CIDRZ Receives Equivalency Determination (ED) Status Making it Equal to a U.S. Charity

To earn this recognized status CIDRZ governance, financial controls, and operations have successfully passed rigorous scrutiny from NGOsource (www.NGOsource.org). Earning Equivalency Determination status and being considered equivalent to a U.S. public charity makes it much easier for important potential donors – such as the Bill & Melinda Gates Foundation –  to confidently consider CIDRZ as a grantee, and allows CIDRZ to operate more efficiently with these donors.

Since becoming an independent Zambian NGO in 2011, and restructuring with new executive leadership under Director and CEO Dr Charles Holmes, CIDRZ has intensified focus on increasing the effectiveness of the management of its operations, and especially its financial, governance, and control environment. With the addition of a 5-member strong Internal Audit team, led by an experienced Certified Internal Auditor and Fraud Examiner who reports directly to the Board of Directors Audit Committee Chair, CIDRZ is confident about its accountability and control environment.

An independent Zambian NGO, CIDRZ collaborates with multiple partners so as to leverage diverse resources to assist it in delivering on its mission “To improve access to quality healthcare in Zambia through innovative capacity development, exceptional implementation science and research, and impactful and sustainable public health programmes.” The Bill & Melinda Gates Foundation is one such important donor. The Foundation recently granted CIDRZ a USD$4.76 million award for the Better Information for Health in Zambia study.

CIDRZ Welcomes David Ojok MSc, MPH who joins as Laboratory Quality Control Manager

David earned a BSc degree in Biomedical Science from University of Lincoln, UK; a MSc degree in Immunology and Clinical Microbiology from Makerere University, Kampala Uganda; and is preparing to defend his thesis for a Masters of Public Health degree from Uganda Christian University. He joined CIDRZ in November 2014 as Laboratory Quality Control Manager and also serves as Chair of the Lab Accreditation Committee. In his most previous role David was Team Leader of the Makerere University and Johns Hopkins University Research Collaboration Core Laboratory.

Rural Voices: SCOPE – The Sinazongwe Combination Prevention Evaluation Study

HIV prevention messages don’t always reach deep into rural areas like Sinazongwe District located on the north shore of Lake Kariba in the far south-east corner of Zambia’s Southern province. In fact HIV prevention programmes in remote areas are the most neglected and the least evaluated in Zambia. The Sinazongwe Combination Prevention Evaluation (SCOPE) study, funded by the U.S. Centers for Disease Control and Prevention (CDC) through ICAP at Columbia University, aims to evaluate population-level changes in HIV incidence, prevalence, and disease progression as well as knowledge, perceptions and attitudes in Sinazongwe District before and after implementation of a Development Aid from People-to-People (DAPP) integrated HIV programme called “Total Control of the Epidemic” in conjunction with a GRZ Southern Provincial Health Office and Sinazongwe District Medical Office scale-up of health services.

As part of SCOPE the over 50-member local CIDRZ team is conducting two community-based household surveys before and after the implementation of the DAPP HIV programme and GRZ services scale-up, three healthcare facility clinic record reviews, as well as interviews of up to 40 healthcare workers. It is estimated that up to 9,325 people from 24 Census Supervisory Areas (CSA) in Sinazongwe District will be reached per round during the evaluation exercise that started in July 2014.

Milestones Completed:

–        First round Facility survey data collected from 18 District health facilities

–        Interviews with 29 health care staff members

–        First round Community survey enrolled over 9,000 people from 24 CSAs

–        Ongoing data entry, cleaning and analysis

Sensitisation and Community Relations Create Trust

Undertaking such a large community evaluation cannot take place without the support and approval of local leadership; and the SCOPE study team has always valued interaction with Traditional Chiefs and Village Headmen. During a SCOPE study sensitisation meeting, a Chief requested that testing for malaria be included in the protocol as it was such a big health problem for his people. After discussions with the Southern Province Health Office – a key study partner – malaria testing and treatment was written into the protocol with the majority of test kits and all treatment being provided by the government.

Before study start local Community Health Workers (CHW) were identified by health facility leadership and were briefed on SCOPE by the Community Liaison Officer. The CHW plays an instrumental role by assisting the study team meet local leadership and accompanying them in the field on data collection days. By introducing the CIDRZ SCOPE staff to the community through a known and respected member, the community is assured that the survey team is genuine and working with the full knowledge and partnership of government. In addition, prior to a survey team starting activity in an area they are preceded by a trained Sinazongwe-based drama troupe that informs the audience about the survey and explains that the Ministry of Health is a key partner in this evaluation exercise. Providing regular updates to local stakeholders is also very important during the conduct of a study. SCOPE study coordinator, Henry Muloongo makes quarterly presentations to the Southern Provincial Health Office.

The SCOPE evaluation is planned to be completed by 2017. SCOPE data will be shared with key stakeholders and used to inform government health programming to enhance HIV prevention, treatment and support programmes targeting whole communities as it will provide important information about changes in new HIV cases over time at the population level. It is hoped that SCOPE data will contribute to Zambia, other country governments, and donors benefitting as they decide on the best allocation of resources to achieve reduction in new HIV infections.

It Takes Multiple Partners

A large evaluation such as the SCOPE study requires collaboration of multiple partners. Key entities involved in this study are the: Zambian Ministry of Health, Southern Provincial Health Office, Sinazongwe District Health Management Team, University Teaching Hospital, Centers for Disease Control and Prevention (Zambia and Atlanta U.S. offices), International Center for AIDS Care and Treatment Programs, FHI360, Development Aid People-to-People, University of North Carolina at Chapel Hill, and CIDRZ.

CIDRZ Assists Lusaka District Community Health Office Improve ARV Drug Access to Clinics

Through support provided by CDC/PEPFAR, CIDRZ was able to donate a new, 7-ton, containerized drug delivery truck to the Lusaka District Community Health Office to assist them to deliver life-saving Anti-Retroviral drugs to Lusaka District HIV Treatment and Care Clinics. Previously the District faced logistic challenges as they did not have their own dedicated vehicle for this important activity and so they reached out to CIDRZ to assist.

Since 2003, CIDRZ, with generous support of the CDC/PEPFAR, has contributed to meaningful improvements in the delivery of Zambian paediatric and adult HIV prevention and treatment, including scale-up of counseling and testing, introduction of home-based HIV testing, integration of Couples Counseling and Prevention for Positives, and provision of prevention of mother-to-child HIV transmission (PMTCT) services, as well as improving linkages to care and treatment. During this time CIDRZ assisted Lusaka District with ARV drug delivery by assigning a truck, fuel and driver for this purpose.

But donation of the dedicated ARV drug delivery truck to Lusaka District is one step further in achieving local programme ownership as well as carrying out the CIDRZ mission of “improving access to quality health care” by supporting a sound drug delivery system that assures access of ARV medication to every Zambian that needs it.

Since receiving the truck in late 2014 the Lusaka District drug logistics system has become more efficient and health facilities now receive timely ARV deliveries. District Pharmacist, Mr George Kadima commented “the dedicated truck had tremendously reduced the ARV drug delivery challenges faced by the Lusaka District.”

ACADEMIC ENDLINE Survey Launches to Evaluate Rotavirus Vaccine

From 2011-2014, the Programme for the Awareness and Elimination of childhood Diarrhoea (PAED) at CIDRZ organized and implemented interventions to decrease overall and diarrhoea-related post-neonatal Under 5 child mortality in Lusaka Province.  These interventions included the early roll-out of the rotavirus vaccine in a facility-based study and community-based behaviour change programming to improve child hygiene, feeding and diarrhoea treatment practices.

As PAED began activities, CIDRZ initiated the Baseline of ACADEMIC (A Comprehensive Assessment of Diarrhoea and Enteric Disease Management in Children) to establish the pre-intervention levels of child mortality and diarrhoea-related morbidity. Baseline included a multi-centre facility study to evaluate rotavirus vaccine effectiveness as well as a paper-based community survey reaching over 21,000 households in 220 Census Supervisory Areas to estimate child mortality.

After completion of the ACADEMIC Baseline and all PAED activities, training for the ACADEMIC Endline study commenced in January 2015. A study team of 16 Team Leaders and 46 Team Members were trained to conduct household-based surveys using Nexus 7 handheld tablets and Endline household data collection commenced in late February. In addition to meeting their data collection responsibilities, study staff members have also attended bi-weekly all-team meetings. There, they have received professional development training to increase their knowledge of health topics and enhance their research presentation skills. These efforts have boosted the confidence and morale of all staff to perform to the best of their potential.

The ACADEMIC Endline survey is the first tablet-based CIDRZ research study to successfully use electronic data capture in the field. It also marks the first time Open Data Kit-based survey programming and database generation has been managed in-house. ACADEMIC Endline data collection is projected to complete by mid- July of 2015.

CIDRZ contributes to improved child health in Zambia by donating Vaccine refrigerators and Expanded Programme on Immunisation cold-chain equipment to Government

 

On Friday 27th March, with the support of ELMA Vaccines and Immunizations Foundation, CIDRZ was privileged to handover Kw 14 million worth of Expanded Programme on Immunisation vaccine refrigerators, delivery trucks and allied cold-chain equipment to the Government of the Republic of Zambia in support of the nation’s child immunisation programme. The celebratory event at the Child Health Unit in Lusaka was a culmination of years of work, representing the partnership of the Government with multiple stakeholders, including the WHO, UNICEF, JICA, and the CIDRZ Programme for the Awareness and Elimination of Diarrhoea (PAED) led by Dr Roma Chilengi to strengthen Zambia’s vaccine cold chain system. By working hand-in-hand with government, CIDRZ PAED leadership and other stakeholders were able to perform a National Effective Vaccine Management Assessment and develop a detailed cold chain expansion plan which increased the capacity of the national level vaccine cold storage facility from 144 to 212,000 litres. ELMA Vaccines and Immunizations Foundation generously provided resources for the purchase and transport of the equipment, and training support.

Because vaccines require a strict temperature-regulated “cold-chain” storage and conveyance system to keep them effective, the delivery of 349 vaccine refrigerators, solar panels and batteries, vaccine cold boxes and carriers, and two new 15-ton flatbed trucks brings Zambia closer to the dream that every child regardless of where they live will have access to life-saving vaccines.

In Zambia, combating childhood morbidity and mortality by targeting vaccine preventable diseases is imperative as infants and children under 5 death rates are still unacceptably high. The 2013-14 Zambia Demographic Health survey reported 45 infants of every one thousand live births dying; and 75 children under 5 dying per thousand live births. In efforts to improve child health and reach Millennium Development Goal targets Zambia recently added three important new infant vaccines to the Zambian childhood immunisation system – pneumococcal, second dose measles, and rotavirus.

When delivering the equipment to the Acting Permanent Secretary of the Ministry of Community Development Mother and Child Health Mr Simmy Chapula, CIDRZ CEO Dr Charles Holmes remarked, “Today’s celebration is about the children— this vaccine cold chain equipment will directly provide a positive and healthy impact on the lives of Zambia’s children by ensuring that safe, life-saving vaccines are available for all children and especially those of hard-to-reach families in rural areas. I pledge that CIDRZ will continue to work diligently to ensure that we make a true and dedicated contribution to the improvement of the Zambian health system for all Zambians.”

CIDRZ Welcomes Dr Monde Muyoyeta MBChB, PhD who joins as Director, TB Department

Dr. Monde Muyoyeta joins CIDRZ from ZAMBART where she served as Head of Diagnostic Studies and spent over nine years designing and conducting field epidemiological and laboratory studies. She holds Bachelor degrees in Human Biology, Medicine and Surgery from the University of Zambia, and a PhD in Infectious Disease Epidemiology from The London School of Hygiene and Tropical Medicine, University of London, U.K.

While at ZAMBART Dr Muyoyeta held several key positions including Investigator in the ZAMSTAR study, a large, two-country randomized control trial of community-level interventions aimed at reducing the burden of TB and HIV. She is also an Investigator on the AERAS TB vaccine trial, and has led studies evaluating computer-aided TB diagnosis using digital radiography and field evaluations of Xpert MTB/RIF, a new TB diagnostic technology.  Her research interests include implementation and evaluation of new diagnostic technologies specifically in patients with both TB and HIV, and for TB control and prevention.

CIDRZ Welcomes Dr Samuel Bosomprah MSc, PhD who joins as Head, Analysis Unit

CIDRZ Welcomes Dr Samuel Bosomprah MSc, PhD who joins as Head, Analysis Unit

Dr Sam Bosomprah earned his MSc in Medical Statistics, and PhD in Biostatistics and Epidemiology from The London School of Hygiene and Tropical Medicine, University of London.

In his immediate previous role he served as Senior Lecturer and Head of Department of Biostatistics at the School of Public Health, University of Ghana.

His research interests include the design and analysis of intervention trials; methods for health surveys in developing countries; vaccine evaluation; and application of advanced statistical methods to answer complex questions that involve multi-level/hierarchical data. He is broadly interested in maternal health, newborn health and child survival, and has published a number of research articles/methodology in peer-reviewed journals. Dr Bosomprah has facilitated courses in biostatistics, epidemiology, and monitoring and evaluation of health interventions for a broad range of health programme managers and health professionals from across Africa.

Better Information for Health in Zambia study pilot launches!

On 10th February 2015, the CIDRZ Better Information for Health in Zambia study – known locally as BetterInfo – initiated study data collection activities in Lusaka, Eastern, Western and Southern provinces to begin the pilot phase of the Bill & Melinda Gates Foundation grant award of USD 4.76 million. After receiving all required international and local regulatory approvals and consulting the National, District and Provincial Health officials, Traditional leadership and Neighbourhood Health Committees where the pilot will be conducted, study training activities for the approximately 30 member study team took place at the CIDRZ offices in the capital Lusaka.  Training was led by the three study PIs, Dr Elvin Geng of University of California – San Francisco, Dr Charles Holmes and Dr Izukanji Sikazwe of CIDRZ, and Study Coordinator Sandra Simbeza, Co-investigators and CIDRZ BetterInfo study management.

Some of the members of the Lusaka-based BetterInfo study management team. From Left: Nancy Czaicki – UC Berkeley, Laura Beres,  Monde Bwalya, Paul Somwe, Sandra Simbeza, David Parker, Chanda Mwamba, and Njekwa Mukamba.

Some of the members of the Lusaka-based BetterInfo study management team. From Left: Nancy Czaicki – UC Berkeley, Laura Beres, Monde Bwalya, Paul Somwe, Sandra Simbeza, David Parker, Chanda Mwamba, and Njekwa Mukamba.

The purpose of the ‘BetterInfo’ study is to systematically gain a better understanding of why some patients enrolled in antiretroviral treatment (ART) stay in care, while others are ‘lost’ from care. It is estimated that as many as 25-40% of patients in HIV care and treatment programmes are lost-to-follow-up. The ‘BetterInfo’ study will trace ART patients, learn of their outcomes, and ask questions about why they have that outcome. This information will enable the study team to more accurately estimate the treatment outcomes of patients who are lost from HIV care thereby gaining a better understanding of the percentage of patients who have chosen to disengage from ART care, those who have chosen to re-engage in ART care at a different facility, and those that have passed away.  Understanding this information will allow Zambian health programmes and facilities to better meet the needs of ART patients so that they stay in care. The ‘BetterInfo’ study staff will use best practices when tracing ‘lost’ patients to protect privacy and confidentiality, and if a patient has stopped receiving treatment they will encourage them to resume ART care.

The ‘BetterInfo’ study will be conducted in 30 sites in Western, Southern, Lusaka and Eastern Provinces of Zambia over a 29-month period and will be able to provide more accurate estimates of HIV care patient outcomes at both clinic and provincial levels which will help the Zambian Ministry of Health, and Ministry of Community Development Mother and Child Health to make informed decisions about HIV care service provision.

Zambian Prisons Health paper features in WHO STOP TB Partnership News Alert

Congratulations to the CIDRZ TB Department whose project and resulting paper, “Screening for tuberculosis and testing for human immunodeficiency virus in Zambian Prisons” feature in World Health Organization’s STOP TB Partnership News Alert. Read the paper here