Country Spotlight: Zambia

Country Overview

In 2012, 81,727 HIV-positive women gave birth in Zambia. Of those, 76,963 received antiretroviral prophylaxis to ensure reduced risk of transmission to their children through pregnancy, delivery or breastfeeding. The mother-to-child HIV transmission rate was 15% in 2013, and there were 20,000 new HIV infections among women and 12,000 among children.

Our Work in Zambia

In 2001, the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) began working in Zambia to enhance access to HIV care and treatment services for both adults and children. To achieve this, EGPAF partnered with several organizations including the Zambian Ministry of Health, the Center for Infectious Disease Research in Zambia (CIDRZ), the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), and the U.S. Centers for Disease Control and Prevention (CDC).

In June 2011, the Zambian government made elimination of pediatric HIV and AIDS a national goal and pledged to decrease the incidence of HIV-infected infants born to HIV-positive mothers to less than 5% by 2015. At this time, Zambia began implementing revised prevention of mother-to-child HIV transmission (PMTCT) guidelines recommending lifelong treatment for all HIV-positive pregnant and breastfeeding women. Today, EGPAF-Zambia uses its expertise to build the capacity of the national health program at all levels. EGPAF’s efforts to expand a strong and effective national health system to combat HIV and AIDS have focused on development and management of a health information system in country. We offer support and technical assistance to the country’s strategic information and evaluation personnel and we implement an electronic health records system called SmartCare, which has been associated with improved patient tracking and follow-up in-country. Our programs have also focused on children affected and infected with HIV. Through several projects, EGPAF ensures the health and psychosocial wellbeing of children across the country. 

EGPAF-Zambia participates in several technical working groups at both the Ministry of Health and Ministry of Community Development Mother and Child Health (MCDMCH) including the PMTCT, pediatric and adult ART, quality improvement, and family planning working groups. EGPAF also supports the national pediatric HIV and the national quality improvement conferences, and provides support to the Ministry of Health and MCDMCH in the development of a national monitoring and evaluation framework for PMTCT (Option B+), family planning, and HIV integration programs. We have also developed national and site-level data collection tools and recommended indicator updates to national registers. 

 

Key Projects in Zambia

The LiveFree Project

(2011-2017) Under this five-year CDC/PEPFAR-funded project, EGPAF-Zambia works closely with the Ministry of Health to provide technical assistance and build capacity in strategic information and evaluation. We support all aspects of the electronic health record system, SmartCare, including: development, implementation, training, management; strategic and programmatic input; and procurement of computer equipment, software, and hardware to ensure high-functioning capacity. This system has resulted in improved patient follow-up and tracking, data analysis and has informed many national HIV/AIDS program improvements. The end-goal of this project is to increase the number of patients remaining on treatment.

Through LiveFree, EGPAF also supports the Tisamala teen mentorship project - an adaptation of a South African peer education project - which offers psychosocial support and life skills development to HIV-positive adolescents. The project aims to improve HIV knowledge among adolescents, and provide them with psychological support, enabling them to better cope with the process of telling friends and family about their HIV-status and the attached stigma of being HIV-positive. The mentorship program is currently implemented in the Lusaka, Kafue, Chongwe, and Nyimba districts. EGPAF also works with local community-based organizations to implement the Mbuya DAISEY program, which trains counselors to lead support groups for caregivers of HIV-positive children who are not yet aware of their HIV status.

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Survive and Thrive Project

(2012-2017) The Survive and Thrive project, funded by the Conrad J. Hilton Foundation, aims to support healthy early childhood development for children under five by targeting children infected and affected by HIV/AIDS in high HIV prevalence areas of Lusaka Province. Interventions under this project include supportive services that assist caregivers and clinicians to understand the importance of early childhood development and provide a continuum of care for children to reach their full cognitive, social, emotional and physical potential.

In Zambia, the project is entering its second phase. The first phase established early childhood development (ECD) centers at Mt. Makulu and Mandevu pediatric clinics. The goal of the second phase is to sustain gains, while transferring responsibilities to ensure continuation of established ECD services. Project activities include integration of ECD in routine health services, such as maternal and child health care; ongoing trainings on early childhood development for health workers, community volunteers and teachers in Lusaka; and development of a national ECD strategy.

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Elton John AIDS Foundation 

(2015-2017) A two-year award from the Elton John AIDS Foundation (EJAF) will ensure greater access to HIV identification and treatment among adolescents in Zambia. This project is a collaboration between EGPAF, the MOH, Ministry of Education, CIDRZ, and Grassroots Soccer. The project focuses on intensified HIV case-finding among 15-19 year olds. This age group is particularly vulnerable to sexual transmission of HIV. HIV-infected adolescents are very likely to default on treatment (30%) and AIDS-related mortality rate is high (20%).

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Expanding Access to Pediatric HIV Testing and Treatment through Intensified Case Finding 

(2015-2018) In November 2015, ELMA Foundation and EGPAF partnered to implement a project responding to challenges in increasing access to care and treatment for children. The goal of this three-year project is to rapidly scale-up pediatric HIV testing among children from 18 months to 19 years of age and initiate HIV-infected children on ART. Through the project, EGPAF will work with the MOH and national partners across three countries, including Zambia, to ensure scale-up of point-of-care early infant HIV diagnosis - complimenting work under UNITAID. The project will be implemented at 25 sites in the four regions of Zambia (Southern, Lusaka, Central and Copperbelt provinces).

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Publications

Country Fact Sheet: Zambia

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Haba Na Haba: Technical Assistance Provision at the Elizabeth Glaser Pediatric AIDS Foundation (2014)

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Journal Article: Lessons learned from early implementation of B+: The Elizabeth Glaser Pediatric AIDS Foundation experience (2014)

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Technical Report: Pediatric and Adolescent Antiretroviral Treatment in Zambia: Estimating the Cost of Universal Access 2014 – 2018 (2014)

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Journal Article: Pregnancy outcomes and birth defects from an antiretroviral drug safety registry for women in South Africa and Zambia (2014)

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Journal Article: The cost-effectiveness of 10 antenatal syphilis screening and treatment approaches in Peru, Tanzania, and Zambia (2015)

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