The Southern African AIDS Trust, Zambia (SAT Zambia) is part of the Southern African AIDS Trust (SAT), a not-for-profit making regional organisation that supports community responses to HIV and AIDS in southern Africa. The SAT Zambia office was started in 1991 as part of SAT’s expansion into communities in Southern Africa. Since its inception, SAT Zambia has supported many CBOs and NGOs and has seen many of these organizations graduate from the SAT capacity development programme to become self-sustaining organisations. Currently SAT Zambia supports 25 NGOs, community and faith based organizations. The support is two-fold, namely, grant-making and organizational capacity strengthening activities through lessons-sharing workshops; skills-training seminars; mentoring relationships; exchange and study visits.
SAT Zambia recently celebrated 21 Years of Strengthening Community HIV and AIDS Competence in Zambia. The Conference was held at Mulungushi International Conference Centre in Lusaka, Zambia. The conference was officially opened by Local government minister, Prof. Nkandu Luo, who also sits on the Zambia Cabinet Committee of Ministers on HIV and AIDS. In attendance were Cooperating Partners, National AIDS Council, strategic partners, representatives of Government Line Ministries, members of the Civil Society Leadership Coalition, graduated and current SAT Zambia partner organisations. Other participants included the SAT Zambia Country Advisory Committee members, current and former members of SAT Zambia staff.
The conference was premised on the following objectives:
• To share the key outcomes of the work of SAT Zambia in strengthening community HIV and AIDS competence in the past 21 years.
• To improve partner programming through reflection and documentation of achievements, lessons learned and challenges in the last two decades of SAT activities in Zambia.
• To draw lessons from the past work of SAT Zambia and secure stakeholder input into its strategic direction for the period 2012 -2016.
Thematic Focus Areas of the Conference and Methodology
The Conference was delivered in both plenary and break-away sessions which among others highlighted the programme areas of SAT Zambia partner organisations, namely, HIV Prevention; Treatment, Care and Support; Impact Mitigation and Gender, Human Rights and HIV. The break-away sessions showcased “success stories” which were part of the outcomes of the work of SAT Zambia partner organisations over the years in addressing HIV and AIDS at community level. In addition, the conference provided a platform for partner organisations to exhibit and showcase their work.
Key highlights of the Conference
As echoed by the Guest of Honour Professor Nkandu Luo MP, Minister of Local Government and Housing in her opening remarks, HIV prevalence in Zambia remains high at 14.3%. This means that HIV prevention remains a priority area in the National response to HIV and AIDS in Zambia. In that regard, the conference discussed various success stories around HIV prevention especially partners’ work around addressing the key drivers of HIV in Zambia. Among the stories showcased was the “Faith House Model “by Kuba Lusa Community Based Organisation which aims at addressing Multiple Concurrent Partnerships through promoting sex and sexuality dialogue at household levels. Kapombo AIDS Programme, one of the partners discussed the integration of Sexual reproductive health and rights for young people through an Initiative called “Letter League” resulting in increased access and utilization of sexual reproductive and health services by young people.
HIV Treatment, Care and Support
In 2006, the Zambian Government declared that ART would be free in all public health facilities, to-date about 368,000 people are on ART. SAT Zambia has supported partner organisations in community mobilization for HIV treatment and the Conference provided an opportunity for partners to share the outcomes of their work at community level on HIV treatment Care and support. Among the success stories was that of an HIV positive adolescent of Kapiri NZP+ who has taken a lead role in promoting ART adherence among young people through formation of support groups to reduce stigma and increase access to treatment. The availability of free ART in public health facilities in Zambia has generally increased access to ART leading to improved quality of life of many clients that were once bed ridden. This in turn has greatly influenced partner programming at community level such as the transformation of a Home Based Care Service Centre by Twafwane Christian Community Care to an ART adherence distribution and support services centre. These changes were demonstrated by partner success stories shared during the Conference.
Zambia has an estimated 1 300,000 orphans and vulnerable children out of which 700,000 are orphaned due to AIDS. Over the years SAT Zambia has provided support to partner organisations aimed at mitigating the impact of HIV and AIDS on children. With the support received from SAT, partners shared the results achieved at community level in addressing the impact of HIV and AIDS on children. One such success story was that on “Ambuya Support Group Model” shared by Chisomo Community Programme demonstrating one of the sustainable OVC support Initiatives. The initiative emphasizes on addressing a broader scope of needs of the OVC through engaging in household based income generating activities.
Gender, Human Rights and HIV and AIDS in Zambia
During the two decades of its work in Zambia, SAT Zambia has supported partner organisations to mainstream and integrate Gender and Human Rights in HIV programming. In line with the theme on gender and human rights, partners shared success stories on Integrating Human Rights in community HIV and AIDS responses, in addition, outcomes on partner engagement with Policy makers on Laws related to HIV were shared.
Linking Organisational Development to Service Delivery and Sustainability
One of the key outcomes of organization development support is improved capacity for partner organisations to deliver services at community level. It was evident from the presentations made by both graduated and current SAT Zambia partners that the support from SAT had greatly contributed to improved quality of their services and enhanced programme sustainability. Partners demonstrated how the support received from SAT helped them enhance their ability to resource mobilize and remain attractive to other potential resource providers. In one of the presentations a partner demonstrated how they embraced the SOCAT to be a tool for self reflection and continuous organizational improvement as illustrated by the comment from ZARAN below:
“We never viewed the SOCAT as a SAT thing that we just had to do but viewed it as way of identifying and celebrating progress as well as challenging ourselves to do better.”
Cross Cutting Issues
In November 2011 the National AIDS Council hosted a National HIV Prevention conference at which Resolutions were passed aimed at addressing the six identified key drivers of HIV in Zambia (were low levels of male circumcision, low levels of condom use, mother to child transmission, multiple and concurrent sexual partnerships, mobility and migrant labour, vulnerability and marginalized groups as well as treatment as prevention). During the SAT Zambia 21st Anniversary conference, the National HIV Prevention Conference resolutions were shared and their implication on SAT Zambia programming were discussed. In taking care of the resolutions, SAT Zambia will ensure that the new strategy for the period 2012-2016 is responsive to the resolutions within its capacity and programming scope.
The need for evidence based programming was another aspect which took a centre stage in most of the conference discussions. Documentation of good practices should always be part of HIV programming so that these good practices and lessons learnt could be shared with other players in responding to the HIV and AIDS pandemic.
Lessons for the Future
Despite the many strides that Civil Society Organisations and other stakeholders continue to make in addressing the HIV and AIDS epidemic, the situation in Zambia has not changed much. For instance, the HIV incidence of about 226 infections every day is still high. In addition, the cost of HIV treatment remains high and largely dependent on donor support rendering it unsustainable in the context of shrinking resource envelopes to support HIV and AIDS work. This situation underscores the need to scale up efforts towards evidence based and combination prevention.
In order to address the evolving HIV situation both in terms of the epidemic and the diminishing financial resources to support the response, it is important that support to HIV and AIDS responses is regarded as a social investment. In addition, there is need to shift from doing business as usual that has yielded less results to more innovative approaches in HIV programming.
In that regard, SAT Zambia will increasingly focus its work on partnerships that demonstrates high degree to deliver results especially through the integration of SRH&R in HIV and AIDS programming. Community driven and evidence based interventions supported by strong M&E including operational research, will continue to be at the core of SAT Zambia`s approach to strengthening community HIV and AIDS competence.
In the light of diminishing financial resources for HIV and AIDS responses, there is need for increased probity in the use of resources to maximize impact.
Capacity strengthening for enhanced Community HIV and AIDS competence is a gradual process which requires investment of time and resources in a manner that is responsive to the needs in the communities. In view of this, SAT Zambia will scale-up its efforts of enhancing Community HIV and AIDS competence using the School Without Walls methodology to ensure strengthened community systems.
There is need for the new SAT Zambia strategy to include strategies for addressing advocacy issues, gender based violence and programming around disabilities in the context of HIV and AIDS.