PEPFAR supports the Twinning Centre in implementing partnerships, initiatives, and volunteer placements that help build critical institutional and health human resource capacity to combat HIV/AIDS. Through funding from the Department of Defense, the Twinning Centre has a partnership with the Zambia Defense Force Medical Services (DFMS) under which the following defense force sites are supported Maina Soko Military Hospital, Defense Force School of Health Sciences, Gondar Army Barracks camp hospital, Zambia Air Force (ZAF) Mt Eugenia camp hospital, ZAF Mumbwa camp hospital, Zambia National Service Kitwe camp hospital and Tugargan Army Barracks camp hospital.

The overall goal of this partnership is to strengthen the capacity of the military health personnel to effectively and efficiently provide HIV treatment and care for military personnel and surrounding communities by improving their access to evidence based resources through information and communication technologies. The specific objectives include 1. Supporting ZDF partners in identifying and having access to both relevant health and up to date on line evidence based resources and downloads and store e-resources to use for offline references. 2. Assisting ZDF partners to expand their leadership and project management skills including practical skills in monitoring and evaluation of their programmes. 3. Providing support to identify and respond to other capacity gaps in the provision of an HIV/AIDS continuum of care and support in the military sites and surrounding communities, 4. Expand Learning Resource Centres to rural military health sites and create telecommunication linkages and increased collaborations between these Learning Resource Centers (LRC) with the referral sites in Lusaka.

In FY 2010, APCA and the Twinning Center will continue to support the development of human and institutional capacity of PCAZ. The partnership will finalize the PCAZ strategic plan for 2009-2012, including related business and marketing plans. With PEPFAR funding, APCA will provide training and mentoring to support PCAZ in the implementation of the strategic, business, and marketing plans. Partners will work closely with the newly selected PCAZ board of directors to ensure their engagement and support of PCAZ activities consistent with the new strategic plan. APCA will capacitate PCAZ management and staff members to more effectively manage programs and activities supporting the palliative care agenda in Zambia.

With PEPFAR funding, APCA will support PCAZ in increasing and enhancing the array of resources and services PCAZ provides to members. These resources include the continuation of the quarterly newsletter and PCAZ organizational website. APCA will assist PCAZ in the implementation of its marketing plan, to increase PCAZ membership, thereby increasing private revenue and making PCAZ more sustainable.

APCA will help PCAZ with the development of training activities, educational materials, and advocacy efforts on important issues in palliative care, including pain relief (including morphine availability) and dispensation by palliative care providers. PCAZ will continue to map palliative care services provided by hospices and home-based care providers, and provide technical support in cascading palliative care training for members. As a member of the palliative care technical working group, PCAZ with the support and leadership of APCA- will further review standards of HIV palliative care and educate its membership on the latest changes and available information and resources.

The Twinning Center will establish an LRC at PCAZ, which will serve as a palliative care resource center to be utilized by PCAZ members and staff. With the LRC, PCAZ will be able to access current evidence-based resources on palliative care and other related HIV/AIDS issues. The LRC will serve as a venue for training and education of PCAZ members, and help PCAZ to develop and produce training and educational materials. The LRC will raise the standard and number of services PCAZ is able to offer its members and enhance the capacity of PCAZ to carry out its work in education and advocacy for HIV palliative care.

In FY 2011 PCAZ will be twinned with ZAMCOM, which will work closely with PCAZ on the development of palliative care information for healthcare providers, policymakers and the general public. ZAMCOM will assist PCAZ in sharing information about palliative care to the general public through effective messaging through various media, including television, newspapers, radio, etc. Through this Zambian twinning relationship, PCAZ will be ca

In FY 2012, the Twinning Centre will continue to work with the 8 established LRCs of which 2 are in Lusaka and 6 in rural and peri -urban areas. The partnership will assess and establish of 7 new LRCs mostly in rural areas and one based at the DFMS head quarters bringing the total number of LRCs to 15. A total of 30 military health staff from the health sites hosting LRCs will receive training in LRC management to promote sustainability. Twenty five staff among them Commanding Officers, Nursing Directors and hospital administrators from target health sites will be exposed to the evidence based resources and how they can support the health cadres in promoting evidence based planning and practice in the Defense Force Medical Services.

Telecommunication links will be establishd in the first phase between 6 LRCs and Maina Soko, the main referral hospital for the Defense Forces. This will promote tele-consultations and improve access for patients in rural health sites to specialist diagnosis.

The partnership will collaborate with Project Concern International (PCI) to ensure a suitable monitoring tool is developed that will be integrated into the existing monitoring framework.

A review of the Nursing Assistants course will be conducted at Maina Soko Military hospital. A review committee of 8 professionals from key stakeholders including government MOH will be part of the committee.

A functional nursing skills laboratory will be set up at the Emmasdale School of Health Sciences and to strengthen the practical nursing skills of the military medical assistants trainees. The skills laboratory will be expanded to all Provincial centres in COP 13 to provide in service training within reach of the health professionals. They will not have to travel to Lusaka for continuing professional education. The trainings will be designed to take place at Provincial level as the Twinning Centre endeavors to work with partners more on the ground and in rural and underserved areas.

A Memorandum of Understanding will be signed directly with the Emmasdale Defense Force School of Health Sciences to establish a Nursing partnership with a peer Nursing counterpart from USA or another country in Africa that has made tremendous strides in Nursing education.

Finally the partnership will conduct a practical leadership and management training for LRC Coordinators, Project leaders and Commanding Officers targeting at increasing sense of sustaining projects in the absence of external funding; local control and effective management of the projects. 50 officers will be trained across the 54 sites.

Additional funding will be provided for creation of a Skills Lab to strengthen the academic curriculum and incorporate new technologies for HIV diagnosis and management at zonal laboratory training institutions associated with the referral hospitals. ZDF referral hospitals will create professional development opportunities for laboratory staff and managers through national, regional, and international training.

The second part of this initiative is to extend the health care worker skills labs to provincial level so as to increase the number of health care workers having access to practical skills training within their local environment.

Through USAID in Zambia, the Twinning Center supports a twinning partnership between the Zambia Institute of Mass Communication (ZAMCOM) and the University of Kentucky (UK). The overall goal of the partnership between ZAMCOM and UK is to build the capacity of ZAMCOM to provide technical assistance and media support for organizations, particularly community radio stations across the country.

Activities in this area will focus on supporting the communications network to develop and broadcast HIV prevention messages across an array of community radio stations. Activities could include, but are not limited to development of messages, and their onward broadcasting throughout the ZAMCOM network of radio stations.

Within this area messages will be focused on abstinence and fidelity, particularly targeting couples in union. Discordant couples will be one focus area to provide messages to avoid re-infection and infection across the partnership. These messages will be balanced and matched with those under the HVOP category as appropriate. Given the network of community radio stations across the country, the reach could be quite wide, with unique targeting in discrete areas to tailor messages to be culturally appropriate within the geographic location. Messages and activities will target males and females equally but realizing that the form and content of the message may need to differ to reach each target group.

Activities in this area will also link with other programs that target adolescent/youth HIV prevention activities including work with community print media partners to develop a planned quarterly newsletter supplement targeted at school children.

Through USAID in Zambia, the Twinning Center supports a twinning partnership between the Zambia Institute of Mass Communication (ZAMCOM) and the University of Kentucky (UK). The overall goal of the partnership between ZAMCOM and UK is to build the capacity of ZAMCOM to provide technical assistance and media support for organizations, particularly community radio stations across the country.

Activities in this area will focus on supporting the communications network to develop and broadcast HIV prevention messages across an array of community radio stations. Activities could include, but are not limited to development of messages, and their onward broadcasting throughout the ZAMCOM network of radio stations. As per the activities under HVAB, targeting will be accomplished through the network of community radio stations building on the coverage and population aspects of their catchment areas.

Within this area messages will be focused on high risk sexual activity including multiple and concurrent partners, particularly outside of union. Activities in this area will link with other programs that target adolescent/youth HIV prevention activities. This supplement will be distributed to schools and libraries along with lesson-plans for teachers in the hope that after learning this material in school, the children would also take it home and share with their families.

The Overall goal of this partnership is to contribute to the HIV/AIDS programmes of the Centers of Excellence (COE) by strengthening the clinical skills capacity and management roles of the Zambian pharmacists through exchanges and training. Specifically the partnership is to enhance the capacity of Zambian pharmacists and pharmacy technologists who are responsible for the following 1. Assuming the role and functions of practitioner members of the HIV/AIDS Clinical teams at Lusaka and Livingstone COE and 2. Demonstrating the knowledge and skills required to organize and manage pharmacy services for the delivery of Anti Retro Viral Therapy (ART) interventions in support of HIV/AIDS prophylaxis, treatment and care for mothers, infants and children. In supporting pediatric ART, the partnership will collaborate with other partners aligning with the approach that devolves services down through the district health facilities and consistently working with accepted quality assurance standards.