CIDRZ is pleased to have hosted Dr. Craig Wilson, Director of University of Alabama at Birmingham (UAB) Sparkman Centre for Global Health. Dr. Wilson a Professor of Epidemiology Pediatrics and Microbiology made a presentation on “Community mobilization for HIV prevention and impact on the Continuum of Care in 15 cities in the US” at the CIDRZ research meeting.
Notable from Dr Wilson’ presentation were lessons and experiences leading to the formation of an Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) in the United States of America, a network funded primarily by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) with Office of AIDS Research funds and supplemented by National Institute of Mental Health (NIMH), National Institute on Drug Abuse (NIDA) and the National Institute on Minority Health and Health Disparities (NIMHD) focusing on youth aged 12-24 years.
The ATN community initiatives were implemented from 2002 to 2016 through a model, Connect to Protect (C2P): Mobilizing Communities for Structural Change to Impact HIV/AIDS conceptualized In 2001, when half of all new HIV infections were among people 25 years and younger, HIV determinants were viewed through a narrow lens, individual-level interventions were primary focus and limited collaboration with stakeholders outside of traditional HIV prevention and care..
The C2P model is based on the “Community Empowerment Framework” that emphasizes seven factors for successful coalition development and function namely, defining a clear vision and mission, strategic planning, coalition leadership, providing resources to mobilizers, documentation of coalition efforts and feedback on progress, technical assistance and making outcomes matter.
The central focus of C2P was the identification of local social and structural factors that impede HIV prevention and treatment in youth and utilized the power of community stakeholders to bring about structural level changes that would be difficult for any single organization to achieve independently.
Dr. Wilson has nearly 15 years of experience in Zambia working predominantly on capacity building programs supported by PEPFAR and working with CIDRZ, Ministry of Health and UNZA SOM.
His first Zambian visit was in 1998 before CIDRZ was operational to establish HIVNET 025 study and returned in 2004 to support CIDRZ scale up efforts and trainings. He facilitated technical aspects of Kalingalinga laboratory remodeling and establishment from 2004 to 2006 and did clinical trainings (pediatric and adult) in Lusaka, Southern and Eastern Provinces.
Since inception, CIDRZ has been committed to answering research questions relevant to improving health in Zambia. The work, ranging from pharmacokinetic, behavioural studies, individual and cluster-randomized trials to large multi-country programme evaluations, aims at identifying locally-relevant, culturally-acceptable, resource-appropriate, evidence-based interventions that will influence policy and thus raise healthcare service delivery in the public health sector.
CIDRZ research teams are supported by a research and regulatory infrastructure with dedicated staff skilled in regulatory affairs, human subjects protections, Good Clinical Practices, quality control and assurance, data management, analysis, and research pharmacy and laboratory. The findings are disseminated at local, regional and international meetings after sharing with the Ministry of Health.
In all its work CIDRZ strives to contribute to the Zambian healthcare system through innovation in programming and as part of achieving the above, a one-day scientific symposium centred around diversifying research funding was held on the 6th of November 2017.
The symposium brought together CIDRZ researchers, Principal Investigators (PIs) and Board members to showcase current CIDRZ research activities and see how best to build a vibrant research practice at CIDRZ.
CIDRZ Grants and Contracts Consultant, Jill Morse said
“a more targeted strategy for financial diversification among our grants will be developed, department-level business plans will be created to identify key types and potential areas for funding, and business development at the departmental level will be tied to key strategic plan targets for revenue concentration”.
CIDRZ Chief Scientific Officer Dr Roma Chilengi said CIDRZ had a lot of opportunities in its training programs.
“Our HealthCorps Fellowship program has produced critical -thinking scholars in the areas of clinical trials, implementation science, health systems strengthening, laboratory science, HIV/AIDS, Tuberculosis, Hepatitis and Enteric Disease, Non-Communicable Diseases, Women’s cancer control, Reproductive & Maternal Health, Newborn & Child Health, Water, Sanitation & Hygiene and data analysis.
The quality of fellows we produce at CIDRZ could contribute immensely to research work in the organisation. And being the largest healthcare related non-governmental organisation in Zambia, our laboratory would compete favorably in sub-Sahara Africa”.
Some of the research presentations included:
- Hepatitis B by Dr Michael Vinikoor, which looked at the growing global recognition of Hepatitis B by stakeholders and what CIDRZ has accomplished around HBV since 2003. CIDRZ work in this area has the potential to make the organisation the leading African implementer of HBV research and programmes.
- Factors associated with Rotavirus vaccine failure in Zambiainfantsts by CIDRZ PhD candidates, Michelo Simuyandi, Natasha Labana and Katayi Kazimbaya.
- The aetiology of diarrheoa among Zambia infants presenting with moderate and severe diarrhoea in Zambian health facilities byCarol Chisenga, John Mwaba and Neha Buddhdev.
Other presentations were on studies and programs: Better Information for Health in Zambia; Community ART for Retention in Zambia; ART Readiness in HIV-infected Pregnant Women; Finding Efficiencies in Zambia’s Immunisation Supply Chain; and Reaching At-Risk Adolescents through Facility-Based Youth-Friendly Services.
And CIDRZ Board Member, Mr. Charles Mpundu, said “listening to the different presentations gives an idea of not only the skill-set CIDRZ has, but also the amount of work and dedication that goes into the various programs.
The insights the Board Members have received here today would not have any impact had we just read about it. Given the amount of work done, there is need to package the information in a simplified way for more people to understand and eventually attract more financial support.”
CIDRZ has awarded 12 landlords for improving their toilets in Bauleni Compound under the organisation’s behavioural change meetings dubbed ‘Indaba Yama Landlords’ (meeting of landlords).
This is under the CIDRZ, in collaboration with the London School of Hygiene and Tropical Medicine project which is aimed at ‘Sanitation Demand: Creating Demand for Sanitation in Peri-urban Areas or SanDem.’
A total of 508 Landlords participated in Bauleni Compound and each of them was asked to make four improvements to their toilets:
- Initiate the ‘pamodzi’ cleaning rota for the toilets which would involve the participation of all households within a housing unit;
- Provide an inside lock to ensure privacy in the toilet;
- Provide an external lock to the toilet to ensure that toilets are kept clean all the times and used responsibly; and
- Provide a cover pan to reduce the smell.
Meetings were held with landlords to sensitise them on the key issues including the building of improved toilets. Within a period of four weeks, we saw great improvement as some landlords worked on all the four requirements and some went further and bought modern fittings including cisterns, while others even started the process of constructing new toilets. This elated the CIDRZ SanDem project who decided to award the outstanding landlords with various prizes.
The SanDem project is funded by the U.K. Department for International Development (DFID) under the Sanitation and Hygiene Supply for Equity (SHARE) project.
The project is designed to create demand for sanitation in peri-urban areas of Lusaka such as Bauleni Compound through formative research, innovation, and intervention. The aim is to determine how far a state-of-the-art communication approach to behaviour change can enhance demand for and acquisition of improved toilets in urban Zambia.
Evidence shows that poor sanitation and exposure to human excreta have been implicated in the transmission of many infectious diseases including diarrhoea, cholera, typhoid, intestinal worms, infectious hepatitis, trachoma among many others.
Globally, diseases related to water and sanitation are one of the major causes of death in children under five years old. About 4 billion cases of diarrhoea occur per year, causing 1.8 million deaths among children under five. Therefore improving sanitation is an effective and sustainable means to reduce the risk of infection, the severity of infection, and ultimately, morbidity and mortality.
The United Nations Children’s Fund and the World Health Organization report that about 2.5 billion people have inadequate toilets globally, and almost one billion defecate in the open.
In Zambia, out of a population of ≈15 million, 5.6 million have no safe toilets and 2.3 million defecate in the open.