Community-based ART is a key component of service delivery for stable HIV positive patients

Workshop participants drawn from the Ministry of Health, National AIDS Council, CIDRZ, University of Maryland, USAID EQUIP and ZAMBART

HIV is a major public health problem in Zambia. HIV treatment became available in 2004 in the public sector, while the last decade has seen successful scaling-up of antiretroviral therapy (ART) services resulting in over 700,000 adults and children accessing HIV care and treatment services in Zambia. However, this scale-up has caused a strain on the health system, threatening the quality of care and crowding out other services.

To help address this challenge, the World Health Organization (WHO) developed guidelines in 2015 highlighting the need for Differentiated Care Frameworks with variations in service frequency, health worker cadre, service location and service intensity across countries and populations. In Zambia, the Ministry of Health has contextualized this and authorized implementing partners such as CIDRZ to pilot different models of community-based ART service delivery.

With support from the Bill & Melinda Gates Foundation, CIDRZ has been implementing four Differentiated Service Delivery (DSD) models: Community Adherence Groups (CAGs), Urban Adherence Groups (UAGs), FastTrack and Streamline ART Initiation (START), under the Community ART for Retention in Zambia study.

 

 

 

 

 

The objectives of the Community ART study were:

  • To determine the acceptability, appropriateness, and feasibility of a differentiated care system in Zambia
  • To evaluate the effectiveness, efficiency, and healthcare quality of a differentiated care system that includes targeted models of care
  • To develop a “methodologic” toolkit for assessment of local needs and preferences and for implementation during scale-up of differentiated care models in this and in other contexts

To share lessons learnt and recommendations from implementing these models, CIDRZ conducted a five-day meeting with other organisations that have been implementing similar models. Among them, the University of Maryland gave an update on the Community HIV Epidemic Control (CHEC) model. Other organisations that participated are the Zambian Ministry of Health, Zambart, National AIDS Council, and the USAID EQUIP Project.

The meeting was aimed at learning lessons about the most applicable model in the Zambian context and how such a model will inform the revision to the National HIV Policy to include community-based ART service delivery as a major component of service delivery for stable HIV-infected patients in Zambia.

CIDRZ provided an outline of an Online Toolkit being developed which will capture the CIDRZ experience of implementing DSD and provide resources to assist future implementers as well as how to assess DSD models.

During the meeting, participants analyzed the different models presented and discussed the advantages, disadvantages and provided recommendations for adaptation for possible scale-up. The meeting also looked at the required indicators for reporting by partners implementing DSD and for tracking by the Ministry of Health.

Participants agreed to incorporate DSD into the National HIV policy and , and drafted a road map to manage takeholder expectations, communicate plans and coordinate the consolidated HIV treatment guidelines, and finalized the monthly reporting tool for DSD Indicators for implementers.

CIDRZ and Zambian Government Launches Protocols and Training Manuals … We want to reduce neonatal Mortality Rates in Zambia

CIDRZ Chief Executive Officer, Dr Izukanji Sikazwe with some of the children that have benefited from CIDRZ  interventions on improving neonatal care.

CIDRZ and the Ministry of Health have launched the Essential Newborn Training Manual and Newborn Protocols as the Zambian government reiterated its obligation to improving child survival in line with the global commitment and related targets.

Speaking during the official launch, Minister of Health (MoH) Hon. Dr Chitalu Chilufya, in a speech read on his behalf by MoH Permanent Secretary Health Services, Dr Jabbin Mulwanda said “it is well stated within [party] manifesto and in other policy governments that government will work with the cooperating partners and other stakeholders to better the lives of all citizens; and child health is on top of the agenda,” Dr Chilufya added.

The Minister reiterated that the Ministry “is focusing on health promotion, prevention of disease and death, as well as driving curative and rehabilitative health services…. There, the Essential Newborn Care Training Package and Newborn Protocols, when implemented, will contribute to the Ministry’s objective of ‘training and making available competent and adequate numbers of human resources for health to manage health services.”

MoH PermSec, Dr Jabbin Mulwanda, during the official launch of manuals. He was representing the Minister of Health, Dr Chitalu Chilufya.

“Support the Ministry of Health, in any way possible to celebrate every birth & save life of every mother and newborn countrywide. Together we can markedly reduce deaths,” Dr Chilufya appealed.

Speaking earlier, CIDRZ Chief Executive Officer, Dr Izukanji Sikazwe said “for most people, pregnancy and birth is a joyous life event. Sadly, however, many families suffer a pregnancy-related bereavement. To learn that a newborn baby is unwell and is not going to survive must be one of the most harrowing situations imaginable for any parent.”

Dr Sikazwe reiterated CIDRZ commitment to working with the government through the Ministry of Health “in the fight towards the reduction of neonatal mortality through training, capacity building, and provision of medical supplies as we begin the scale-up of these guidelines in Lusaka, Rufunsa and Luangwa Districts.”

“The guidelines being launched today are designed to provide our colleagues with the skills required to reduce neonatal mortality either due to birth asphyxia, neonatal sepsis, preterm birth, or hypothermia. With the launch of these guidelines, it is my plea and hope, to our fellow partners, but most importantly to our Frontline Workers, our healthcare providers, to help us witness a 10-fold reduction in neonatal mortality in the near future,” Dr Sikazwe added.

Some of the participants during the official launch of the protocols and training manuals.

Currently, Zambia’s under-five and infant mortality rates stand at 75 per 1000 live births and 45 per 1,000 live births respectively, while neonatal mortality rate is estimated at 24 per 1,000 live births as of 2014. Zambia’s target is to reduce the neonatal mortality rate to less than 12 per 1,000 live births by 2021.

Mr Emmanuel Appiah Qua-Enoo joins CIDRZ as Deputy CEO

Mr Emmanuel Qua-Enoo, CIDRZ DCEO

CIDRZ CEO Dr Izukanji Sikazwe is pleased to welcome Mr Emmanuel Appiah Qua-Enoo as he joins CIDRZ as Deputy Chief Executive Officer.

I am delighted to welcome Mr Qua-Enoo to CIDRZ. His experience in financial compliance, strategic planning, business development, and organisational and stakeholder relationship management brings a key skill to our CIDRZ leadership. He will play a major role as CIDRZ continues to grow and flourish as a permanent, independent, indigenous organisation serving the health and research needs of Zambia.” said Dr Sikazwe.

Originally from Ghana, Mr Qua-Enoo is a Chartered Accountant and a registered member of the South African Institute of Chartered Accountants. He holds two Bachelor of Commerce (Hons) Degrees, in Accountancy, and Accountancy and Finance, from the University of KwaZulu-Natal and a Master’s of Commerce Degree in International Taxation from the University of Johannesburg, South Africa. He is also an alumnus of the United States Venture Capital Institute.

Mr Qua-Enoo has worked at PricewaterhouseCoopers in their Johannesburg Practice where he specialised in Financial Services and Management of Internationally Funded Institutions. During his career, he has also consulted for numerous international donors and their recipients across Africa and has a broad understanding of U.S. government regulations governing their foreign assistance programmes. While working at the United States Agency for International Development (USAID) Office of the Regional Inspector General in Pretoria, South Africa he was responsible for the management of all Non-Federal Audits in Eastern and Southern Africa, covering 21 countries. He has also served as the Chief Financial Officer of the Southern Africa Enterprise Development Fund, a USAID sponsored Private Equity and Venture Capital Fund that invested in Southern Africa.

After an extensive search the CIDRZ Board of Directors Recruitment Committee selected Mr Qua-Enoo, who had previously served CIDRZ as a short-term consultant strengthening our financial and reporting systems compliance with CIDRZ policies, donors, and prevailing law.

 

CIDRZ Central Laboratory Launches the Largest Solar Plant in Zambia

Ministry of Health Permanent Secretary for Technical Services Dr Jabbin Mulwanda cuts the ribbon at the Official Opening of the solar plant at the CIDRZ Central Laboratory with CIDRZ Board Chairperson Mr Bradford Machila

Today, with generous support from the U.S. National Institutes Health through the University of Alabama at Birmingham, CIDRZ officially opened an 83.2 kW capacity solar plant at its Central Laboratory at the Kalingalinga Health Centre in Lusaka.

Speaking at the event, Ministry of Health Permanent Secretary for Technical Services Dr Jabbin Mulwanda commended CIDRZ for the initiative. “What CIDRZ has done exemplifies the importance of collaboration between non-state actors and government. Knowing what Zambia has experienced recently in terms of power deficits, this solar plant guarantees continued quality laboratory services to Zambians in the public health sector. This is a big achievement not only for CIDRZ and the Ministry of Health but for everyone. Thank you CIDRZ and your sponsors for the laboratory services you have provided to the country over the years. Whenever I think about CIDRZ I think of quality.”

Minister of Health, Honourable Dr Chitalu Chilufya (MP) also commended CIDRZ for its continued partnership with his Ministry to ensure quality health services are delivered as close to the people as possible, as well as for going green. “We see here today the Ministry of Health and the Ministry of Energy cooperating to attain a milestone achievement. We must create and leave a legacy. We must be committed to the preservation of the planet, and we must be committed to reducing the effects of climate change that is causing so much suffering to people the world over. Through the installation of this solar plant, a clean, reliable and cost-effective source of energy, CIDRZ has not only complemented Government’s efforts towards the provision of uninterrupted laboratory services, but also its commitment to renewable energy.”

Acting Director in the Ministry of Energy, Mr Arnold Simwaba added, “this solar plant will significantly help to reduce overload on the national grid. Our Ministry and the government encourages businesses and private individuals to emulate what CIDRZ has done and use alternative sources of abundant energy such as solar.”

CIDRZ Board Chairperson, Mr Bradford Machila, who attended the event with other Board Directors explained that CIDRZ was compelled to act due to the load shedding that had characterised the country’s energy sector. “In mid-2015, our Central Lab started experiencing 8 hours of power load-shedding every 24 hours causing a great challenge. Biomedical laboratory testing is a precise activity: temperature sensitive specimens require refrigeration or air conditioning to maintain sample quality, and sophisticated laboratory instruments and complex testing regimens require uninterrupted power to assure reliable results to healthcare providers and their patients.”

Currently, CIDRZ supports 84 government health facilities within Lusaka province with HIV viral load testing and early infant HIV diagnostics, the Central Lab conducts more than 2000 tests on a daily basis.