The Nazarene Compassionate Ministries Zambia program is a New Partner Initiative (NPI) project in

Zambia. This is an ongoing activity which began in FY 2007. Nazarene Compassionate Ministries Inc.

(NCMI) will rapidly scale up prevention services in Zambia using its faith-based network of churches,

indigenous non-governmental organizations, and community-based organizations. NCMI will work through

its lead agency Nazarene Compassionate Ministries Zambia (NCMZ), operating in partnership with sub-

recipients Christian Reformed World Relief Committee (CRWRC) and World Hope International Zambia

(WHIZ). These partners are already working in Zambia under a President's Emergency Plan for Aids Relief

(PEPFAR) Track 1.0 OVC partner World Concern International. This ongoing alliance will, under the New

Partners Initiative (NPI), provide prevention programs through abstinence and be faithful (AB) messages

and train 35,000 youth and adults to promote AB messaging in FY 2008. NCM will use the OVC Track 1.0

platform to disseminate AB messages to older OVC.

The AB prevention program follows the successful peer education model developed by Food for the Hungry

and successfully implemented with Track 1.0 ABY PEPFAR funding in Ethiopia, Nigeria, Mozambique and

Haiti. The model involves youth-to-youth (Y2Y) groups where trained promoters or youth leaders lead

ongoing training to groups of 14 other peers. Training is for the period of twelve months and includes

discussions of the Choose Life curriculum. This curriculum was developed by World Relief with

supplemental enhancements provided by Food for the Hungry. This program promotes a positive approach

to abstinence and uses barrier analysis and behavior change communication methods to identify and

overcome barriers to abstinence and faithfulness. NCMI will also ensure that they fully comply with the

national prevention strategy and campaigns once it is finalized and takes effect.

The program will make significant progress in FY 2008 toward endline targets by utilizing the multiplication

effect of the Y2Y training model in training promoters who will later train their peers in small groups. In FY

2008, the partnership will reach 30,900 individuals with direct AB messages. NCMI will reach an additional

4,100 married individuals with faithfulness messages. NCMI will encourage couples to remain faithful by

attending faithfulness classes and primarily in church-based training events, and discordant couples to

protect the uninfected spouse through correct usage of condoms.

To support the scale-up of AB programs in Zambia, NCMI affiliate, Helping Hands Africa (HHA), based out

of South Africa will provide technical support, capacity building, monitoring and evaluation, and overall

program support for its local implementing affiliates and partners.

NCM Zambia will offer AB programs through its network of churches. NCMZ will reach 15,000 youth with

AB messages and 1,400 married individuals with be faithful messages. NCM Zambia will also train 1091

individuals to promote HIV/AIDS prevention through abstinence and/or being faithful. The coverage areas

for NCMZ will include five locations in North-Western Province namely, Solwezi, Kasempa, Kabompo,

Zambezi, and Chavuma districts.

CRWRC will reach 12,600 youth through its sub-partners, namely, Church of Central Africa Presbyterian -

Relief and Development (CCAP - R&D), The Reformed Church of Zambia (RCZ), Reformed Community

Support (RCS), and The Reformed Church in Zambia Eastern Diaconia Services (RCZ EDS) and 1,400

married individuals with be faithful messages. CRWRC will also train 866 individuals to promote HIV/AIDS

prevention through abstinence and/or being faithful. Coverage areas will include Lundazi and Chipata

districts in Eastern Province, Ndola on the Copperbelt Province, and Mumbwa in Central Province.

WHIZ will reach 3,300 youths and adults with AB messages and 1,300 married individuals with "Be faithful"

messages in Mazabuka, Choma, Gwembe, Kazungula, Livingstone and Kalomo districts in Southern

Province. WHIZ will also train 248 individuals to promote HIV/AIDS prevention through abstinence and/or

being faithful.

The program will promote abstinence among youth and youth leaders primarily through church youth

groups and secondary schools through participatory education and behavior change communication

techniques. Using an integrated approach, NCMI and its partners will use a variety of creative

methodologies to reinforce abstinence and faithfulness messages including videos, school events, sporting

events, drama, and music. NCMI will train 4100 parents and guardians in prevention and to support the

commitment of their children in remaining abstinent. These parents/guardians will also serve as co-

promoters for the Y2Y groups.

For on-going quality assurance of the AB program, NCMI is placing a high priority on strengthening

monitoring and evaluation (M&E) systems for the AB program in FY 2008. Dedicated M&E personnel from

NCMI and HHA will enhance the M&E system and provide training to local M&E staff in Zambia. Post tests

will be given to the youth after every three sessions to ensure that youth are retaining the AB messages.

The youth leaders are expected to score 70% in their post tests, and those who fail to score the minimum

result will be advised to attend make up sessions. The tests will be prepared centrally and sent to the

project sites. Quality improvement and verification checklists (QIVC) will be used in activities such as

trainings and counseling sessions to ensure the quality of the service provision.

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The project design seeks to ensure sustainability by building ownership from within the local community and

local NGO levels. All project activities are designed to encourage independence and self-governance in the

planning, design, implementation of outputs, and outcomes. This local ownership and involvement will

begin with focus group discussions among all community stakeholders that are conducted in preparation of

initiating a training cohort in each new geographic location. The role of the NGO partners is to build the

capacity of communities to do their own direct service with the skills and knowledge gained during their

trainings in an effective and quality manner. The church networks are essential to the ongoing sustainability

of the program as the local churches have a long term commitment to their local communities. The targeted

training of church leaders and utilization of key youth leaders, volunteers, and promoters from church youth

groups and schools will enable the program to continue beyond the initial investment under NPI.

At the same time, the indigenous NGO partners will receive intensive capacity building support from HHA

and NCMI to strengthen their organizational, administrative, financial, human resource, and technology

infrastructure. At the conclusion of the project each partner organization will be in a position to sustain and

enhance their role in AB programs through their own networks.

All FY 2008 targets will be reached by September 30, 2009.

Nazarene Compassionate Ministries Inc. (NCMI) will rapidly scale up palliative care services in Zambia

using its faith-based network of churches, indigenous non-governmental organizations (NGOs), and

community-based organizations (CBOs). NCMI will work through its lead agency Nazarene Compassionate

Ministries Zambia (NCMZ), operating in partnership with sub-recipients Christian Reformed World Relief

Committee (CRWRC) and World Hope International Zambia (WHIZ). These partners are already working in

Zambia as sub-partners under a President's Emergency Plan for AIDS Relief (PEPFAR) Track 1.0 OVC

grant to World Concern International. In FY 2008, this on-going alliance under the New Partners Initiative

(NPI) will provide palliative care to 6,193 people living with HIV/AIDS (PLWHA) through home-based care

services offered through 150 locations. NCMI will use the OVC platform already established under the OVC

Track 1.0, to identifying palliative care clients. Conversely, the palliative care platform being established will

also be used for identifying OVC. To prevent any duplication, NCMI partners will coordinate with other USG

home-based care programs such as RAPIDS and SUCCESS and participate in the USG palliative care

forum.

NCMI affiliate, NCM-Zambia will offer palliative care to PLWHA through its network of churches. Through

home-based care, NCM Zambia will reach 1,113 PLWHA with services that include frequent home visits,

basic nursing, health and nutrition support, symptomatic treatment, psychosocial counseling, and end of life

planning. The coverage areas for NCM Zambia will include three locations in Lusaka Province including

Kafue, Chongwe, and Lusaka districts; Solwezi, Kasempa, Kabompo, Zambezi, and Chavuma district will

be covered in North-Western Province.

CRWRC will serve 2,130 PLWHA with palliative care through its sub-partners, namely, Church of Central

Africa Presbyterian - Relief and Development (CCAP - R&D), The Reformed Church of Zambia (RCZ),

Reformed Community Support (RCS), The Reformed Church in Zambia Eastern Diaconia Services (RCZ

EDS). Coverage areas will include Lundazi and Chipata districts in Eastern Province, and Kalulushi and

Kitwe on the Copperbelt Province.

WHIZ will serve 2,950 PLWHA with palliative care services in Mazabuka, Choma, Gwembe, Kazungula,

Livingstone, and Kalomo districts in Southern Province.

To support the scale-up of palliative care programs, NCMI affiliate, Helping Hands Africa (HHA), based out

of South Africa will provide technical support, capacity building, monitoring and evaluation, and overall

program support for its local implementing affiliates and partners.

The palliative care program will make significant progress in FY 2008 toward endline targets by expanding

coverage into new geographic areas not previously reached by the program. In these new target

communities, NCMZ and its partners will conduct an inventory of PLWHA that are located within a two

kilometer radius from the local church, volunteer, or community based organization (CBO). Home-based

care coordinators from each agency will train a total of 1,052 community volunteers to conduct an inventory

of PLWHA to determine the services that are needed, identify potential beneficiaries, and identify the groups

already engaged in home-based and palliative care services in the community. The identified beneficiaries

will receive basic information on HIV/AIDS, hygiene, medicines, and food supplements, when available.

Special consideration will be given to PLWHA and the chronically ill who are unable to access food and

medical support due to pain and inability to reach health centers.

Palliative care efforts will focus on mobilizing and certifying volunteer home visitors; this includes developing

an individualized care plan for each beneficiary. The care plan will feature basic care, home nursing,

hygiene, food supplementation, psychosocial counseling, and end of life care; referrals for treatment,

medical services, and linkages to wrap-around services provided by other community resources such as

food security, education, skills development, and economic self-sufficiency will also be provided. Those

clients in need of special care will be referred to health centers for further management and antiretroviral

treatment. Volunteers and caregivers will receive home-based care kits to help them look after the clients.

For motivation, volunteers will receive a bicycle, food packs (when available), to enable them reach the

clients and reduce volunteer burnout. Volunteers and caregivers will be trained and supervised by trained

nurses. NCMI will actively participate in the USG Zambia Palliative Care Forum and the Palliative Care

Association of Zambia to enhance efficiency and effectiveness of program activities and ensure clients are

offered quality palliative care services that are in keeping with best practices and national standards. In

coordinating with other service providers, NCMZ and its partners will strengthen its referral network and

continue learning best practices from other providers in the area of palliative care provision.

For ongoing quality assurance of the palliative care program, NCMI is placing a high priority on

strengthening monitoring and evaluation (M&E) systems in FY 2008. M&E personnel from NCMI and HHA

will enhance the M&E system and provide training to local M&E staff in Zambia. Quality improvement and

verification checklists (QIVC) will be used in activities such as trainings and counseling sessions to ensure

the quality of the service provision. Pre and post tests will also be utilized to ensure that training sessions

are being understood by the volunteers.

The program is designed for sustainability by building ownership from within at the local community and

local NGO levels. All project activities are designed to encourage independence and self-governance in the

planning, design, implementation of outputs, and outcomes. A local commitment of resources is part of the

planning and implementation process. This local ownership and long-term commitment will be achieved by

establishing local coordinating committees of key community leaders and volunteers and training and

empowering these committees to assist the PLWHA in their communities. In nearly every community

served by the project, local churches and church leaders will be sensitized and trained to take an active role

in mobilizing volunteers, obtaining local resources, and participating in the local coordinating committees

serving PLWHAs. The involvement of the local churches in serving PLWHA is an essential strategy for the

sustainability of the program since the church is a local grassroots institution with a spiritual mandate to

reach out to the suffering and the sick. Each of the partners has a unique and extensive network of several

hundred churches that will be trained and mobilized for the long term care of PLWHA that will last beyond

the initial investment of the NPI.

NGO partners will also receive intensive capacity building support from HHA and NCMI to strengthen their

organizational, administrative, financial, human resource, and technology infrastructure. At the conclusion

of the project each partner organization will be in a position to sustain and enhance their role in home-based

care through their own networks.

All FY 2008 targets will be reached by September 30, 2009.

Activity Narrative: Nazarene Compassionate Ministries Inc. (NCMI) will rapidly scale up palliative care services in Zambia usin