ZAMBIA CENTRE FOR COMMUNICATION PROGRAMMES

Title: USAID Stop GENDER-BASED VIOLENCE PROJECT-Quarter 1 Report FY 2020 Lead Author: Johans Mtonga Cooperative Agreement No. 72061119CA0001 Sponsoring Office: USAID/ Development Objective: DO3: IR 3.2: Health Status Improved

FY 2020

Quarter 1 Report 1st October 2019 – 31st December, 2019

Table of Contents Project Information ...... 3 Acronyms ...... 4 Executive Summary ...... 6 Introduction ...... 8 Project sites ...... 8 Progress for the Year ...... 9 Objective 1: To prevent GBV and increase support for gender equality among women, men, children and members of key, priority populations and PWD...... 9 Project Monitoring and Data Quality ...... 28 Risks Management ...... 28 Value for Money...... Error! Bookmark not defined. Challenges ...... 29 Lessons Learnt ...... 30 Recommendations ...... Error! Bookmark not defined. Success Stories ...... Error! Bookmark not defined. List of Upcoming Events ...... 30 Annexes ...... 30 Annex 1: List of stakeholders that attended National Stakeholder’s Dialogue . Error! Bookmark not defined. Annex 2: DEBS Offices engaged ...... Error! Bookmark not defined. Annex 3: Gender Integration ...... Error! Bookmark not defined.

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Project Information Project Name USAID Stop Gender-Based Violence Project Cooperative Agreement 72061119CA00001 No: Grant Period November 15, 2018 - November 14, 2023 Lead Organization Zambia Centre for Communication Programmes (ZCCP) Sub Partners WiLDAF Lifeline/Childline Technical attachment for OSC: Ministry of Health USAID Contact Person Chipo Tembo (Agreement Officer Representative) Telephone +260 211 357000 / +260-211-357086 E-mail [email protected] Registered Office Lusaka, Zambia Project Budget $17,099,746 Chief of Party Johans Mtonga Contact Details +260-977-604 473

[email protected]

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Acronyms

AGYW Adolescent Girls and Young Women ABYM. Adolescent Boys and Young Men AIDS Acquired Immune Deficiency Syndrome ART Anti-Retroviral Therapy AWP Annual Work Plan CA Community Activist CBO Community Based Organization CD Community Dialogue CM Child Marriages CSE Comprehensive Sexuality Education CSO Central Statistics Office CSO Civil Society Organizations DACA District AIDS Coordinating Advisor DAO District Administrative Officer DHAC District HIV AIDS Committee DC District Commissioner DEBS District Education Board Secretary DDCC District Development Coordinating Committee DHD District Health Director DQA Data Quality Assessment DREAMS Determined Resilient Empowered AIDS-Free Mentored and Safe EC Emergency Contraceptive FBO. Faith Based Organization FGD Focus Group Discussion FPP Focal Point Person FY Fiscal Year GBV Gender Based Violence GEEA Gender Equity Equality Act GLOW. Girls Leading Our World HIM Health Images of manhood HIV Human Immunodeficiency Virus HTCT HIV testing, counselling and treatment HTS HIV Testing Services IR Immediate Result KP Key Populations LAB Legal Aid Board MER Monitoring Evaluation and Reporting MCDSS Ministry of Community Development and Social Services MoCTA Ministry of Chiefs and Traditional Affair

4 MOG Ministry of Gender MOGE. Ministry of General Education MoH Ministry of Health MoJ Ministry of Justice MoU Memorandum of Understand MP Members of Parliament MVS. Mobile Video Shows M&E. Monitoring and Evaluation NGO. Non-Governmental Organization OSC One Stop Centre PAN Paralegal Alliance Network PDO Disabled People’s Organization PEPFAR Presidential Emergency Plan for AIDS Relief PE Peer Educator PEP Post Exposure Prophylaxis PEO Provincial Education Officer PLWH People Living With HIV PO Programme Officer PP Priority Populations PP_PREV Priority Population Prevention PPP Public Private Partnership PrEP Pre Exposure Prothylaxis PWD Persons With Disability RC Regional Coordinator SASA! Start Awareness Support Action SBC Social Behaviour Change SGBV Sexual Gender Based Violence SRHR Sexual reproductive heath rights STIs Sexually Transmitted Infections TEVETA Technical Education, Vocation and Entrepreneurship Training Authority TWG Technical Working Group ToT Trainer of Trainers USAID United States Agency for International Development VCT Voluntary Counselling and Testing VSL Village Savings and Lending VSU Victim support unit WGSC Ward Gender Sub Committee WiLDAF Women in Law and Development in Africa ZAPD Zambia Agency for Persons with Disabilities ZCCP Zambia Centre for Communication Programmes

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EXECUTIVE SUMMARY

Zambia Centre for Communications Programmes (ZCCP) is implementing the USAID Stop Gender-Based Violence (GBV) project aimed at strengthening the environment for girls and women, boys and men, and members of key populations (KP) and priority populations (PP) in Zambia, to live lives free of GBV and enjoy healthy-supportive, gender-equitable relationships.

The USAID Stop GBV project will be implemented from 15th November 2018 to 14th November, 2023 and is being implemented in sixteen selected districts1. ZCCP, as a Prime implementer of the USAID Stop GBV project, has partnered with two organizations to meet the objectives of the USAID Stop GBV project: • WiLDAF is leading on interventions to promote advocacy and access to justice for GBV survivors; the training of paralegals; supporting paralegal services at One Stop Centers (OSCs) and engagement with legislators and judiciary on strengthening the GBV laws. • Lifeline/ChildLine Zambia is leading on tele counselling and referrals for services for GBV survivors and key populations (KP) especially those that seek anonymity. • ZCCP is leading on the following; (i) GBV/HIV prevention and awareness, (ii) Capacity building and quality improvement of the OSCs including engaging with Ministry of Health (MoH) to manage OSCs housed in health institutions to respond to post GBV care and HIV testing services (HTS) and, (iii) engagement of boys, men and KP through HIM.

Achievements for the quarter

This report covers the period 1st October to 31st December, 2019. Below are the major achievements during the reporting period under review;

Indicator Annual Targets Q1 Achievement %

HTS_TST 2,670 2,037 76%

HTS_TST(All)2 2,670 2,933 110%

1 Chingola, , Chongwe, Kabwe, Kalulushi, Kapiri Mposhi, Kitwe, Livingstone, Luanshya, Lusaka, Masaiti, Mongu, Mufulira, Ndola, Sesheke and Solwezi

2 All include both Directly Supported Ditricts (DSD) and Technical Assistance Districts (TAD). The following are the Districts; Chingola, Chipata, Chongwe, Kabwe, Kalulushi, Kapiri Mposhi, Kitwe, Livingstone, Luanshya, Lusaka, Masaiti, Mongu, Mufulira, Ndola, Sesheke, Solwezi, Kalomo, Choma, Monze, Mazabuka, Kafue, Mumbwa, Chibombo, Mpika, Nakonde, Nyimba and Katete

6 PP_PREV 137,507 45,442 33%

GEND_NORMS 276,899 98,759 36%

GEND_GBV 10,688 3,736 35%

Sexual GBV 2,670 460 17%

Physical GBV 8,018 2,320 29%

Sexual GBV (All) 2,670 653 24%

Physical GBV (All) 8,018 3083 38%

PEP (All) - 194 %

In addition to achievements above, the project actively participated in the sixteen days of gender activism, conducted radio programs, mobile video shows and community awareness on GBV and HIV. It also supported and participated at national and district level launch of World AIDS Day (WAD) and International Day of Persons with Disabilities (IDPWD). These activities helped increase awareness on GBV and HIV.

Challenges

• Late reporting of sexual violence cases to the one stop centre (OSCs) continued to be a challenge due to distance, untrained personnel and cultural values. • The concept of direct to government (D2G) has not been fully embraced by the Health facilities hosting OSCs. • Limited space to host the OSC in Sesheke and Solwezi. • Inadequate funding to OSC by Government.

Lessons Learnt

• The lack of permanently assigned police officers to support legal services in the OSCs has negatively impacted case follow up; hence the need to lobby for permanent personnel from these institution. • Health facilities which host OSCs with senior medical supritendants appreciate GBV management better. • Community volunteers need constant trainings for quality implementation of activities.

7 INTRODUCTION ZCCP is implementing the USAID Stop GBV project. The project will be implemented from 15th November 2018 to 14th November, 2023 and is being implemented in sixteen districts3 and seven . ZCCP, as a prime implementer of the USAID Stop GBV project, has partnered with two organizations to meet the objectives of the Stop GBV project: • WiLDAF is leading on interventions to promote advocacy and access to justice for GBV survivors; the training of paralegals; supporting paralegal services at One Stop Centers (OSCs) and engagement with legislators and judiciary on strengthening the GBV laws. • Lifeline/ChildLine Zambia is leading on tele counselling and referrals for services for GBV survivors and KP especially those that seek anonymity. • ZCCP is leading on the following; (i) GBV/HIV prevention and awareness, (ii) capacity building and quality improvement of the OSCs including engaging with MoH to manage OSCs housed in health institutions to respond to post GBV care and HIV testing services (HTS) and, (iii) engagement of boys, men and KPs.

PROJECT SITES The project goal is to strengthen the environment for target population (girls, women, boys and men, and members of KPs and PPs) including people with disabilities (PWD), to live lives free of GBV and enjoy healthy-supportive, gender-equitable relationships.

Below are the project objectives; 1. To prevent GBV and increase support for gender equality among women, men, children and members of key and priority populations. 2. Increase access to behavioral change through provision of HIV prevention information and services. 3. To strengthen access to and uptake of quality post-GBV services for GBV survivors. 4. To strengthen and support the implementation of laws and policies regarding GBV, gender equality, and female empowerment, and increase the congruence of customary laws with national laws.

3 Solwezi, Chingola, Mufulira, Kalulushi, Kitwe, Ndola, Masaiti, Luanshya, Kapiri Mposhi, Kabwe, Lusaka, Chongwe, Chipata, Livingstone, Sesheke and Mongu

8 Progress for the quarter one

Objective 1: To prevent GBV and increase support for gender equality among women, men, children and members of key, priority populations and People with Disabilities (PWD).

IR 1- GBV Prevention: Decreased societal acceptance of GBV, reduced perpetration, enhanced protective factors, and improved enabling environment for GBV response.

Sub IR 1.1 Educational initiatives regarding GBV, HIV and Gender Equality expanded During the quarter under review, the project strengthened and heightened collaboration with the Ministry of General Education (MoGE) particularly the DEBS office. In each of the implementation districts, community dialogues with learners were conducted in schools to raise awareness on HIV and GBV among school going children. The project worked with DEBS offices to identify girls and boys to be trained in Girls Leading Our World (GLOW). GLOW is an effective and sustained approach for positive behavior change for adolescent girls and young women (AGYW). A total of 159 girls and 66 mentors (including PDWs) were trained in GLOW. The training increased knowledge and practical skills on HIV and GBV for the AGYW. It is expected that these girls will form Kwatu GLOW clubs and repricate the trainining to other girls in schools and communities with support from their mentors.

Sub IR 1.2 Increased community mobilization for GBV and HIV prevention and gender equality. The project has continued to work with trained community activists and peer educators who mobilized communities on GBV and HIV, and conducted awareness activities using community dialogues, community conversations and Mobile Video Shows. The number of community volunteers working on the project are 562 volunteers. Below is a table showing the number of volunteers that the project worked with in FY20 Q1.

Districts Peer Community HIM CAs Total Educators Activists (CAs) Community Volunteers Chingola 6 16 4 26 Kalulushi 7 9 2 18 Kitwe 14 30 7 51 Luanshya 3 14 4 21 Masaiti 4 8 2 14 Solwezi 3 12 7 22 Mufulira 4 14 2 20 Ndola 11 35 6 52 Mongu 5 13 5 23 Sesheke 6 5 5 16

9 Livingstone 12 17 5 34 Lusaka 52 102 10 164 Chongwe 5 13 5 23 Chipata 10 19 4 33 Kabwe 5 10 5 20 Kapiri 6 14 5 25 Totals 153 331 78 562

Trainings for Community Activists (CA) in SASA! Start Phase were conducted in the months of October and November 2019. A total of 106 (F:49 and M:57) were trained in four districts whilst 225 were trained in the previous quarter. The project uses the SASA! methodology in prevention of GBV. SASA! is a groundbreaking community mobilization approach for preventing GBV especially girls and young women. It is a phased systematic approach that starts with the Start, Awareness, Support and Action phases.

Gender Norms The project uses the SASA! and Health Images of Manhood methodologies to address gender norms at community level.

SASA! is a ground breaking, community driven and benefit-based approach that helps mobilise the community against GBV and HIV. It is a phased approach that closely relates to the SASA! phases of Start, Awareness, Support and Action. In kiSwahili, it means NOW indicating the urgency the community has towards ending GBV and HIV.

The CAs work with organised structures that ensure progress in the communities called SASA! Teams. They conduct conversations4 with the community. The project reached a total of 98,759 (SASA! 97,499; HIM 1,260) participants who fulfilled the SASA! and HIM criteria for being reached. This shows a performance achievement of 36% against the annual target of 276,900 against the quarterly target of 69,225 the achievement is 143%

Gender Norms Performance

Gender norms performance by district Annual Achievem Quarterly District Annual % Quarterly % Target ent Target

Chingola 34% 137% 13,846 4,756 3,462

Chipata 52% 209% 13,303 6,957 3,326

4 These are discussions that take at least 12 hours divided into 4 hours for 3 days. The engagement does not end at these schedule conversations but continues for the next 8 weeks.

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Chongwe 15% 59% 8,169 1,213 2,042

Kabwe 27% 107% 10,634 2,853 2,659

Kalulushi 75% 301% 5,594 4,204 1,399 Kapiri 34% 136% Mposhi 11,437 3,893 2,859

Kitwe 41% 163% 25,809 10,517 6,452 Livingston 58% 232% e 12,960 7,527 3,240

Luanshya 57% 226% 9,525 5,391 2,381

Lusaka 27% 109% 108,080 29,448 27,020

Masaiti 27% 109% 4,070 1,106 1,018

Mongu 68% 272% 8,667 5,900 2,167

Mufulira 46% 186% 9,415 4,367 2,354

Ndola 18% 71% 24,065 4,300 6,016

Sesheke 79% 315% 3,600 2,832 900

Solwezi 45% 181% 7,726 3,495 1,932

Overall 36% 143%

276,900 98,759 69,225

The information in the table above is reproduced in the graph below. You realise that some districts (Chongwe and Ndola) did not perform well because the CAs were just trained within the quarter to provide quality facilitation in balancing power between women and men.

11 SASA! FY20 Q1 Annual Target Vs Achievement

100000 88% 89% 100% 85% 90000 90% 80000 73% 70% 80% 65% 70000 70% 58% 56% 60000 51% 60% 50000 42% 39% 50% 34% 40000 34% 31% 40% 22% 30000 19% 30% 20000 20% 10000 10% 0 0%

Annual Target Achieved %

SASA! FY20 Q1 Quarterly Target Vs Achievement

35000 353% 356% 400% 338% 30000 350% 290% 279% 300% 25000 261% 231% 225% 250% 20000 204% 166% 156% 200% 15000 134% 136% 124% 150% 10000 89% 74% 100% 5000 50%

0 0%

Quarterly Target Achieved %

A total of 98,759 (55%) females and (45%) males were reached in gender norms through using SASA! and HIM. This is because of the magnitude of females that suffer more GBV than men. Please refer to the pie chart below

12 SASA! FY20 Q1 BY SEX Male, 43,214 , 44%

Female, 54,285 , 56%

SASA! FY20 Q1 BY TARGET GROUP Traditional Leaders, 183 , 0% Girls , 23,055 , Men, 25,414 , 26% 24%

Boys, 17,686 , 18%

Women, 31,161 , 32%

Health Images of Manhood draws on promising and best practices to engage men to actively address health as an important component of intimate and other relationships by adopting healthier and more gender-sensitive behaviors. HIM activists at the community and workplace level championed Violence Against Women and Girls (VAWG) and then became change agents to prevent HIV, and linked men to health services. The project implemented HIM through HIM groups5. HIM took advantage of Insaka fora and engaged boys/men in discussions on anti- VAWG, reproductive health, HIV/AIDS and gender awareness topics using HIM discussion cards. Insaka meetings were led by trained HIM activists who created

5 Platform where adult men, young men and boys meet on a regular basis in a safe space

13 trusting partnerships6 through safe spaces which enabled confidentiality for dialogue. An underlying theme of each topic is the importance of constructive male involvement in gender and health issues.

In the period under review the project actively engaged 78 HIM Activists under gender norm in finding men and boys in Gender and HIV. The men and boys were mobilized and reached in various places such as workplaces (private and public companies and bus stations), communities (bars and brothels), DREAMs project (partners of AGYW) and Victim Support Unit (VSU) reported perpetrators of GBV.

The project enrolled 3818 (men 3009 and boys 809) males, created 126 number of groups and held 240 HIM meetings in the 16 districts. A total number of 1260 (boys:409 and men:851) males graduated after attending all required six (6) HIM sessions. The HIM activist conducted HIM session using the HIM discussion cards. The HIM discussion topics taught men how to take care of their own health and the benefits of non violent actions in resolving conflicts with their partners. As a result of these discussions, 152 males (34 boys and 118 men) requested for HIV testing services and were tested, those tested HIV+ were linked and enrolled on treatment. For example, “A man from Kanyama () who was abusing his wife and refusing to go for HIV testing changed through HIM discussions. He then decided to go for testing HIV testing with his wife; they were both HIV+ and have since been initiated on ART and are living in harmony.” HIM Insaka Meeting Row 20- 25- 30- 35- 40- 45- Grand Labels <10 10-14 15-19 24 29 34 39 44 49 >50 Total Chingola 114 29 11 1 155 Kalulushi 20 79 48 40 28 20 14 5 4 258 Kapiri Mposhi 42 53 51 35 42 42 29 30 324 Luanshya 1 3 27 11 11 4 7 8 72 Masaiti 1 36 8 18 15 6 6 2 3 95 Mongu 1 14 10 2 1 2 1 1 3 35 Mufulira 1 24 25 Sesheke 48 18 26 26 26 44 37 12 34 271 Solwezi 25 25 Grand Total 2 132 300 167 175 117 125 104 56 82 1260

The table above shows that 1260 males underwent GBV and HIV prevention messages and completed HIM session.

The project further partnered with 157 private and public companies including the mines to implement the HIM approach in the workplaces. Total of 259 males (49 Directors, 76 managers

6 Workplace and community HIM interventions

14 and 134 representatives of Directors) trained in the HIM workplace approach. The outcomes of these meetings include; - Establised leadership structures. - Development of sexual harassment policies. - Provision of internship programmes for vulnerable women and mentorship programmes for boys in schools.

In this respect, two representatives from Kansanshi mine resolved to incorporate the HIM approach in their focus group called Silicosis where they discuss health related issues with male miners.

IR 1.4 Strengthened governmental and traditional leadership commitment to GBV prevention and response.

In strengthening governmental and traditional leadership, His Royal Highness Chief Mbangombe was supported with training and mentorship. As the result of the capacity built in the traditional leader, the following are the successes reported; • Established GBV committees are effectively working both in the community and at palace. • There is always review meetings every Saturday at the palace to look at progress made in the fight against GBV by representation from all village committees. • Retrieved girls from marriages are enrolled back into school. • Parents are engaged to ensure they support their children into school. • The chiefdom has completed building a classroom block for a secondary school – this will help increased number of learners enroll in school.

In Western Province, the project was invited for the coronation of her Royal Highness Litunga La Mboela. The project raised awareness on GBV and HIV through drama performance and mobile video shows prior to the event.

Sub IR 1.5 Strengthened engagement and coordination of stakeholders in national response.

The project supported and participated in the 26 monthly District Gender Sub-Committee (DGSC) in the project districts. In Lusaka’s DGSC, the project was selected as the interim chair of the committee. This gave the organisation an advantage to mobilize partners in the preparations for the 16 Days of Gender Activism. Sub IR 1.6 Enhanced communication to advocate for positive gender practices through various cost-effective media.

As part of enhanced communication using cost effective platforms, the project conducted a total of 33 mobile video shows that reached out to approximately 13,439 people. A total of 45 drama performances were conducted in 16 districts and approximately 7,329 people were reached. These activities were mainly conducted during the major events of the quarter such as the 16 Days of Gender activism and World AIDS Day.

Notable national events that the project participated in include;

15 i. 16 Days of Gender Activism: - This activity was launched on November 24th 2019 and flagged off on 25th November 2019 at Prince Takamado School grounds in Bauleni by the Minister of Gender. The United States Ambassador gave a moving speech at the launch. During the 16 Days of Gender Activism, the project aired radio programmes in all the 16 districts. ii. The project also participated in commemorating of the WAD and IDPWD.

Objective 2: Increased Access to Behavioral Change through Provision of HIV Prevention Information and Services IR 2.1: Reduced new HIV infections among priority populations especially adolescent girls and young women, sex partners to AGYW and mobile populations.

Sub IR 2.1.1: Increased access to behavioral change through provision of HIV prevention information and services. PP_PREV The project reached 45,442 (23,893 F and 21,549 M) PPs with the standardized, evidence- based intervention(s) required that are designed to promote the adoption of HIV prevention behaviors and service uptake. The implementation of PP_PREV was done in small groups comprising 24 participants. The project targeted priority population7 shown in the graphical presentations below. For the period under review, the total target was 34,377 and achievement was 45,442 which translates to a 132% achievement.

PRIORITY POPULATION GROUPS

ABYM (10 - 30 Mobile Populations Males) 31% 28%

Clients of Sex Workers 2% AGYW (10 - 24 Females) 39%

7 1. Adolescent Girls and Young Women (AGYW) 2. Adolescent Boys and Young Men (ABYM) 3. Mobile Populations 4. Fishing Communities 5. Clients of Sex Workers

16 Priority Population Type Numbers Reached ABYM (10 - 30 Males) 12,714 AGYW (10 - 24 Females) 17,620 Clients of Sex Workers 873 Displaced Persons 71 Fishing Communities 47 Mobile Populations 14,117 Grand Total 45,442

District Annual Target Achievement % Quart. Target % Chingola 5,096 1,665 33% 1,274 131% Chipata 10,813 2,781 26% 2,703 103% Chongwe 4,549 1,050 23% 1,137 92% Kabwe 4,419 1,270 29% 1,105 115% Kalulushi 6,854 1,093 16% 1,714 64% Kapiri Mposhi 5,863 1,344 23% 1,466 92% Kitwe 13,222 4,920 37% 3,306 149% Livingstone 3,299 2,223 67% 825 269% Luanshya 3,081 1,603 52% 770 208% Lusaka 47,340 16,139 34% 11,835 136% Masaiti 3,923 1,935 49% 981 197% Mongu 4,679 1,299 28% 1,170 111% Mufulira 1,781 565 32% 445 127% Ndola 10,153 2,737 27% 2,538 108% Sesheke 5,670 1,414 25% 1,418 100% Solwezi 6,765 3,404 50% 1,691 201% Total 137,507 45,442 33% 34,377 132%

17 PP_Prev Annual Target vs Achievement 50,000 80% 67% 45,000 70% 40,000 52% 60% 35,000 49% 50% 30,000 50% 37% 34% 25,000 33% 32% 40% 29% 26% 28% 27% 20,000 23% 23% 25% 30% 15,000 16% 20% 10,000 5,000 10% - 0%

Annual Target Achieved %

PP_Prev results by Age and Sex 9000 35% 30% 8000 30% 25% 7000 24% 25% 6000 5000 20%

4000 15% 3000 8% 10% 2000 4% 4% 2% 5% 1000 1% 1% 0 0% 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 >50

Female Male %

Since PP_PREV is only counted when prevention messages have been provided and either HTS is done or a referral is made for HTS, the project tracked the distribution of the numbers as follows:

Testing Services Female Male Grand Total Declined testing and/or referral 6,392 6,142 12,534 Known Positive 285 265 550 Newly tested and/or referred for testing 13,045 11,409 24,454 Test not required based on risk assessment 3,534 3,299 6,833 Grand Total 23,893 21,549 45,442

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Testing Services

Test not required based on risk assessment 15%

Newly tested and/or referred for testing 55%

Known Positive 1%

Declined testing and/or referral 28%

The project is working on a mechanism to track referrals but approximately 40% were tracked to the service providers.

Inclusive programming During the period under review, the project intensified efforts to leave no one behind and reached 2,231 (999 Female and 1,232 Male) PWDs with GBV/HIV prevention messages through dialogues. Thirteen girls were reached through the GLOW training in Chipata at Magwero school for the deaf.

During the PP_Prev dialogues, special attention was given to people with disability to help cub GBV and HIV transmission.

Types of disabilities Female Male Total Blind 531 747 1,278 Deaf and Dumb 62 44 106 Physical 406 441 847 Grand Total 999 1,232 2,231

Objective 3- GBV Survivor Support: Increased availability and timely uptake of quality GBV services by GBV survivors. Sub IR 3.1 Increased availability and accessibility of quality comprehensive post-GBV services for children, adolescents, and adults through an integrated GBV/HIV approach within health facilities both at One-Stop Centers (OSCs) and within health facilities within priority districts

During the period under review, the project reached a total number of 3,736 individuals with post-gender-based violence (GBV) clinical care services based on the minimum package of interventions in both direct service delivery (DSD) and technical assistance (TA) districts. The clients serviced were those that were either survivors of sexual or physical and/or emotional violence. The proportion of those that received sexual violence services was 17% (653) whilst

19 those receiving physical and/or emotional violence was 83% (3,083). Of the total number for physical and/or emotional violence reached, 84% (2,575) were females, whilst 26% (508) were male and for sexual violence 95% (622) were females and 5% (31) were males. Out of these survivours, 99% (192) females received PEP while 1% (2) males received PEP.

Gen GBV - All Districts Disaggregated by sex

2,575 (84%)

508 (16%) 622 (95%) 31 (5%) 192 (99%) 2 (1%)

PHYSICAL AND EMOTIONAL SEXUAL VIOLENCE PEP RECEIVED VIOLENCE

Female Total Male Total

The achievement in the 16 project implementation districts for GEND_GBV was 3,736 which accounted for 36% reach against a target of 10, 810. The survivors of sexual violence reached in the 16 implementation districts was 17% (460) of the targeted (2,670) individuals. These survivors had experienced sexual violence (i.e. penetrative sexual violence and sexual assault) and were provided with clinical care services, including HIV testing services (HTS), post exposure prophylaxis (PEP) for HIV, emergency contraceptive, STI screening and treatment, psychosocial counseling, and referral to other services for continuum of care, including economic and education support. A total of 130 (28%) survivors of penetrative sexual violence who reported the sexual gender-based violence (SGBV) incidence within the prescribed 72 hours were provided with post exposure prophylaxis (PEP) for HIV in order to reduce the new incidence of HIV. All those that were offered PEP accepted. There was generally low uptake of PEP among sexual violence survivors. Some of the reasons for this may be attributed to; late reporting of sexual violence to the OSCs, victims may have little knowledge about the effects of late reporting to the OSC and there may be lack of knowledge by the health staff on the urgency of referring sexual violence cases to the OSC.

A total of 3,083 survivors from the 16 implementation districts experienced physical, emotional and other GBV-related violence. These survivors were provided with psychosocial assessment and psychosocial counseling services, including child counseling, family and couple counseling, and trauma counseling. Other services provided included clinical care like wound treatment, STI screening and treatment, HIV testing services (HTS), and referral to other services for continuum of care.

20 There was strong support in identifying GBV cases by the community and facility staff. Individuals that have been sensitized and/or have undergone trainings in gender norms and GBV were able to identify cases in the community through physical means such as; observing injuries, movement posture, blood stains or toned clothes, child pregnancies, and STIs among children. Behavioral and/or psychological signs such as withdrawal of a child, excessive fear, shame, guilt and disclosure were also things that were observed for further probing to establish if GBV existed. The health facilities trained in multidisciplinary or sensitized through usual screening at health facility were also able to identify GBV cases.

When it was established that GBV existed, community members or health facility staff reported the case by either by calling the OSC or referring the case to the OSC. Some survivors that were not captured through these means came to the OSC as referrals either from the chiefdom secretariats, schools, police posts and other health centers that do not have a OSC. Lifeline assisted in making 9,634 referrals through their tele counselling component. In districts where DREAMS was implemented, 88 girls who were survivors of GBV were referred to the OSC for further management. It was observed that members of the community have become aware of GBV related issues through community and media sensitization. The trainings done to different CAs and conversation held with community members through SASA! and HIM have contributed to increased reporting of GBV cases.

Currently, there are 24 OSCs where needs assessments were conducted in both DSD and TA8 districts that are operational and requires technical support from the project. The OSCs uses the GBV/IMIS which has been malfunctional from the time the previous project closed. OSCs also have vehicles which were donated by the previous project but a lot of them are not operational and others need maintenance. Those that currently functional are not working optimally as the government does not have sufficient funds for fuel due to erratic funding. There is generally limited financial support from DHDs and huge disconnect between DHD and OSCs due to some attitude of some of the decision makers as Head of the institution in supporting the programs specially those not trained in multidisciplinary GBV management. Some OSC not fully integrated into the Ministry of Health system and there also high turnover of staff trained in the multidisciplinary GBV case management.

Multidisciplinary training was held in Kabwe which took 5 days. The following Districts had their staff trained in the multi-sectoral approach in the management of GBV survivors. The districts included: Chipata, Chongwe, Kabwe, Sesheke, Solwezi, Mufulira, Kitwe and Lusaka (chawama and Mtendere). The training had 54 participants which included Nurses, Doctors, Police officers, psychosocial counsellors media personnel and ZCCP staff. Out of 54 participants 31 were females while 26 were males. The training was conducted in a multidisciplinary fashion in enhance coordination among GBV stakeholders in response and awareness. Further, it was hoped that districts train should go ahead to establish these OSC in their respective locations. It is expected that four new OSCs will be established in Sesheke, Solwezi, Mufulira and Kitwe. The four new OSCs had 5 people each trained in

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21 multidisciplinary training together with the program officers from their respective Districts. Mufulira and Kitwe Ndeke OSCs have already started offering a service to the community pending the launch.

OSCs in Lusaka participated in LIVES training organized by Life line Zambia which included a coordinator and a psychosocial counsellor. The OSCs included Chawama, Mtendere and Ngombe. The total number of staff trained staff in LIVES is from the 3 OSCs is 6.

The HIV Testing Services (HTS) indicator counts the number of individuals that have undergone HIV testing and have received their results. The project conducted HIV testing in 11 One Stop Centers (OSC) in the 9 DSD districts and 9 One Stop Centers (OSC) in the 9 TA districts. The target for FY20 is 879 individuals to be tested. During the period under review, a total of 2,933 (334%) individuals were reached with HTS services and received their results. Of those reached, 83% (2,497) were females whilst the other 15% (436) were males. The total number of people found positive was 222, giving a positivity yield of 8%. Females accounted for most positives as there were 193 (87%) whilst males were 29 (13 %). All HTS positive results were followed up to ensure linkage to care and treatment as well as risk reduction messaging was done to all in order to mitigate further transmission of the virus. Follow ups were conducted in both the linkage registers and smart care databases to ensure that positive clients were linked to treatment. The linkage rate to ART during the reporting period was at 90%. This was because some clients opted not access ART services from the OSC facilities due to long distances from their homes. Those that opted not access ART services from OSCs were followed up to ensure that they enrolled on treatment.

The modality used to conduct HIV testing was mainly Emergency HTS as all clients tested during the quarter under review were tested through the OSC at the health facility. The clients tested were mainly survivors of sexual and physical violence. This explains the reasons for a higher number of females being tested compared to males, because females are most at risk of Gender Based Violence (GBV). Sexual violence survivors were those that experienced (penetrative sexual violence and sexual assault). This type of violence places individuals at

22 high risk of contracting HIV. Survivors of sexual violence were provided with clinical care services; including HIV testing services (HTS), post exposure prophylaxis (PEP), emergency contraceptive (EC), STI screening and treatment, psychosocial and paralegal counseling, and referral to DREAMS services (AGYW), other services for continuum of care, including economic and education support.

Lifeline provided tele counselling services to 9,634 individuals. In districts where DREAMS was implemented, 88 girls who were survivors of GBV were referred to the OSC.

Multidisciplinary training was conducted for following districts; Chipata, Chongwe, Kabwe, Sesheke, Solwezi, Mufulira, Kitwe and Lusaka (chawama and Mtendere). 54 participants were trained (31 females and 26 males) which included Nurses, Doctors, Police officers, psychosocial counsellors media personnel and ZCCP staff. Lifeline organized a training in LIVES for tele counselors and OSC coordinators. The outcome of the training was improved knowledge levels and skills required by counselors and other first line responders in dealing with GBV/HIV cases, improved handling of cases.

Participants during the lives training at mika lodge.

Sub IR 3.2 Increased capacity of partners within the DREAMS Initiative to respond to the needs of GBV survivors. The project is working in collaboration with DREAMS Initiative partners in DREAMS districts. The project referred 2,462 AGYW for layering of services as shown below in the table;

Age Group Total referred to Services referred for DREAMS

10-14 Years 1,454  Enrolment into Safe Spaces  Asset building  School based interventions (School support)

15-19 Years 526  Enrolment into Safe Spaces  Asset building  School based interventions (School support)

23  Condoms Provision  HTS

20-24 Years 482  Enrolment into Safe Spaces  Asset building  School based interventions (School support)  Condoms Provision  HTS  Family Planning

Sub IR 3.3 Quality post-GBV services for children, adolescents and adults at OSCs with strengthened referral networks for other GBV services. Through Lifeline/Childline Zambia, the project provided GBV counselling services, guidance and referral services. These services were provided to women, men, boys and girls9. The tables below show the details of the calls received as per case category.

GBV Counselling Service District Boys Girls Men Women Total Chongwe 7 9 12 34 62 Lusaka 17 25 49 60 151 Chingola 5 4 19 18 46 Kitwe 11 12 22 32 77 Luanshya 16 25 17 30 88 Ndola 24 32 30 47 133 Kabwe 12 32 33 59 136 Kapiri Mposhi 19 31 72 70 192 Chipata 38 63 85 116 302 Livingstone 11 37 60 73 181 Mongu 27 43 60 90 220 Sesheke 6 4 28 29 67 Solwezi 6 9 31 55 101 Kalulushi 3 2 18 30 53 Masaiti 3 8 26 35 72 Mufulira 8 15 52 55 130 TOTAL 213 351 614 833 2,499

As can be seen above, Lusaka, Mongu, chipata, kabwe, Ndola recorded high number of calls overall compared to the other districts. Of these mentioned districts, only Mongu districts showed a significant increase in number of calls in the months of October and November which

9 Girls – 0 – 19, Boys 0 – 19, Men 20+, Women 20+

24 had not always been the case. Masaiti, Sesheke, Solwezi continue to record low utilization of the helpline for information and counselling.

The table below shows a breakdown of calls received per case category as recorded in the call center, disaggregated by age and gender,

GBV CASE SUMMARY

727 661 636

344

39 67 18

PHYSICAL EMOTIONAL SEXUAL ECONOMICAL INFORMATION CHILD CHILD INQUIRY MARRIAGE DEFILEMENT

number

The Call Centre recorded various GBV cases, 636 were physical abuse, 661 were emotional abuse, 39 were sexual abuse, 344 were denial to economic opportunities abuse, 727 were information inquiry, 67 were child marriages, and 18 were child defilement cases. The trend continues to show more cases related to physical and emotional abuse to be more reported compared to cases related to sexual and child marriages. However, Chipata continues to rank high in both cases of child marriages and physical violence. The data further indicate that both women and men suffer equally from emotional abuse with men rarely speaking out about such issues. The male callers were counselled and encouraged to always seek help and were referred to the HIM groups. A total of 6,109 (2,890 F and 3,219 M) HIV related calls were received in the period under review. The table below shows the number of referrals that were initiated out of the HIV and GBV calls contacts made to the helpline and where they were referred to for further service provision.

25 REFERRAL (GBV/HIV)

Number 1919 709 464 106 60

OSC HEALTH FACILITY V.S.U DREAMS HIM

There were more referrals initiated to health facilities compared to OSCs. This is because some districts did not have a OSC. Clients were referred to the health facilities and other service providers in their districts. Referrals were made to the Victim Support Unit (VSU) and WILDAF for cases that needed legal interventions. AGYW were also referred to DREAMS centres.

Objective 4 - Laws and Policies Regarding GBV and Gender Equality: Strengthened regulation and support for the implementation of laws and policies regarding GBV and gender equality

Sub IR 4.1: Strengthened Capacity of GBV Health and Psychosocial Services Providers to Implement GBV Laws and manage GBV cases The project enhanced linkages and knowledge of the health care service providers at the OSCs on the flow of the legal management of GBV cases by updating the care pathway for GBV survivors. The draft pathway has expanded the role of law enforcement officers to include social support for victims of GBV.

Sub IR 4.2: Strengthened Capacity of Legal and Law Enforcement Personnel to implement laws and policies related to GBV and gender equality During the period under review, the project placed paralegals in the OSCs in Kitwe, Chingola, Luanshya, Ndola, Kapiri Mposhi, Kabwe, Lusaka (Ng’ombe and Mtendere OSCs) Chongwe, Chipata, Mongu and Livingstone for purposes of expanding the accessibility of legal services by the victims/survivors of GBV.

Sub IR 4.3: Increased Congruency of Customary law with National regarding GBV and Gender Equality During the period of reporting, the project trained Trainer of Trainers (ToT) in Mongu, Sesheke, Livingstone and Chipata districts on GBV and related laws. The participants included traditional and community leaders (section/ward chairpersons, headpersons and religious leaders). The participants were selected through their Royal Highnesses in the aforementioned activity districts, Gender Sub Committees and the project officers (POs) in the project districts.

26 The training was aimed at improving access to justice for the survivors of GBV; increasing GBV knowledge and its related laws among the community leaders; and strengthening the capacity of leaders in GBV case management and effective implementation of laws. A total of 55 traditional and community leaders (43 M and 12 F) were trained.

Fig 1: Participants engaged in the Gender exercise during the ToT in Chipata district

The immediate results of the training were: • Identification of the chiefdoms that have not documented the GBV By- laws such as Mukanda, Nzamane, Chanshi, Chinunda and Munukwa in Chipata Mushimbo, Ilyangu, Silumbu and Imbwae in and Lealui, Mukulwambula, Luandui, Namuyambi and Lumbo in and engaging them on the development of the GBV By – laws; • Commitment by the traditional and community leaders to conduct sensitization and awareness raising on GBV and related laws in their various communities. • Commitment to work with the paralegals to identify and refer cases of GBV to the institutions authorized to deal with GBV.

In order to increase the congruence of customary law with the national law regarding GBV, the project supported the traditional and community leaders who were trained in FY2019 to conduct capacity building meetings for their peers on GBV and harmful traditional practices in Masaiti, Luanshya, Solwezi, Chingola, Mufulira, Kalulushi, Kitwe and Ndola districts. A total of 215 (71 F and 144 M) traditional and community leaders were engaged in the process. The meetings enabled the increase of GBV knowledge and its related laws among the community and traditional leaders and the identification of the harmful traditional practices that are still being practiced in the aforementioned districts.

In order to facilitate the codification of the customary laws, the project engaged His Royal Highness Senior Chief Chiwala of Masaiti and the senior Indunas from Lealui, Mukulwambula, Luandui, Namuyambi and Lumbo on the review of the chiefdom GBV By- laws.

Sub IR 4.4: Strengthened laws, Policies and Implementation regarding GBV, Gender equality and Female Empowerment by National and Local Traditional structures The project engaged the MoG and the Zambia Law Development Commision (ZLDC) regarding the review of the Anti- GBV Act. In the two separate meetings, it was revealed that the MoG has initiated the process of reviewing the Anti-GBV Act to address some of its challenges. Accordingly, the ZLDC has appointed a Technical Working Group to review the Act and the project will be represented on the review team by WiLDAF.

27 Project Monitoring and Data Quality FY2020 started on a good note with new finalized data collection tools and defined data management processes that were developed to fully capture project implementation. In order to equip program staff as well as partners with skill in performing the M&E related functions in year two, an M&E training was conducted in Lusaka for five days. The training highlighted the changes to the tools and provided a practical feel of how the new tools have been structured to respond to program strategy and MER guidance. Refresher presentation on each program component by Technical Advisors and Coordinators were made for purposes of ensuring that participants relate the implementation guidelines to the tools developed. Discussions around data quality and data management were also conducted during this training. The expectation is that Program Officers as well as staff implementing the program at district level will cascade this information to volunteers and counsellors in quarter two of FY2020. This will make implementation smooth and will improve data quality across the whole spectrum of implementation.

Data trace and verification exercises as part of data quality assessments continued to be a key feature during quarter one of FY2020. Districts that had not undergone this process in FY2019 (Solwezi, Ndola, Chipata, Chongwe and Lusaka) were visited for purposes of improving their data management as well as quality at district level. The data trace and verification exercise established variances between the data on file and that in the system (reported). The observed variances were highlighted and then a corrective action plan was provided with a fixed timeline and ensured that all the observed data quality issues were addressed.

Development and review of protocols for data management information systems as well as baseline/outcomes harvest study were conducted during the period under review.

The M&E team continued to provide regular and ad hoc M&E support to all the districts on data tools, program quality and data management. The team also worked well in ensuring that there was coordination among project partners and that the project was being implemented in a coordinated manner. This saw regular joint check-in meetings among M&E project staff on weekly basis.

Risks Management The table below shows the project risks and mitigating actions. Current Net Risk Rating

Likelihood Impact Risk Description Current Mitigation Actions

SN

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The suspected The project will increase targets in next ritual killings in quarter should we have under Copperbelt has performance in current quarter made community High Medium volunteers reduce on community 1 activities Flooding in The project will redistribute the targets selected districts restricting Medium Medium movements

2 Stock outs of key Advocate with MoH on improving the commodities in key commodities supply chain OSCs required to meet the minimum High High package for post GBV care

3 Project staff high turn over will Build capacity in other project staff to be 4 Medium Medium affect able to cover gaps. implementation

Challenges and Recommendations

Below are the challenges and how they would be addressed.

Challenges Recommendations Victims keep requesting the courts/police to There is need for sensitization meetings on the withdraw cases of GBV, including the same so that communities can understand that aggravated ones; hence due to the same, all criminal cases are against the state and Victims and witnesses are unwilling to testify cannot be withdrawn unless by an order of or if they testify, they don’t give accurate court. information. Stock out at OSC essential commodities Advocate with MoH on improving the key commodities supply chain Late reporting of sexual violence cases to the Increase community awaresness about the OSCs continued to be a challenge due to services of OSCs

29 distance, untrained personnel and cultural values. The concept of D2G has not been fully Engage the MoH to take ownership of the embraced by the Health facilities hosting OSCs OSC. Limited space to host the OSC in Sesheke and Engage MoH to find alternative space for new Solwezi OSCs and the PPPs.

Lessons Learnt

• The lack of permanently assigned police officers to support legal services in the OSCs has negatively impacted case follow up; hence the need to lobby for permanent personnel from these institution; • Health facilities which host OSCs with senior medical supritendants appreciate GBV management better • Community volunteers need constant trainings for quality implementation of activities

List of Upcoming Events

Plan for the FY20 Q2 – January to March 2020 Activity Partner Q2 ZCCP, Lifeline, WiLDAF Ncwala Traditional Ceremony 29th February, 2019 ZCCP, Lifeline, WiLDAF, Internatinal Womens Day Ministry of Gender 9th March, 2019 ZCCP, Lifeline, WiLDAF, International Youth Day Ministry of Youth 12th March, 2019

Environmental Monitoring and Management Plan

An ongoing Environmental Monitoring and Management Plan (EMMP) is a tool to proactively manage and confirm that impacts of the project activities do not exceed the stipulated environmental quality standards expected. The EMMP presents an overarching approach to environmental management and monitoring during the implementation of the USAID Stop GBV Project. It identifies activities to be implemented, the environmental impact these activities have, mitigation measures to be implemented, frequency to monitor the measures and by who.

The project conducted training of all staff and volunteers on the EMMP. This was to ensure that the activities do not or least affect the effectiveness of the environment to serve the present and future generations. The main activities reflected in the report include conducting of community conversations, training of different communities, stakeholders and staff, the medical refuse from the OSC through appropriate waste bins (colored) and incinerated, media activities that include Mobile Video Shows, minimal use of paper in all activities. The USAID Stop GBV quarterly EMMP report is embedded

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ANNEXES

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