• Country Overview
• Active Programs
• Past Programs

COUNTRY OVERVIEW

Zambia faces many challenges to meet the vision of health reform established by its government in 1991: "equity of access to cost-effective quality health care as close to the family as possible." The Zambian Integrated Health Programme (ZIHP) is an ambitious program developed by USAID in partnership with the Government of Zambia to address the main health problems of the people of Zambia and to continue the process of health reform initiated by the government. Part of the process of health reform includes decentralizing health services by strengthening the provision of local services through District Health Management Teams (DHMTs). Zambia's population of 9.8 million people is linguistically and culturally diverse, with 72 recognized ethnolinguistic groups. More than two-thirds of Zambians are under 25. Major factors contributing to high rates of infant and childhood morbidity and mortality nationwide are malaria, diarrheal disease, and malnutrition. The realization of productive lives for Zambia's adult population is hindered by high rates of HIV/AIDS transmission and low contraceptive prevalence rates. It is estimated that by 2004, AIDS will account for about 210 deaths per day among 15 to 49 year olds. According to the Zambia Urban Sexual Behavior and Condom Use Survey (1999), about 25% of men and women surveyed had had sexual intercourse by age 15, and about 75% by age 19. Although 98% of married women know of at least one method of modern contraception, only 14% of married Zambian women are currently using a modern method. Zambia's fertility rate is 6.1 (1996 DHS).

ZIHPCOMM, Communication and Community Partnerships implemented by Johns Hopkins University/CCP, is responsible for the behavior change communication (BCC) and community /partnership activities under ZIHP. Our mandate under ZIHP is to provide communication support for the minimum package of basic health services, including RH, HIV/AIDS prevention, child health care and nutrition, and malaria prophylaxis. We are addressing these needs through activities focusing on caretakers and health care providers, support for community-based interventions, such as neighborhood health committees, and the implementation of national campaigns to generate demand for health services.

ZIHP's goal is to improve primary health care services for all Zambians by providing technical assistance to local counterparts in the areas of:

• increasing demand for services;
• increased delivery of services at the community level;
• increased delivery of services by the private sector;
• improved quality through improved health worker performance; and
• improved policies and planning and support systems for the delivery of health care interventions.

Of these goals and objectives, JHU/CCP contributes to the first two. The remaining three objectives are those of the other ZIHP partners, Abt Associates, John Snow, Inc. (JSI), and Society for Family Health.

We have also supported the following:

• Child Health Weeks and various IEC and BCC activities in the health sector
• Zambians attending leadership and strategic communication workshops in Baltimore, such as the Gates and Advances workshops
• HIV/AIDS, IEC, malaria committees at the national level
• HIV/AIDS Youth Mass Media Campaign
• Red Ribbon Campaign
• Mother-to-Child Transmission Materials
• Workplace Leaflets and posters
• Sports Initiative: Increasing Men's Participation
• Family Planning Campaign
• Safe Motherhood Interventions

ACTIVE PROGRAMS

• NHC (Neighborhood Health Committee) Strengthening Package
  This program strives to build the skills and capacity of NHC members to be well informed and skilled health promoters in their communities. NHC members are trained to mobilize their communities, identifying problems, prioritizing them and working toward a solution. Face-to-face training is complemented by distance education through radio, as well as the provision of print materials.

• Clinic Program: Improving Family Planning Services
  The Family Planning Counseling Kit was developed to serve as a facility-based counseling tool for service providers. Included in the kit are guidelines on how providers can profile clients to meet their individual needs during each visit, and also how providers can counsel clients on dual protection, especially in the context of married couples.

• Clinic Program: Improving the Services of Midwives
  The Maternity Counseling Kit is being developed to enhance the service providers’ ability to tailor a counseling session to the needs of the client using a holistic and integrated approach.

• Youth Grants
  ZIHP is currently working with four youth organizations that have been supported to implement different youth activities on sexual reproductive health and HIV/AIDS. The interventions seek to increase knowledge and attitudes and change behavior among adolescents, ages 14-24, both in and out of school.

• FACEAIDS: AIDS in the Workplace
  FACEAIDS is based on the idea that people make the best behavioral choices when they can get accurate information and have access to services. It also based on the belief that employers are in the strategic position to make this information and material available to their staff and to facilitate education on integrated reproductive health, STDs, and HIV/AIDS. The FACEAIDS package builds awareness at worksites about HIV/AIDS prevention through group education and prevention sessions, training of peer educators among the employees, distribution and promotion of male and female condoms, provision of information on voluntary counseling and testing (VCT), family planning and double protection. It also assists in the formulation of an HIV/AIDS policy for the organization.

• The Better Health Campaign
  The Better Health Campaign is a multi-media campaign (print, radio and television) designed to provide Zambians with the information they need to learn the art of being well. Campaign designers research a variety of health issues and then develop messages-one per week, including three or four key "Health Tips" around a central monthly theme-that are carried by all three media channels.

• The HEART (Helping Each Other Act Responsibly Together) Campaign
  This mass media campaign promotes healthy sexual behaviors among urban youth.

To read more about current projects in Zambia, please go to the HCP Zambia page.

PAST PROGRAMS

Zambia Family Planning Services Project