This activity will contribute to the availability of HIV/AIDS strategic information, including monitoring and

evaluation indicators and trend analysis to guide decisions on appropriate interventions, and geographic

information and mapping useful for planning, monitoring, and evaluation of PEPFAR activities in Zambia. It

consists of three parts: the Zambia Sexual Behavioral Survey/AIDS Indicator Survey (ZSBS/AIS, $450,000);

HIV/AIDS component of the Zambia Demographic and Health Survey (ZDHS, $300,000); and secondary

data analyses based on both surveys ($500,000).

The first part is a continuation of the planning and implementation of the 2008-09 round of the ZSBS/AIS.

The Central Statistics Office (CSO) of the Government of Zambia (GRZ), with technical assistance from the

MEASURE Evaluation implementing partners, has completed four bi-annual rounds of the ZSBS/AIS since

1998. Through MEASURE Phase III Monitoring and Assessment for Results (also known as MEASURE

Evaluation Phase III), the CSO will complete the 2008-09 ZSBS/AIS by FY 2010. This survey, involving a

nationally representative sample of 2,500 men and 2,500 women, adopts an internationally standardized

protocol to collect, analyze, and report data on HIV/AIDS program indicators, including HIV/AIDS-related

knowledge and attitudes, voluntary counseling and testing, sexual behavior, and orphans and vulnerable

children. The protocol calls for the analysis of data disaggregated by sex, residence, and other socio-

demographic characteristics and reporting of data in standardized tables and text that discuss trends and

compare them from the four previous surveys. In FY 2009, the CSO will prepare for the survey by updating

and translating the questionnaire, planning logistics, training interviewers and supervisors, and initiating

fieldwork. Supported by an allocation of $450,000 through MEASURE Evaluation Phase III, it will complete

data collection, processing, and analysis; host an analysis workshop; write and print the report; and

coordinate the national dissemination in FY 2010.

The 2008-09 ZSBS/AIS also provides an opportunity to continue the capacity development activities

initiated earlier. These activities aim to strengthen the institutional capacity of the CSO to assume full

responsibility for future rounds of the ZSBS/AIS and other surveys. Integrated into the existing

organizational structure, the capacity development activities will enhance the technical and management

skills of the CSO staff and officials, gradually decreasing their reliance on international technical assistance.

Such activities include staff exchanges between the CSO and MEASURE Evaluation Phase III

implementing partners; workshops for CSO staff; as well as training and supervisory instruction during

survey implementation. As an initial capacity development activity for the ZSBS/AIS, a workshop on survey

planning will address and resolve implementation issues that have caused problems and delays in previous

survey rounds. A subsequent workshop, along with staff exchanges, will build the analytical skills of the

CSO staff, with modules on: preparation and management of data sets; data analysis using the most recent

version of Stata and other statistical software packages; preparation and analysis of frequency tables and

other univariate statistics; calculation of relevant PEPFAR, UNAIDS, and UNGASS indicators; interpretation

and reporting of results; and drafting the technical report of the ZSBS/AIS.

The second part of this activity is a continuation of the data analysis and reporting of the HIV Prevalence

Survey in the 2007 ZDHS. ORC Macro, in collaboration with the Ministry of Health (MOH), Tropical Disease

Research Centre (TDRC), and University of Zambia (UNZA), collected and analyzed blood samples and

basic demographic information from men and women of reproductive age in a nationally representative

sample. Data collection commenced in April 2007 and lasted for six months. In FY 2008 and FY 2009,

ORC Macro has been working with the CSO, MOH, National HIV/AIDS/STI/TB Council (NAC), and other

government agencies to finalize data analysis and produce the preliminary and final reports.

The 2007 ZDHS will provide demographic and health information linked to HIV prevalence data. Along with

the 2005 Zambia Service Provision Assessment Survey (ZSPA) and 2008-09 ZSBS/AIS, it can guide

evidence-based advocacy, planning, and monitoring and evaluation efforts at the national and provincial

levels. To increase access to and use of these data, the project, in collaboration with the CSO, MOH, and

NAC, will conduct broad-reaching dissemination activities, supported by an allocation of $300,000 through

MEASURE Evaluation Phase III. Such activities in FY 2010 include the:

•Publication of the preliminary and final reports on the HIV Prevalence Survey linked with the 2007 ZDHS;

•National seminar to present and dissemination the HIV/AIDS-related findings of the final report in Lusaka;

•Publication of survey briefs, in collaboration with the CSO, MOH, cooperating partners, NGOs, and other

stakeholders, featuring the "top-line highlights" or key findings and policy/programmatic recommendations

with easy-to-read text, charts, maps, photographs, and other graphics for government officials,

policymakers, and practitioners in non-health sectors involved in the multi-sectoral HIV/AIDS response;

•Publication of brochures with charts, maps, photographs, and other graphics displaying HIV/AIDS data

disaggregated by province, residence, and other socio-demographic characteristics; and

•Development of a press packet, including a press release with selected background materials, survey

briefs, and brochures, and coordination of a press conference to increase the quality and quantity of

coverage of the HIV/AIDS-related findings from the national surveys in the electronic and print media.

Finally, the third part of this activity is a continuation of the secondary data analyses to achieve two goals:

(a) understand the epidemiologic and structural features of the increasingly heterogeneous HIV/AIDS

epidemic in Zambia and (b) provide further capacity development opportunities for the CSO to use their

primary datasets for applied studies on HIV/AIDS.

In FY 2008, the cooperating partners, MOH, and NAC have drafted the HIV/AIDS/STI/TB research strategy

and agenda. Based on this effort, topics proposed for secondary data analyses include determining the

factors that can explain the:

•Observed changes in the point prevalence of HIV infection in the 2007 ZDHS, compared to previous

rounds;

•Differences in the point prevalence of HIV infection between provinces and districts; and

•Extent of multiple concurrent partnerships, especially as they relate to issues such as gender identity and

sexuality, in sustaining HIV transmission in the general population.

Conduct of these secondary data analyses in FY 2009 and FY 2010 will entail additional capacity

Activity Narrative: development activities, supported by an allocation of $500,000 through MEASURE Evaluation Phase III,

directed to technical staff in the CSO and MOH. These activities include classroom-based and on-the-job

training on study design; data management and analysis with Stata and other statistical software packages

(especially on merging multiple datasets, preparing tables, and understanding and performing more

advanced analyses such as multivariate ordinary least squares and logistic regression); and writing reports

for diverse audiences.

Some secondary data analyses, such as the proposed study on provincial and district differences in HIV

prevalence, will involve the compilation and analysis of spatial statistics and generation of informative maps

through extensive use of Geographic Information Systems (GIS). With a week-long workshop and

supplementary supervisory instruction, technical staff in the CSO and MOH can use geo-referenced ZDHS

and ZSPA data and produce maps as part of analytical studies and the Zambia Atlas of HIV/AIDS

Indicators. In consultation with the CSO and MOH, selected maps will be posted in the global HIV Spatial

Data Repository launched by with PEPFAR support in FY 2008.

As with the 2007 ZDHS and 2008-09 ZSBS/AIS, dissemination of findings from the secondary data

analyses will occur through the publication of technical reports, study briefs, brochures, and national- as

well as provincial-level workshops.

All FY 2009 targets will be reached by September 30, 2010.

New/Continuing Activity: Continuing Activity

Continuing Activity: 14503

Continued Associated Activity Information

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

System ID System ID

14503 14503.08 U.S. Agency for To Be Determined 6853 6853.08 MEASURE

International Evaluation

Development follow on

Table 3.3.17: