Access for All
The University Teaching Hospital (UTH) Adult Centre of Excellence
September 2017 – April 2019
Zambia has been hard hit by HIV. The nation’s overall HIV prevalence is in the double digits – and that percentage is twice as high in urban areas such as Lusaka. The Government of Zambia’s efforts to curb the spread have focused on the reduction of new HIV infections, primarily through preventing sexual transmission of HIV among heterosexual partners and vertical transmission from mother to child. Key populations (KPs) – including gay, lesbian, and transgender people; sex workers; people who inject drugs; discordant couples; and other marginalized groups – have largely been left out of Zambia’s HIV/AIDS epidemic response. These critical groups are often unable or unwilling to access HIV prevention, care, and treatment services because of stigma and discrimination by healthcare providers and a prohibitive legal environment for disclosing their status.
For Zambia to curb its HIV epidemic, comprehensive HIV prevention, care, and treatment services must be available and accessible to all. Critical populations that have been marginalized by past HIV response require appropriate, respectful, and confidential health services, to build trust in the public health system and to complement and reinforce peer-based interventions.
Under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) Strategy for Accelerating HIV/AIDS Epidemic Control (2017-2020), Zambia was identified as one of ten high-HIV burden countries on course for achieving epidemic control by the end of 2020. Resonance – in collaboration with the University Teaching Hospital (UTH), Zambia’s largest hospital network – spearheaded the rollout of a comprehensive, KP-friendly sexual health and HIV services clinic through its Adult Center of Excellence. The clinic provides regular medical, testing, prevention, and psychosocial support for patients by a roster of specially trained physicians and medical support personnel.
The PEPFAR-funded, 20-month USAID Access for All Activity responded to pillar number three of the PEPFAR Strategy: “Key Populations: Ensuring Human Rights and Leaving No One Behind.” Through Access for All, USAID/Zambia aimed to increase the number of KPs in Zambia receiving HIV/Sexually Transmitted Infection (STI)-related health services from the UTH Adult Center of Excellence by developing the capacity of UTH to provide high-quality KP services.
To lead Access for All, Resonance drew on our experience providing targeted capacity building, developing community engagement and outreach strategies, conducting critical procurements to improve service delivery, and coordinating human resource management of quality healthcare service providers.
Access for All’s key activities included:
Access for All reached and supported over 1,400 new KP clients through sensitization meetings, outreach, medical services, and testing over the course of the 20-month project. Of this number, more than two-thirds identified as sex-workers, whose unequal cultural, social, and economic status makes them more vulnerable to HIV and less likely to seek treatment.
Specific activities and results include: