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Zimbabwe HIV/AIDS Partnership Project & Behaviour Change

Zimbabwe HIV/AIDS Partnership Project & Behaviour Change

Effective collaboration

Effective collaboration and capacity-building at the national level contribute to sustainability.As project activities contribute to the expansion and scaling up of HIV prevention activities in Zimbabwe, USAIDand DFID support are contributing to a significant and sustainable health impact. Sustainability is being achievedthrough building local capacity and increasing Zimbabwean ownership of the program. To enhance sustainability,for example, PSI/Z has adopted a strategic approach informed by lessons learned from the previous program anduses evidence-based strategies to tailor activities to local needs. The guiding operational principles (collaborationand coordination; support for national HIV response; local ownership of HIV response through partnerships; andreliance on evidence-based decision making) all combine to make the program more sustainable for the long term.The program also works with the MOHCW and the NAC to build national capacity. These efforts enhance thescale and quality of local HIV and AIDS initiatives by providing technical and communications support to publicprogram and structures at the central and district levels. PSI/Z is transferring technical expertise, managementcapacity, and financial resources to build long-term national capacity to implement HIV prevention program inZimbabwe. Local CBOs, FBOs, and other NGOs are working with PSI/Z to design and operate activities forwider coverage and sustainability. PSI/Z also supports local organizations in the design and realization ofcommunity and participatory BCC approaches.Zimbabwe HIV/AIDS Partnership Project & Behaviour Change Programme: A Joint USAID/DFID Assessment 27

6. PROGRAM RECOMMENDATIONSThe following recommendations based on the findings of the assessment relate to future efforts within currentfunding levels. They are offered with a view to maximizing total project results and increasing the potential forfurthering the national HIV/AIDS program.• Support of client-initiated and other VCT services should be continued even as provider-initiated testingexpands. Client-initiated testing, particularly through outreach, currently is extending T&C alternatives tothose who might not otherwise access health care services and making such services available to more at-risksegments of the population.• Outreach for T&C efforts should increasingly be directed to hard-to-reach, at-risk, mobile, displaced, andother vulnerable populations. Better definition is needed of subsets of these target populations as a basis forplanning work and monitoring progress. The research and evidence-based planning capacities within theprogram offer important bases for identifying the most effective ways for increasing VCT access withinpriority segments of the population.• Communications strategies should identify new ways to reach socially excluded groups, such as formercommercial farm workers, displaced populations, and people living with disabilities.• Since directly managed PSI/Z sites for T&C contribute 55–60 percent of total monthly client volumes forT&C within the project, any planned phase-over or transfer of these functions to other organizations shouldbe delayed until the project ends.• Mass media should continue to be an active part of the BCC media mix. Even with power outages, radio andtelevision still reach sizable numbers of people and are among the most cost-efficient ways to reach people.• The program should scale up the current BCC campaigns on concurrent sexual practices, both within thegeneral population and for socially excluded groups, with campaign materials addressed specifically toindividual vulnerable populations.• In communications to support HIV/AIDS services, more intensive work is needed for PMTCT among thegeneral population and vulnerable groups. Strategic partnerships could be strengthened with others whoalready work with socially excluded groups.• PSI/Z should reassess its current goals related to stigma and discrimination. The present target of 80 percentseems too ambitious; it may not be achievable by 2011. A lower target would be more realistic.• Those program elements that directly support the delivery of services and products to clients should be givenpriority for funding. Costs in a constantly changing environment are difficult to predict. Without additionalfunding, it may become necessary to choose between program components to keep operations within budget.If so, current care and support efforts, such as those represented in the New Life centers, could be limited ortransferred to organizations already active in supporting positive living with HIV.• New Life centers need to make more deliberate efforts to respond to the needs of youth and adolescents;linkages could be enhanced between PSI/Z and local organizations and centers for young people living withAIDS.• If the environment improves and donors like DFID and the EU extend support for the service-deliverysystem, both public and private, the project should expand opportunities to share or transfer its experiencewith HIV prevention service-delivery to local and national organizations.• Until viable private alternatives for product distribution re-emerge in Zimbabwe, the project should continueto build up its direct distribution mechanisms, but exploration of indirect product distribution is important asa means to expand market coverage and reduce distribution costs if commercial options return to themarketplace.• A ready supply of packaged product is necessary to keep pace with demand for condom products, both maleand female. Sufficient financial resources for packaging need to be guaranteed so that product uptake will notbe artificially limited.28 Zimbabwe HIV/AIDS Partnership Project & Behaviour Change Programme: A Joint USAID/DFID Assessment

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