Mobilizing and Empowering Neighborhood Health CommitteesZambia

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• Mobilizing and Empowering Neighborhood Health
  Committees-Zambia
• Chabu Kangale

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Overview of Zambian Program

• VISION Individuals, families and communities
  taking action for health
• Integrated Health Program
• Child Health / Maternal Health
• Family Planning/Reproductive Health
• HIV and AIDS
• Malaria
• Focus on hard-to-reach, rural areas
• Emphasis on community-level action for health
• Communication and capacity building are mutually
  reinforcing

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Our reach 9 provinces (22 districts)

• Insert Zambia map highlighting HCP districts

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Primary Strategies

• Building and Linking Communities
• Environmental and capacity needs assessments
• Capacity building training
• Ongoing support for action plans and exchange
  visits

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Primary Strategies (cont.)

• Community theater
• Distance learning through community radio
• Sister Evelina
• Living and Loving

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Primary Strategies (cont.)

• Focus on Youth
• HEART Life Skills
• Creative HEART
• HEART Waves

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Primary Strategies (cont.)
Chiefs provincial health and DHMT staff hold
Chiefs Against AIDS workshop in Mongu,
Western Province

• 3. Leadership
• Psychosocial counselors
• Traditional leaders / headmen
• Societal gatekeepers (de facto leaders)

Senior Chiefs in discussion at workshop
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Primary Strategies (cont.)

• Message Harmonization
• Child Health Weeks / Measles Campaign
• Malaria
• Family Planning/ Reproductive Health
• Male Circumcision
• Concurrent Partnerships
• ART (including pediatric)
• PMTCT
• HIV Prevention

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Primary Strategies (cont.) Message
Harmonization
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Primary Strategies (cont.) Message
Harmonization
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The Zambian Health System
Ministry of Health
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Provinces
Districts
72
10-15
Health Centre
Health Centre
Health Centre
Health Centre
NHCs
10,000
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Building Linking Communities NHC/CBO Model

• Formed by decentralization of MOH
• NHCs are closest link to community members
• Key to use existing structures for both reach and
  sustainability
• CBOs included in model -- also strengthened
• Capacity-building key component

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A Communitys Story
How do HCP Zambias programmes affect these
people?

• Mikunku Neighbourhood
• Health Committee (NHC)
• Mkushi, Central Province, Zambia

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Impact

• Learning to
• use data for
• decision
• making and
• creating
• community
• action plans

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Impact (cont.)
Income generation projects to fund community
activities for better health

• NHCs sweet potato fields that generate funds
  that care for orphans - Serenje

Community-supported school for orphans in Luanshya
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Impact (cont.)

• Understanding how to improve communitys health
  and participating in the process

NHC members assist in growth-monitoring in an
under-5 wellness clinic under the trees Mpongwe
district, Copperbelt
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Impact (cont.)
When I came for this (theatre) training I
thought there was nothing much to learn about
theatre because I have been in drama for a long
time to the contrary I have learnt a lot of
skills and when I go back I will make an impact
on my group and the community at large. Mr.
Ackim Phiri ,one of the theatre trainees in
Chongwe.
Three members of the Chongwe training promptly
went for an HIV test after the training so they
could be in a better position themselves to
teach others.
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Impact (cont.)
Mr Raphael Nyama, of Mwapona HIV/AIDS Support
Group in Choma, wrote in a letter The radio
programme Living and Loving has helped change
my life. My wife was against the idea of my
going public as a person living with HIV and
when I was invited to any meeting to give a talk
on positive living, she would caution me not to
mention her in my speech. But when our group was
involved in listening to the Living and Loving
programmes organized by Health Communication
Partnership, my wife started taking interest in
the radio series and now she is sharing that
information with other members who dont own
radios.
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Impact (cont.)

• today I realized that pupils can do something
  for their health in the days of HIV and AIDS.
  People should continue supporting pupils in their
  schools and homes.
• Mutinta Mweenya, youth from Lusitu Basic
  School.

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Impact (cont.)

• The Positive Living Handbooks are very good and
  beneficial to PLWHA. It is exciting to see in
  print, something we were so closely involved in.
  NZP Copperbelt
• I had just found out I was pregnant when I saw
  Mwana Wanga on the clinic TV. Then I had an HIV
  test at antenatal. I tested positive. Seeing
  Mwana Wanga made me know what I had to do to keep
  the baby from getting HIV from me. It is still
  only a chance but I saw how strong the lady in
  the video was and I found courage. HIV mother
  at George Clinic, Lusaka (name withheld per
  request)

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Impact (cont.)

• Another HIV test was done and I was HIV positive.
  I became depressed. I saw Harriet Mulenga
  (Tikambe) on TV telling the nation of how ARVs
  helped her. Her testimony gave me a lot of
  encouragement. Ruth Mulima, Chelstone Support
  Group, Lusaka

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Impact

• Full impact evaluation will be done in
  2008-2009.

Open discussion with out-of-school youth
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Our experience

• Multi-faceted approach combining communication
  and community mobilization
• Community action resulting in health impact