zambia and to strengthen the Health Management Information System (HMIS). The activity
The project will, over the five years of project implementation period, gradually wean off well performing
districts from project technical support.
owned health facilities such as for the mines, to enhance provision of quality adult ART services. The
program will also link these facilities to the government supply chain for provision of ARV drugs and HIV test
kits and other diagnostic laboratory reagents.
Continuing Activity: 16419
16419 16419.08 U.S. Agency for To Be Determined 6842 6842.08 ZPCT FOLLOW
Table 3.3.09:
A new procurement on palliative care to follow the Zambia Prevention, Care, and Treatment Partnership
(ZPCT) project is being developed. This activity links with other program areas including: PMTCT, ART,
CT, TB/HIV, and Laboratory Support activities as well as with the Government of the Republic of Zambia
(GRZ) and other US Government (USG) partners. The activity will strengthen and expand clinical palliative
care services in Central, Copperbelt, and the more remote Luapula, Northern, and North-Western
provinces. By June 2008, the project trained over 800 home care workers (HCWs) and pharmacy staff in
ART/OI management, ART/OI refresher, and HIV-related pharmacy management courses, and about 218
facilities were providing clinical palliative care services. Additionally, in 2009/2010, over 86,000 clients will
receive palliative care services in project supported facilities
In 2009/2010, the new project will strengthen the expansion of the current activities by providing technical
support, ensuring quality services, and building district capacity to manage HIV/AIDS services. Palliative
care activities will include four components: 1) strengthening palliative care services including management
of opportunistic infections and pain management within health facilities, and support moderate renovations
as needed; 2) increasing referral linkages within and between health facilities and communities working
(MOH) and the National HIV/AIDS/STI/TB Council (NAC) to develop a strategy, guidelines, and standard
The project will strengthen palliative care services within health facilities, and will support at least 228 health
facilities. In addition to the ART/OI training mentioned above, HCWs will also be trained, using GRZ-
approved curriculum, to provide cotrimoxazole prophylaxis, symptom and pain assessment and
management, patient and family education and counseling, management of pediatric HIV in the home
setting, and provision of basic nursing services as part of the overall package of palliative care services.
Pharmacy staff will be trained in data collection/reporting and ordering, tracking, and forecasting HIV-related
commodities to ensure availability of critical medical supplies and drugs. The project will also liaise closely
with the USIAD | DELIVER PROJECT and the Partnership for Supply Chain Management Systems (SCMS)
on forecasting drug supply requirements.
The project will increase referral linkages within and between health facilities and communities, building on
Zambia's history of working with Faith-Based Organizations (FBOs) and Community-Based Organizations
(CBOs) that provide home-based care for people living with HIV/AIDS (PLWHAs). These organizations
serve as critical partners for facility-based programs supported by GRZ and USG. The project will work
closely with these established entities to strengthen referral networks linking clinical palliative care services
with community-based programs. The project will also continue to work with the Ndola Diocese home-
based care program, and with other available Diocese home-based care programs in the operational sites,
and other USG supported home-based care partners such as, Catholic Relief Services/SUCCESS and
RAPIDS to better link clinical services to related community programs.
involvement. It will also build community volunteers' capacity, and involve PLWHAs in palliative care
services at the community level to reduce stigma and discrimination and thereby improve quality and
efficiency of these services. The project will use materials developed by or adapted from materials
produced by the Behavior Change and Communications partner.
The project will participate and provide assistance to the USG Palliative Care Forum as well as coordinate
with the Palliative Care Association of Zambia and Ministry of Health (MOH) to develop a national palliative
care strategy, guidelines, and standard operating procedures, including policy and advocacy activities
supporting scale-up of the use of Morphine for pain management. Through these efforts, the project will
aim to improve access to quality clinical palliative care services; promote the use of evidence-based
practices and share lessons learned in project implementation; and support the revision of national palliative
care guidelines and protocols in accordance with GRZ policies.
The project will support evaluations of lessons learnt from palliative care interventions to identify and scale
up best practices and to develop appropriate training and service delivery packages to increase access to
palliative care services in public and private health facilities. The process of evaluation will include:
identifying critical activity areas that require evaluation and conducting evaluations as needed; substantive
involvement of policy makers, managers, service providers, and other stakeholders involved in the response
to HIV/AIDS including building sustainable links between key players, from identification of evaluation
Activity Narrative: strengthening physical and equipment infrastructures; and improving laboratory equipment and systems.
of the project implementation period. Involvement of people living with HIV/AIDS (PLWHAs) gives a human
face to the problem of HIV/AIDS, reinforces basic messages, and helps create a more supportive
providers will also enhance program sustainability.
Table 3.3.10:
areas including: HVCT, PMTCT, HVTB, HBHC, and HLAB activities as well as the Government of the
Republic of Zambia (GRZ) and other US Government (USG) partners as outlined below. This activity will
strengthen and expand pediatric ART services in the Central, Copperbelt, and more remote Luapula,
Northern, and North-Western provinces. With FY 2009 funding, this project will support approximately
2,000 new pediatric clients on ART.
support, ensuring quality services, and building district capacity to manage pediatric HIV/AIDS services.
The activity will: 1) provide comprehensive support to strengthen ART facilities and services; 2) expand
implementation of the ART outreach model; 3) strengthen referral linkages and improve service integration
to increase demand for ART services; 4) scale-up pediatric ART services; 5) participate in and support the
national ART Technical Working Group; and 6) increase program sustainability with the GRZ.
services. The project will also support pharmacy refurbishments to enhance proper storage and distribution
of ART drugs. In addition to refurbishments, the project will provide needed furniture and equipment.
support, and community outreach and 250 HCWs. The 2009/2010 support will also further reduce stigma
and discrimination associated with ART by working with community leaders and key stakeholders regarding
the importance of CT and availability of ART.
The project will provide assistance to the GRZ in scaling-up ART services and treatment for pediatric
patients to serve at least 6,000 children in 2009/2010. The project will continue to provide technical
assistance and mentoring to GRZ facilities and staff in the five provinces to address limited HIV/AIDS
pediatric expertise, with special attention to routine provider initiated CT, timely initiation of ART, and
contrimoxazole prophylaxis.
Working through the under-five clinics, the project will strengthen the system to provide support and ensure
that infants of HIV-infected women are tested for HIV at nine and 18-months as per the revised National
PMTCT and ART Protocol Guidelines. The project will work with hospitals currently equipped with
Polymerase Chain Reaction (PCR) machines to process an early diagnosis for HIV-infected infants, and will
coordinate with the PCR activities supported by the Centers for Disease Control and Prevention (CDC), in
collaboration with the Clinton Foundation HIV/AIDS Initiative. The project will continue to integrate
innovative approaches to pediatric ART case management, including mentoring, on-site training, and
strengthening basic ART/OI pediatric management. ASWs will continue to assist families in addressing
ART adherence and other challenges to effective pediatric case management.
their babies have the Dried Blood Spot (DBS) DNA PCR test, and children who test positive are linked to
HIV care and treatment services. The project will also scale-up early childhood diagnosis through
integration with in and out patient child health services, couple and child counselling, and promotion of male
involvement in PMTCT services.
communities to expand access to pediatric HIV care, including tracking of mothers and their infants for up to
18 months through the under-five clinics. The project will work with churches and local community groups
to reach families with information and referrals for CT and ART for children under 14 years of age. The
activity will also support development and implementation of a USG/Zambia food and nutrition strategy, as
well as consider adopting a common technical approach to food and nutrition support.
Activity Narrative: At national level the project will continue providing technical assistance to the national ART Technical
materials, protocols, and policies.
by children by developing and implementing gender related activities such as scaling up male involvement
in PMTCT services; scaling-up couple counseling to promote testing of men and to build their support for
their female partners and efforts in targeting families; promoting participation of male and female caregivers
in community based activities; promoting community participation in PMTCT services by working through
stakeholders to encourage couples to take their children or access PMTCT services, and encourage
partners and discordant couples to be involved in couples counseling and testing for PMTCT; and
developing indicators and reporting system for gender integration activities.
will also participate and share best practices at President's Emergency Plan for AIDS Relief (PEPFAR)
of project implementation period.
owned health facilities such as for the mines, to enhance provision of quality pediatric ART services. The
Table 3.3.11:
A new procurement on HIV/AIDS service delivery support to follow the current ZPCT project is being
developed. The new project will expand the geographic areas and scope of HIV/AIDS services: integrating
HIV/AIDS services with other health interventions such as family planning, maternal and child health,
sexually transmitted infections (STIs), Tuberculosis (TB), and malaria, as appropriate; integrating gender
equity and sensitivity in HIV/AIDS services; strengthening learning and evaluation by developing systems
for documenting and sharing best practices in HIV/AIDS prevention, care and treatment services, and
identifying and conducting operational research as needed; promoting and strengthening community
mobilization for services, by using community structures such as neighbourhood health committees (NHC),
community health workers (CHW), faith based organizations (FBOs), community based organizations
(CBO) and community support groups for youth, women, men and people living with HIV/AIDS (PLWHAs);
and developing viable mechanisms and exit plans in collaboration with Ministry of Health (MOH), provincial
health offices (PHOs), district health management teams (DHMTs), health facilities, and other implementing
partners, to enhance program sustainability.
The activity will link to other project program areas including: PMTCT, ART, Counseling and Testing (CT),
Palliative Care, and Laboratory Support activities as well as with the Government of the Republic of Zambia
(GRZ), and other US Government (USG) agencies and partners as outlined below.
Up to 70 percent of TB patients in Zambia are HIV positive, and TB is the most common opportunistic
infection (OI) in HIV patients. In 2007 23,356 (47% of total TB notifications were tested for HIV out of which
11,623 (68.5%) were HIV positive and 4,723 (40.6%) were put on HIV treatment (MOH). In FY 2009/2010,
the project will collaborate with the Centres for Disease Control and Prevention (CDC) and the GRZ to
increase the proportion of TB patients testing for HIV through the following activities: 1) harmonizing TB/HIV
trainings and service delivery protocols; 2) providing training to 200 health care workers and lay counselors
in cross-referral for TB/HIV and other opportunistic infections (OIs); 3) providing microscopes and laboratory
reagents; 4) renovating TB laboratory infrastructure; 5) strengthening provider initiated counseling and
testing for HIV in TB clinics; 6) strengthening and expanding TB services among HIV-infected individuals,
including TB microscopy and treatment; and 7) supporting initiatives for TB infection control and intensified
TB case finding. The project will also strengthen and expand quality DOTS programs, and increase
community involvement and awareness of TB. The project will support the GRZ to strengthen and expand
TB/HIV services in Central, Copperbelt, and the more remote Luapula, Northern, and North-Western
provinces.
The project will strengthen the integration of provider initiated counseling and testing for HIV in all the TB
clinics supported by the project. HIV-infected TB patients determined eligible for ART will be offered ART
on-site or referred to nearby ART facilities if ART is not available at the facility. The TB/HIV link will be
strengthened in facilities offering HIV services to ensure that all HIV infected patients diagnosed with TB are
provided with appropriate TB treatment and care. Furthermore, provider initiated counseling and testing for
HIV will be offered to the TB patient's family, with emphasis on reducing stigma and discrimination
associated with TB and HIV. Over 4,000 patients received TB/HIV CT services HIV/AIDS care and
treatment services in 2008. At least 7000 TB clients will receive CT services in 2010.
The project will strengthen and expand TB services for HIV-infected individuals. This will involves TB
diagnosis among all HIV-positive patients for reducing the incidence of TB Immune Reconstitution
Syndrome and for offering appropriate TB and/or ART services. Laboratory equipment, such as
microscopes, will be procured as needed to strengthen diagnosis of TB in selected project health facilities
that currently have weak TB diagnostic capacity, and facilities will be renovated as needed. Through these
interventions, approximately 5,000 HIV-TB co-infected persons will receive needed TB treatment.
The project will train health care workers and lay counselors in cross-referral for TB/HIV and other OIs, the
project will work with GRZ facility management personnel to ensure that counselors are trained and are
available to provide TB/HIV related services in TB clinics in project-supported facilities. Lay counselors will
be trained and assigned to provide support in these clinics, as needed. In addition to counseling skills,
health care workers (HCWs) and lay counselors will be trained in making referrals for appropriate HIV/AIDS
services. Training in cross-referrals between TB and HIV/AIDS services will be included in all CT and
ART/OI management training supported by the project.
The project will work at the national level with the national TB and ART Technical Working Groups, to
ensure that policies and guidelines are optimal for TB/HIV linkages at all levels of the health care system
(e.g., national, provincial, district, and community.
The project will support evaluations of lessons learnt from TB/HIV interventions to identify and scale up best
practices and to develop appropriate training and service delivery packages to increase access to palliative
care services in public and private health facilities. The process of evaluation will include: identifying critical
activity areas that require evaluation and conducting evaluations as needed; substantive involvement of
policy makers, managers, service providers, and other stakeholders involved in the response to HIV/AIDS
including building sustainable links between key players, from identification of evaluation questions,
conducting training in evaluations, doing evaluations, and documenting, disseminating, and utilizing
evaluation results in program implementation. The evaluations will be conducted in close collaboration with
the provincial and district health offices to promote ownership of the results by the government of Zambia
and to strengthen the Health Management Information System (HMIS). The activity will also participate and
share best practices at President Emergency Plan for AIDS Relief (PEPFAR) implementer's meetings,
stakeholder meetings, and other fora
Activity Narrative: management capacity through training of managers, and facilitating joint planning and budgeting including
owned health facilities such as for the mines, to enhance provision of quality TB/HIV services. The project
will also link these facilities to the government supply chain for provision of HIV test kits.
Continuing Activity: 14446
14446 14446.08 U.S. Agency for To Be Determined 6842 6842.08 ZPCT FOLLOW
Table 3.3.12:
Delivery Support Program in 2009. Targets will be adjusted based on the actual starting date of the new
A new procurement on counselling and testing to follow the ZPCT project is being developed. This activity
will link to other project program areas including HTXS, PDXS, HVTB, PMTCT, HBHC, PDCS, and HLAB as
well as with the Government of the Republic of Zambia (GRZ), Japan International Cooperative Agency,
MSF-Spain, and other US Government partners as outlined below. The focus is to improve counselling and
testing (CT) services in the Central, Copperbelt, and more remote Luapula, Northern, and North-Western
Provinces.
During FY 2009, the new project will consolidate the expansion of current activities by providing technical
support to ensure quality services and build district capacity to manage HIV/AIDS services. The project will:
1) provide comprehensive support to facility-based CT services to enhance commodity management and
provision of quality CT services; 2) provide technical assistance to Neighbourhood Health Committees, non-
governmental organizations (NGOs), faith-based organizations (FBOs), and community-based
organizations (CBOs) to expand access to CT via mobile outreach programs; 3) strengthen linkages to
treatment and other related services; 4) promote routine, targeted CT; 5) increase integration of CT with
PMTCT, FP, and ante-natal care services; 6) promote couple and child counselling and testing including
establishment of youth friendly CT services; 7)expand and strengthen inter-facility and community referral
systems; and 9) promote follow-up services for negative clients.
The project will continue to provide comprehensive support to facility-based CT services, in the current 217,
and additional 11 facilities, to manage CT commodities (including HIV test kits), conduct moderate
refurbishments where needed, train and mentor, increase quality assurance mechanisms, build human
capacity, and improve systems for tracking patient flow, accessibility, and acceptability of CT services. The
project will continue to support ‘Testing Corners' (minimal laboratories placed within or in close proximity to
CT sites to facilitate same day test results) in 228 sites; this includes integrating CT with other clinical
services, such as TB and STI care. The project will enhance staff capacity to forecast and order HIV test
kits and supplies in a timely manner, and to improve data entry. The project will support facilities and
District Health Management Teams (DHMTs) to maintain CT site accreditation status of these facilities,
making them eligible to receive supplies from Medical Stores Limited (MSL). In collaboration with GRZ,
DELIVER, and Partnership for Supply Chain Management Systems, pharmacy, laboratory, and counselling
staff in the supported facilities will be trained in data collection and reporting, ordering, tracking, and
forecasting of CT-related commodities.
Linkages with USG and non-USG partners will increase the number of people reached with CT services and
will avoid duplication of services. The program will also link negative clients to comprehensive prevention
services. Through collaborative efforts with the Behaviour Change and Communications, Social Makerting),
and Peace Corps, the project will continue to provide targeted IEC materials, developed in local languages
for use by community groups. The project will also seek opportunities to leverage resources by partnering
with organizations that provide CT services, such as the social marketing stand alone CT services and
mobile CT network, and strengthening referral networks to the project's ART-supported facilities. The
project will continue to collaborate with projects supporting home-based care services, such as Catholic
Relief Services/SUCCESS and RAPIDS, to promote and expand CT services for the communities in which
they work. Additionally, the project will work in the communities surrounding the CT sites to increase
demand and acceptance of CT services by targeting and including discordant couples. The project will
work with facilities and NGOs/FBOs/CBOs to deliver CT services through mobile teams of HCWs and lay
counsellors. This integrated effort of bringing together NGOs/FBOs/CBOs, Neighbourhood Health
Committees, community leaders, and facility health workers will greatly increase access to CT services in
rural areas and will mobilize overall demand for and acceptance of CT. HIV-infected individuals will be
referred for other services, including PMTCT, ART, and palliative care including TB.
At national level, the project will provide technical assistance to the national CT Technical Working Group
on strategies for scaling up CT services and developing, revising, and disseminating training materials,
protocols, and policies.
In FY 2009, the project will train approximately 500 HCWs in one (or more) CT training including: initial CT
training; counselling supervisors' training; and counselling for children. Out of the 500 HCW to be trained,
about 150 of these will be lay counsellors from CBOs, FBOs, and existing TB treatment supporters. These
will be trained to support CT services in health facilities and increase CT demand in communities. These
community representatives will also assist health facility management and staff to make CT services more
accessible and acceptable among the population they serve.
The project will support routine, targeted HIV CT, especially for babies with positive mothers, patients
diagnosed with other sexually transmitted infections, and those with tuberculosis. Clients will be targeted on
both an in and out-patient basis. Furthermore, CT will be better integrated into PMTCT, ante-natal care,
child survival, tuberculosis (TB) and other sexually transmitted infections (STI), malaria (IPTp), and family
planning services. Greater emphasis will be placed on couples and child counselling. After delivery, many
couples do not bring their children back for routine testing and HIV infected children are left behind until they
present with symptoms. In addition, the project will promote youth friendly CT services to increase to CT
services by young people.
The project will work with facilities, communities, and partner organizations to establish, strengthen, and
widen referral linkages. Inter- and intra-facility referrals between CT and TB, STI, ante-natal care, in-
patient, and out-patient services will be expanded and existing community-based services will be integrated
into an active referral system. In FY 2009/2010, support will also further reduce stigma, discrimination, and
gender inequalities associated with ART by working with community leaders and key stakeholders
Activity Narrative: regarding the importance of CT and availability of ART.
The project will identify and address gender disparities and other issues that hinder access to CT services
by developing and implementing gender related activities such as scaling up male involvement in CT
services; scaling-up couple counselling to promote testing of men and to build their support for their female
community based activities; promoting community participation in HIV/AIDS activities by working through
couples to be involved in couples counselling and testing; and developing indicators and reporting system
The project will support evaluations of lessons learnt from counselling and testing interventions to identify
and scale up best practices and to develop appropriate training and service delivery packages to increase
access to counselling and testing services in public and private health facilities. The process of evaluation
will include: identifying critical activity areas that require evaluation and conducting evaluations as needed;
of key GRZ management officials in monitoring, supportive supervision, and in quality assurance/quality
of the project implementation period. Involvement of People Living with HIV/AIDS (PLWHAs) gives a human
Continuing Activity: 16416
16416 16416.08 U.S. Agency for To Be Determined 6842 6842.08 ZPCT FOLLOW
Table 3.3.14:
A new project to develop laboratory infrastructure in Zambia, to follow the ZPCT project, is currently being
developed. This new activity will link to other programs including: HVCT, PMTCT, ARV, HVTB, and HBHC
activities, DELIVER well as with the Government of the Republic of Zambia (GRZ) and other US
Government (USG) partners as outlined below.
This activity will provide support to GRZ to strengthen and expand laboratory services in the delivery of
HIV/AIDS care in the Central, Copperbelt, and the more remote Luapula, Northern, and North-Western
Provinces. In FY 2009, the project will strengthen laboratory services in the current 111GRZ laboratories
providing HVCT, PMTCT, ART, and/or HBHC services, and to at least 10 additional facilities by providing
technical support, supporting renovations, providing equipment, and training staff to provide quality
laboratory services. At least half of the supported facilities will have the capacity to conduct more advanced
HIV laboratory tests, such as CD4 and lymphocyte tests as a result of this assistance. Additionally, in FY
2009, the project will support the Laboratory Management Information System to track HIV-related
laboratory tests, and provide technical assistance and mentoring on this system. The project will work with
facilities transporting specimens for HIV-related laboratory tests from health facilities, some with limited
laboratory capacity, to referral laboratories. This system greatly improves the ability of more rural facilities to
provide quality HIV/AIDS services, leading to same-day test results and an increase in new ART patients.
The project will work closely on laboratory activities with CDC, the Clinton Foundation HIV/AIDS Initiative,
MSF Spain and the Partnership for Supply Chain Management Systems.
During 2009/2010, the new project will strengthen the expansion of the current activities by providing
technical support, ensuring quality services, and building district capacity to manage HIV/AIDS services.
The five activity components include: 1) strengthening laboratory infrastructure; 2) improving laboratory
quality assurance mechanisms, information systems, and personnel capacity; 3) working with the CDC and
other collaborating partners to realize the GRZ's plans for the scale-up of high quality services; 4) providing
training of laboratory technicians and ensuring consistency in laboratory supplies through the national
logistics system; and 5) participating in national laboratory working groups and national laboratory related
The project will strengthen laboratory infrastructure in all sites that provide the full complement of basic
equipment for CD4 hematology and biochemistry and supplies. Additionally, the project will identify and
support laboratory renovations if needed. Equipment purchased, such as CD4 hematology and chemistry
analyzers, will be in accordance with GRZ guidelines/policies. Other equipment, including autoclaves,
centrifuges, microscopes, and refrigerators, will be provided as needed. The project will continue to link
ART sites currently without access to CD4 testing to nearby ART facilities with appropriate technological
facilities. The project will also work in close collaboration with the GRZ to ensure provision of supplies for
CD4 enumeration in the hard-to-reach areas. The project will work with hospitals that currently have
capacity for early infant diagnosis and ensure transportation for Dried Blood Spot (DBS) samples. The
project will also coordinate with activities supported by the Centers for Disease Control and Prevention
(CDC) and collaborate with the Clinton Foundation HIV/AIDS Initiative. In 2009/2010, the number of project
supported laboratories with capacity to perform HIV, CD4, and lymphocyte tests will be 60, and
approximately 540,000 tests will be performed.
The project will work with the GRZ and CDC to strengthen laboratory quality assurance mechanisms,
information systems, and laboratory personnel's capacity to ensure adherence to GRZ's recommended
laboratory standards. The project will also make certain that laboratory standard operating procedures are
at all sites to ensure that all facilities implement proper laboratory practices. Finally, 100 laboratory staff will
continue to be trained in commodity management and lab-related activities. Assistance for this second
component will be coordinated with DELIVER, SCMS, CDC, and GRZ to avoid duplication of efforts and to
ensure that facility-level forecasting and procurements provide constant supplies of required laboratory
commodities.
The project's staff will participate in national laboratory groups and lab related activities to share their
experiences and expertise with other partners in country, and to participate in the development or review of
policies, guidelines, standard operating procedures, and training manuals.
The project will increase program sustainability with the GRZ, by supporting the MOH laboratory quality
assurance (QA) assistance plan in collaboration with CDC. The project will work with GRZ to strengthen
QA activities and provide support to strengthen the capacity of GRZ hospital laboratories. The MOH,
through the Provincial Health Offices, will then assume responsibility for the monitoring of the GRZ
hospitals' laboratories' QA program.
By working with GRZ facilities, the project will be able to establish a sustainable program by training health
care workers, developing standard treatment protocols, strengthening physical and equipment
infrastructures, implementing facility-level quality assurance/quality improvement programs, improving
laboratory equipment and systems, and developing and strengthening health information systems.
owned health facility laboratories such as for the mines, to enhance provision of quality laboratory services.
The program will also link these facilities to the government supply chain for provision of laboratory
reagents.
Continuing Activity: 16420
16420 16420.08 U.S. Agency for To Be Determined 6842 6842.08 ZPCT FOLLOW
Table 3.3.16:
