Overview

The PROUD-Z program, implemented by CIDRZ demonstrates how targeted technical assistance, strong government partnership, and data-driven quality improvement can strengthen HIV prevention, treatment, and surveillance systems at scale.

The program is a collaboration with the Ministry of Health (MoH), the Lusaka Provincial Health Office (LPHO), CDC, and other implementing partners. It focuses on closing service delivery gaps for priority populations such as children, adolescents and young people, men, pregnant and breastfeeding women, and key populations. This is done while strengthening provincial and facility-level capacity for sustainable impact.

Core Approach

PROUD-Z is grounded in provincial ownership and systems strengthening, rather than parallel service delivery. It combines:

• Specialized, gap-focused, and data-driven technical assistance.
• Continuous quality improvement (CQI).
• Onsite mentorship and technical supportive supervision (TSS).
• Strong use of routine and surveillance data.
• Integration of HIV services with TB, NCDs, mental health, and sexual and reproductive health.

This approach has ensured that improvements are embedded within government systems and sustained beyond the life of the program.

Key Achievements

1. Improved HIV Testing and Case Finding
   The program strengthened the quality and efficiency of HIV testing through collaboration on the updated national guidelines, enhanced counselling standards, tester certification, data quality audits, and expanded targeted testing strategies. Social Network Testing, index testing, and paediatric case-finding approaches were strengthened, improving identification of people living with HIV across underserved populations.
2. Expanded HIV Prevention and PrEP Access
   PROUD-Z supported the scale-up of combination prevention, including PrEP for adolescent girls and young women, pregnant and breastfeeding women, and key populations. Differentiated service delivery models, improved tracking systems, and strengthened provider capacity improved both uptake and continuity of prevention services.
3. Strengthened HIV Surveillance and Public Health Response

Using recent HIV infection surveillance, and integrated case based infection surveillance, ProudZ were able to actively use surveillance data to identify transmission and acquisition hotspots, and guide targeted public health responses, improving program precision and accountability. 

• Equitable Services for Key Populations
  Through the key population Wellness Centres, the program delivered integrated HIV, SRH, PrEP, ART, mental health, and referral services in stigma-reduced settings. Peer-led models improved access, fostered trust, and ensured safe continuity of care for female sex workers, men who have sex with men, transgender individuals, people who inject drugs, and incarcerated populations.
• Stronger Treatment Outcomes and Retention
  The program supported progress toward 95-95-95 Joint UNAIDS targets by strengthening person-centred care, reducing treatment interruptions and silent transfers, improving viral load monitoring, and expanding differentiated service delivery models, including men-focused services.
• Integration of Advanced HIV Disease and Non-Communicable Disease (NCD) Care
  Advanced HIV Disease and NCD management were integrated into routine HIV care across high-volume facilities. Training, mentorship, improved diagnostics, and commodity support strengthened care for patients with complex clinical needs.
• Improved Paediatric, Adolescent, and PMTCT Services
  Targeted support improved early infant diagnosis, paediatric and adolescent case finding, mother–infant pair tracking, adolescent-friendly services, and retention across the treatment cascade.
• Mental Health Care
  Mental health screening and treatment, including the Common Elements Treatment Approach (CETA), were embedded within HIV services, addressing a key barrier to retention and adherence.
• Cervical Cancer Prevention and Care

This focussed on screening and treatment for women living with HIV. Key strategies included training screening centres, technical supportive supervisory visits to ensure service quality, and procurement of essential equipment and supplies. The program emphasized capacity building, mentorship, and efficient data management to improve screening uptake and treatment outcomes. Collaborative efforts improved processes, ensuring timely HPV testing and histopathology results, ultimately advancing cervical cancer elimination efforts.

1. Data Systems and Digital Health Strengthening
   Enhanced use of SmartCare, DHIS2, and analytic dashboards improved data quality, reporting timeliness, and routine data use for decision-making at facility, district, and provincial levels.

Overall Impact

The PROUD-Z program showed that HIV epidemic control is achievable when prevention, treatment, surveillance, and equity were addressed together. By strengthening government-led systems, building workforce capacity, and embedding data-driven quality improvement, PROUD-Z delivered measurable improvements in service quality, access, and sustainability across Lusaka Province, and across all service points in the Country.