Title: USAID Stop GENDER-BASED VIOLENCE PROJECT-Quarter 3, 2019 Report

ZAMBIA CENTRE FOR COMMUNICATION PROGRAMMES

Title: USAID Stop GENDER-BASED VIOLENCE PROJECT-Quarter 3, 2019 Report. Lead Author: Johans Mtonga Cooperative Agreement No. 72061119CA0001 Sponsoring Office: USAID/Zambia Development Objective: DO3: IR 3.2: Health Status Improved

FY 2019

Quarter 3 Report

APRIL 1 - JUNE 30, 2019

Date: July 31, 2019

Table of Contents

Project Information ...... 3 Acronyms ...... 4 Executive Summary ...... 6 Introduction...... 8 Progress ...... 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 Objective 2: To strengthen access to and uptake of quality post-GBV services for GBV survivors...... 12 Objective 3- GBV Survivor Support: increased availability and timely uptake of quality GBV services by GBV survivors...... 20 Objective 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...... 23 Project Monitoring and Data Quality ...... 26 Challenges ...... 26 Lessons Learnt ...... 27 Financial Report Highlights [SF-425] ...... Error! Bookmark not defined. List of Upcoming Events ...... 28

Project Information Project Name USAID Stop Gender-Based Violence Project Cooperative Agreement No: 72061119CA0001 Grant Period November 15, 2018-November 14,2023 Lead Organization Zambia Centre for Communication Programmes WiLDAF Sub Partners Lifeline/Childline Technical attachment for OSC: Ministry of Health USAID Contact Person Emmanuel Ngulube (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

+260-977-604-473 Contact Details [email protected]

Acronyms AGYW Adolescent Girls and Young Women AIDS Acquired Immune Deficiency Syndrome ART Anti-Retroviral Therapy AWP Annual Work Plan CA Community Activist CD Community Dialogue CM Child Marriages CSE Comprehensive Sexuality Education CSO Central Statistics Office CSO Civil Society Organisations DHAC District HIV AIDS Committee DC District Commissioner DEBS District Education Board Secretary DDCC District Development Coordinating Committee DHD District Health Director DREAMS Determined Resilient Empowered AIDS-Free Mentored and Safe EC Emergency Contraceptive FGD Focus Group Discussion FPP Focal Point Person FY Fiscal Year GBV Gender Based Violence GEEA Gender Equity Equality Act HIV Human Immunodeficiency Virus 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 MOG Ministry of Gender MoH Ministry of Health MoJ Ministry of Justice MoU Memorandum of Understand MP Members of Parliament OSC One Stop Centre PAN Paralegal Alliance Network 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_PREV Priority Population Prevention PPP Public Private Partnership PWD Persons With Disability

RC Regional Coordinator SASA! Start Awareness Support Action SBC Social Behaviour Change 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 WGSC Ward Gender Sub Committee WiLDAF Women in Law and Development in Africa ZCCP Zambia Centre for Communication Programmes

Executive Summary

Zambia Centre for Communications Programs (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 districts1. 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 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 KPs.

Achievements for quarter This report covers the period 1st April to 30th June 2019. Below are the major achievements during the reporting period:

• All districts had project introductory meetings with the Government heads at district level that is District Commissioners (DCs), District Administrative Officers (DAOs), District Health Directors (DHD), District Education Board Secretaries (DEBS), Town Clerks and Mayors. These meetings resulted in the project having high level Government buy-in at district level. • A successful national orientation stakeholders meeting was conducted to introduce the project to national level stakeholders. This resulted in national stakeholders coming up with commitments on their roles and responsibilities on preventing GBV and HI, and engaging with these stakeholders has continued. • Stakeholder meetings were replicated at district level which resulted in various stakeholders understanding their roles and responsibilities on how they will support reducing GBV and HIV. Coordination with most of these stakeholders has equally continued at the district level.

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

• A successful national orientation stakeholders meeting was conducted to introduce the project to national level stakeholders. This resulted in national stakeholders coming up with commitments on their roles and responsibilities on preventing GBV and HI, and engaging with these stakeholders has continued. • Stakeholder meetings were replicated at district level which resulted in various stakeholders understanding their roles and responsibilities on how they will support reducing GBV and HIV. Coordination with most of these stakeholders has equally continued at the district level. • The project through Lifeline/Childline Zambia conducted awareness raising activities and reached 3206 (F-2,077: M-1,129) people with prevention messages. During the period under review, the helplines (933 GBV Helpline and 116 Childline) recorded a total of 4,464 calls related to GBV and HIV. • WiLDAF implemented the following activities that includes meeting with MoH on the review of the In-service Curricula for Health Service Providers, Ministry of Gender (MoG) on the establishment of the Fund on GBV and Ministry of Justice (MoJ) on the establishment of the Equity and Equality Commission. Challenges • Late approval of workplan and late implementation has affected attainment of targets for the quarter and quality may be compromised. • There is inadequate supply of test kits and condoms. • There has been transport challenges at district level which affects coverage of activities.

Learns Learnt • There are a lot of knowledge gaps and myths surrounding HIV in the communities. For example, during some dialogues conducted in Mufulira district, some participants were of the view that HIV positive clients who adhere to medication become negative again. • The lesson from the meetings with the community leaders is that addressing GBV requires capacity building of key focal point persons who influence further engagement with their communities. • Engaging key stakeholders at project inception results in project support during implementation and sustainability beyond the project.

Introduction Zambia Centre for Communications Programs (ZCCP) is implementing the USAID Stop Gender-Based Violence (GBV) project. The USAID Stop GBV project will be implemented from 15th November 2018 to 14th November, 2023 and is being implemented in sixteen districts2. 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.

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; • To prevent GBV and increase support for gender equality among women, men, children and members of key and priority populations. • Increase access to behavioral change through provision of HIV prevention information and services. • To strengthen access to and uptake of quality post-GBV services for GBV survivors. • 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.

The project is working in 7 provinces of Zambia (Central, Copperbelt, Eastern, Lusaka, Northwestern, Southern and Western) in 16 districts. In the districts, the project operates in 105 sites and in 529 hotspots.

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

Progress for the Quarter Objective 1: To prevent GBV and increase support for gender equality among women, men, children and members of key, priority populations and 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 collaborated with the Ministry of General Education (MoGE) to map 417 schools in our operational districts. This was done with support from the PEOs (3), DEBS (12) and 258 headmasters. Other meetings with those not yet met have been planned in the next quarter. The engagement of relevant authorities from MoGE happened at various levels. At national level, MoGE was engaged to facilitate access in schools. At district level, the DEBS were engaged on identification of learners, champions, mentors and activists from schools. At school level, the project engaged the guidance and counselling teachers to help identify girls and boys for the Girls Leading Our World (GLOW)3 and Health Images of Men (HIM)4 clubs in schools. Continuous engagement of the PEOs and DEBS offices is key as will help in the success of these activities in the project.

Sub IR 1.2 Increased community mobilization for GBV and HIV prevention and gender equality. As a startup activity to mobilize the community on GBV and HIV prevention, community volunteers (lay counsellors, peer educators and community activists) were identified, recruited and trained so that they can conduct social mobilization activities. These community volunteers were identified through health facilities and community leaders. As a way of continued capacity building, these community volunteers were supported by the programme officers. Below is table ( Table 1) on community volunteers recruited by district. Project Community Volunteers by District and Type. Districts Lay Counselors Peer Community HIM CAs Total Educators Activists Community (CAs) Volunteers Chingola 7 21 13 41 Chipata 15 20 13 4 52 Chongwe 17 12 10 5 44 Kabwe 5 16 10 4 35 Kalulushi 8 4 4 5 21 Kapiri Mposhi 7 11 9 6 33

3 GLOW-safe spaces for girls where they are taken through a 13 weeks curriculum on life skills and HIV/GBV prevention. 4 HIM-safe spaces for boys and men where they are taken through a curriculum on gender and HIV prevention.

Kitwe 26 33 17 10 86 Livingstone 18 14 6 5 43 Luanshya 5 14 9 28 Lusaka 178 94 60 16 348 Masaiti 2 6 4 3 15 Mongu 11 10 5 5 31 Mufulira 5 14 9 5 33 Ndola 41 13 13 67 Sesheke 5 8 3 5 21 Solwezi 4 12 7 5 28 Total 354 302 192 78 926 Table 1-Community volunteers per district

The project uses the SASA! methodology in prevention of GBV. It is 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. The project has so far been implementing in 11 districts at Awareness and Support phases and the five are in the Start Phase. During the community dialogues5, the project worked with local and community groups to raise awareness on preventing GBV and HIV. In addition, the One Stop Centre (OSC) services and Lifeline/ChildLine toll fee lines (933 and 116) services were promoted. Table 2 below provides details on the number of people who attended dialogues this quarter against target. GENDER NORMS District Cumulative Q3 Target Achieved Percentage Chingola 1,327 1,104 83% Chipata 1,274 1,584 124% Chongwe 783 303 39% Kabwe 1,019 1,197 117% Kalulushi 536 581 108% Kapiri Mposhi 1,096 1,494 136% Kitwe 2,473 2,782 113%

5 Community dialogues provide a unique platform where community members share personal stories and experiences, express perspectives, clarify viewpoints, and develop solutions to community concerns among themselves.

Livingstone 1,242 1,786 144% Luanshya 913 1,917 210% Lusaka 10,355 - 0% Masaiti 390 240 62% Mongu 830 805 97% Mufulira 902 1,079 120% Ndola 2,305 2,880 125% Sesheke 345 - 0% Solwezi 740 120 16% Grand Total 26,528 17,872 67% Table 2- Gender Norms Overall, the project had a good performance of 67% against quarter three targets considering the tight space of ten days that was there between approval of the annual work plan and end of the quarter. Sesheke and Lusaka have zero percent achievement because of the issue mentioned above and the time was used to identify, recruit and train the community volunteers. The project has put in place measures to catch up on these targets in the next quarter and is on course to achieving the annual targets.

Sub IR 1.3 Economic opportunities for GBV vulnerable women, men and youth increased. During the period under review, the project assessed the existing Village Savings and Lending (VSL) groups which is still work in progress. This helped identify the needs of the various groups that are being addressed. Field facilitators and trainer of trainers (ToTs) will be identified and trained in the next quarter. Lessons learnt from the existing groups will be considered as new groups are being formed in the next quarter.

IR 1.4 Strengthened governmental and traditional leadership commitment to GBV prevention and response. In the period under review, the project worked with the Ministry of Chiefs and Traditional Affairs (MoCTA) to engage the traditional leaders as partners to help in the fight against child marriages, teenage pregnancies, HIV in their respective chiefdoms. The project engaged 11 MoCTA officers in the district to discuss the planned activities and how the traditional leaders will be engaged. A national event of stakeholders was held in Lusaka where both government and traditional leaders came up with the roles and responsibilities on how they will support the project on GBV and HIV prevention. The project will support reviewing these commitments on a regular basis.

Sub IR 1.5 Strengthened engagement and coordination of stakeholders in national response. The project through the office of the District Commissioner, supported District Gender Subcommittee (DGSC) meetings in five districts6. The DGSC meetings are comprised of heads of government line ministries, Non-Governmental Organisations (NGOs), Community Based Organisations (CBOs) and Faith Based Organisations (FBOs). These meetings are aimed at improving district level coordination on gender. The project has also collaborated with other like-minded project and organizations at different levels in the districts especially the USG partners like JSI-SAFE, JSI-Discover, ZCHPP, Open Doors, Peace Corps, DAPP-ZAMFAM, SARAI. Some examples of outcomes of these collaborations are;

• In several districts, referrals of the eligible girls to the DREAMS and OSCs is being done. • In Kitwe and Chingola, the project is working in partnership with JSI_SAFE and ZCHPP in index testing and initiating new clients on ART. • In Kapiri Mposhi, the project refers positive clients for ART initiation to JSI_SAFE. In addition, from the meetings held so far, some level of coordination has been observed where government ministries conduct joint activities with the project.

Sub IR 1.6 Enhanced communication to advocate for positive gender practices through various cost-effective media. In the period under review, the project engaged the communities on adoption of positive gender norms and elimination of child marriages. Approximately, 5,701 people were engaged through the mobile video shows and these were followed up by community dialogues. The project has planned to conduct theatre performances that will be done in the next quarter.

Objective 2: To strengthen access to and uptake of quality post-GBV services for GBV survivors.

IR 2.1: Reduced new HIV infections among priority populations especially adolescent girls and young women and their sexual partners, mobile populations (as classified per geographical area), discordant couples, PLWH and non-injecting drug users).

Sub IR 2.1.1: Increased access to behavioral change through provision of HIV prevention information and services. The project working in collaboration with the MoH mapped 529 hotspots and documented findings. Out of the mapped hotspots, categories of priority7 and key8 populations were identified. The community volunteers were identified from with these groups and from the respective populations. In this period, 235 community dialogues were conducted in the supported districts by community volunteers. Some of the notable challenges from the discussions were that;

6 Chingola, Chipata, Chongwe, Livingstone and Lusaka. 7 Priority- AGYW and their sexual partners, PLHIV, non-injecting drug users, mobile population, sero discordant couples. 8 Key- Men having sex with men, transgender, people who inject drugs, sex workers

o Out of school adolescent girls have inadequate information on Sexual Reproductive Health e.g. condom use. o Insufficient availability of condoms in the communities was highlighted as a major concern by community members. o Most adolescents from the community prefer on spot HIV testing to facility testing but testing kits may not always be available. During dialogues with in-school adolescents, it was noted that schools lack adequate Social Behavioural Communication (SBC) materials with age appropriate messages and communities depend on youth friendly spaces that have limited information. Some of the lessons from dialogues conducted with sex partners of AGYW suggested the need for moonlight HIV Testing Services (HTS) and an introduction of men’s wellness days to encourage male involvement in reproductive health. In the Priority Population Prevention9 (PP_Prev) dialogues, 162,322 people (M: 90,052 F: 72,270) were engaged in dialogues on a package of prevention messaging (PP_Prev) and referrals to high impact services. Table 3 below provides details of the gender disaggregation on number of people reached per district. To reach the 162,322 people, about 6,763 dialogues were conducted which comprised of 55.48% females and 44.52% males. Figure 1.0 below (next page) is a graph that provides sex and age on this data and figure 1.1 (next page) is a graph that provides data on targets versus achievement.

Table 3- PP_Prev dialogues Districts Female Male Grand Total

Chingola 6,250 3,900 10,150

Chipata 5,513 4,440 9,953

Chongwe 4,313 1,452 5,765

Kabwe 2,274 1,628 3,902

Kalulushi 2,907 2,189 5,096

Kapiri Mposhi 2,493 2,006 4,499

Kitwe 8,035 7,433 15,468

Livingstone 4,196 4,023 8,219

Luanshya 1,635 1,274 2,909

Lusaka 33,850 32,101 65,951

Masaiti 2,372 783 3,155

9 PP_PREV: priority populations reached with standardized HIV prevention intervention(s) that are evidence- based.

Mongu 3,217 2,086 5,303

Mufulira 2,701 3,908 6,609

Ndola 7,500 3,593 11,093

Sesheke 1,390 1,043 2,433

Solwezi 1,406 411 1,817

Grand Total 90,052 72,270 162,322 Table 3- PP_Prev dialogues

PP_Prev Achieved by Age Group and Sex

10-14 16,601 2277

15-19 24,801 9167

20-24 24,698 23376

25-29 9,107 13119

30-34 5,648 9098

35-39 3,945 6523

40-44 2,523 4378

45-50 1,624 2669

50+ 1,105 1663

30000 20000 10000 0 10000 20000 30000

M F

Figure 1.0 – PP_Prev Age and Sex disaggregation

Most of the people who attended the dialogues were between the ages of 15 and 24 years. The project is putting in place a deliberate effort to reach the 10-14 years being the focus age for the project and increase the boys in this age category. With the starting of other project activities like HIM, more boys and men will be reached on the programs. Below is the graph (figure 1.1) which provides an analysis of the achievement versus target. According to the graph, a number of districts over achieved the targets. Only Chipata and Luanshya districts did not meet the targets. The project has plans in place to ensure that this is corrected in the next quarter.

PP_Prev Targets Vs Achieved by District

70,000

60,000

50,000

40,000 65,953

30,000

9,953 20,000

10,000 18,172 15,468 8,261 10,150 2,909 11,093 5,305 5,765 3,926 4,500 5,096 5,250 6,783 5,250 6,609 2,656 2,558 3,155 3,741 2,775 - 2,250 - 2,396 1,518 - - 2,433- 1,817-

PP_PREV Target PP_PREV Achieved

Figure1.1- PP_Prev targets versus achievement

Figure 1.2 below provides information on the categories of the Priority Populations (PP) that were engaged.

PRIORITY POPULATION GROUPS Sex Partners of AGYW 19% AGYW 27%

PLHIV Discordant 13% Couples 1%

Non-Injecting Drug Users Mobile 13% Populations 27% Figure 1.2- PPs engaged

In an effort of leave no one behind, the project also engaged disabled people’s organizations (DPOs) to coordinate GBV/HIV activities as organizations. The project engaged MCDSS and Zambia Agency for Persons with Disabilities (ZAPD) which resulted in them sharing the list of DPOs10 that the project can coordinate with. A meeting has been planned for the next quarter where these DPOs will work with ZAPD to map out strategies of how they will participate in the project. During the 6,763 dialogues mentioned above, 2,360 people with disabilities were reached. The breakdown of sex and disability disaggregation is shown in Table 4 below.

PWDs who attended dialogues

Persons with Disabilities Female Male Total

Blind 60 37 97

Deaf & Dumb 125 65 190

Physical 1,132 850 1,983

Physical and Blind 35 32 67

Physical and Deaf & Dumb 7 16 22

Grand Total 1,360 1,000 2,360

Table 4- PWDs who attended dialogues

Sub IR 2.1.2: Targeted priority populations know their HIV status HTS is a critical first point of contact for linking individuals to high impact prevention services or to care, treatment, and support for PLHIV. The project targeted high risk and high yield populations for HTS including couples counselling, providing referrals and offering targeted community-based testing (mobile, index case), with focus on index case testing modality. All HTS services were followed up to ensure that people who tested negative accessed services to keep them negative and those that tested positive are linked to ART, disclosure support and adherence support. The project reported 2,512 (1306 F: 1206 M) people who received HIV testing results out of which 566 (340 F: 226 M) were commenced on ART resulting in 23% positivity yield. The modalities used to conduct these tests were two namely community index and community mobile. These two modalities provide high positivity yield as compared to VCT and other community platforms that target general population. Under community index testing, 865 index cases were offered index testing services and of these 635 accepted. The 635 cases that accepted index services elicited 712 individuals resulted in 309 positives and 403 negatives. While under community mobile the project recorded 257 positives and 1,543 negatives. The

10 Zambia Association of the Disabled, Zambia Association of the Deaf, Communication workers Association of Zambia (COWAZ), Zambia Association of the Blind (ZAB), Zambia Association of the Disabled, Zambia Federation for the Disabled (ZAFOD), Zambia National Association of Disabled Women (ZNADWO) Zambia National Association of Disabled Women (ZNADWO) and Zambia Education Teachers Association of Zambia.

16 project worked in hotspots that were identified by stakeholders which are outside health facilities were HIV prevention messages for target populations at risk were disseminated. An HIV risk assessment tool was administered on individuals and those most at risk were tested. Before communities were engaged, the project oriented lay counselors on the HTS indicator using MER guidelines. An in-depth refresher training has been planned for quarter four and will include all gaps identified during quarter three implementation. Table 5 below provides details on HTS_TST Modalities. Figure 1.3 (next pages) is a graph that compares target and achievement and Figure 1.4 and Figure 1.5 provides further age/sex analysis on HTS and by number of positives. HTS_TST Modalities Districts Index Testing Positivity Mobile Service Positivity Rate Modality Rate Modality Chingola 106 34% - - Chipata 54 54% 253 21% Chongwe - - - - Kabwe 5 - 193 1% Kalulushi 23 43% - - Kapiri Mposhi 15 47% 37 14% Kitwe 63 25% - - Livingstone 136 34% 209 10% Luanshya 49 59% - - Lusaka 150 71% 760 16% Masaiti - - - - Mongu 5 0% 286 14% Mufulira 27 30% - - Ndola 66 29% - - Sesheke 13 15% 62 18% Solwezi - - - - Total 712 43% 1,800 14%

Table 5- HTS_TST Modalities According to the Table 5 above, a total of 712 people were tested were through index testing while 1800 people were tested through the mobile testing. The project has learnt lessons to monitor closely the lay counsellors and ensure they conduct index testing as opposed to mobile testing as the yield is higher.

HTS_TST Target Vs Achieved by District

1800

1600 291 1400

1200 66 1000

800 307 1390 600 345 247 1023 400 731 0 200 63 455 66 106 384 910 164 23 52 136 0 27 136 75 0 0 54 0 0 50 0 0 0 0

HTS_TST Target HTS_TST Achieved

Figure 1.3- HTS_TST Target Vs Achieved by District The overall performance of the project is average. This can be mainly attributed to two things i.e. as mentioned above, the time for implementation has been limited and secondly, all districts have been experiencing shortages in Test Kits.

HTS Age/Sex Pyramid by Number Tested

<5 5 10 5-9 1 4 10-14 29 36 15-19 198 99 20-24 365 258 25-29 282 253 30-34 171 214 35-39 125 124 40-44 62 97 45-49 32 50 >50 36 61 Unknown Age 400 300 200 100 0 100 200 300

HTS_TST Male HTS_TST Female

Figure 1.4- HTS Age/Sex Pyramid by Number Tested

HTS Age/Sex Pyramid by Number of Positive

1 3 5-9 1 3 4 15-19 22 5 88 26 25-29 73 32 58 48 35-39 50 38 20 34 45-49 12 18 13 17 Unknown Age 0 100 80 60 40 20 0 20 40 60

HTS_TST_POS Female HTS_TST_POS Male

Figure 1.4- HTS Age/Sex Pyramid by Number of positives Having just started implementation, data is still being collected and verified to ensure quality. The project has planned for an independent DQA to be conducted in the next quarter during which data from all sites will be verified for increased quality control purposes and improved programing. Meanwhile, it has to be noted that some districts are in a startup phase and these include Chongwe, Masaiti and Solwezi districts and initial data is yet to be verified and as a result, compilation and follow-up of contacts made through the index clients is still being updated. This will provide the immediate entry for indexing beginning quarter four. Under HIV Index testing services were offered to 865 index cases that were identified through the ART registers at the health facilities some of which are housing the OSCs. Out of these, 635 accepted index testing services and elicited 712 contacts. The index cases that accepted index testing services provided residential addresses for the elicited contacts. This enabled the project to successfully test 712 people, of whom 309 were newly tested positive resulting in a positivity yield of 43%. Index testing contributed to 28% of the total tested during the quarter under review and 55% of the newly tested positives were tested. The figure below (Figure 1.5) provides details by district.

HTS_TST Positivity Yield per District 59%

43% 34% 27% 30% 29% 23% 25% 25% 19% 17% 14%

Figure 1.5- HTS_TST per district

Sub IR 2.1.3 Increased quality of Orphans and Vulnerable Children (OVC) services to orphaned and Vulnerable Child(ren) infected and affected by HIV and AIDS coordinate care and support services for OVCs and caregivers.

The project is working with various stakeholders in ensuring increased quality of OVC services. During the reporting period, the project focused on messaging through dialogues in the communities. The OVC numbers were derived from PP_Prev and Gender norms dialogues. The project has noticed the gaps in implementation of OVC services and is addressing these gaps in the next quarter. Lack of clarity by USAID on implementation of OVC services contributed to the above-mentioned gap.

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 engaged the OSCs to review the condition and operations of the OSCs. 20 out of 24 were assessed and the rest will be completed in the next quarter. The OSCs assessed so far are running although with varied challenges. Some of the major issues noted are; • Inadequate handover by World Vision. • Lack of support from hospital management on the operations of the OSC hence affecting allocation of funds. • High staff turnover and varied levels of staffing. • Transport challenges in accessing the vehicles and allocation of fuel.

• GBVIMS is nonfunctional. These issues will be addressed in the next quarter and the project will continue engaging with the OSCs. From the community programs especially during the dialogues, there were 150 referrals to the OSCs.

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 Kabwe, Kapiri Mposhi, Ndola, Kitwe, Chingola, Chipata, Lusaka and Livingstone districts. Coordination meetings and activities such as community dialogues are being core-chaired with DREAMS partners in creating awareness and demand creation for DREAMS initiative. A total of 85 girls were referred to DREAMS for layered services. There were 39 and 46 for Chipata and Chingola respectively. Plans are underway to partner with organizations such as Pact, Peace Corps, ECR to map out improvement in the referral system.

Sub IR 3.3 Quality post-GBV services for children, adolescents and adults at OSCs with strengthened referral networks for other GBV services.

The project through Lifeline/Childline Zambia provided psycho-social counselling services, guidance and referral services. These services were provided to abused children, women and the concerned in the communities as response to high GBV as well as violence against children. Please see tables below with details on the calls received. GBV counselling

Case category March April May June Total Age 18+ M F M f M f m f Physical violence 109 138 72 104 88 155 122 192 980 Sexual Violence 7 89 13 39 22 72 11 96 349 IPV 32 143 61 122 102 138 83 171 852 148 370 146 265 212 365 216 459 2,181

Case category March April May June Total Age ≤ 18 M F M f M f m f Physical violence 53 36 79 51 66 72 85 103 545 Sexual Violence 22 62 13 49 18 56 33 87 340 IPV 3 15 7 19 17 29 11 39 140 78 113 99 119 101 157 129 229 1,025 Table 6- GBV counselling

HIV/AIDS Counselling

Case Category Gender March April May June Total

HIV & AIDS Prevention Male 172 126 189 111 598

HIV & AIDS Prevention Female 103 181 129 142 555

Access to Medication Male 123 117 142 161 543

Access to Medication Female 151 176 167 192 686

Information about AIDS Male 212 321 289 302 1,124

Information about AIDS Female 183 122 315 338 958

Grand Total 4,464

Table 6- HIV/AIDS Counselling

The calls are related to those who call on their own behalf and on behalf of others. The variation in calls per month are due to basic awareness which are not yet being conducted especially in the target districts. The number of calls is expected to increase once awareness raising activities starts. LifeLine/ChildLine Zambia is currently upgrading the system, this has affected the number of calls being taken as only a few lines using handsets are working. This has resulted in a high percentage of dropped calls. The project is currently working on the development of the referral system. The ToRs for this activity are being developed and will be concluded in the next quarter.

IR 3.4 GBV Survivor Support: Increased availability and timely uptake of quality GBV services by GBV survivors.

As mentioned above, due to short period of implementation, only few activities were conducted under this result area. The OSCs continued to provide post GBV care services. A total of 481 survivors received post GBV clinical care as per table below.

Districts Physical Sexual Emotional HIV Negative HIV PEP Violence Violence Violence Positive Completed

Kafue 266 71 109 290 62 55

Nakonde 133 6 185 267 9 22

Chibombo 399 77 294 71 77 -

Mongu 650 62 244 41 24

Livingstone 136 288 635 30 276

Choma 402 17 349 40 41

Kalomo 91 53 - 12 -

Total 2,077 574 588 1,856 271 418 Table 7- Post GBV Clinical Care More activities under this result area will be implemented in the next quarter which among them includes Multidisciplinary trainings for Police, Medical personnel and other service providers.

Objective 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.

IR 4.1: 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 service providers to implement GBV laws and manage GBV cases.

IR4.1.1: A Pre - assessment of Gender Based Violence (GBV) service providers conducted

As part of the project’s approach to build the capacity of GBV health and psychosocial service providers to implement GBV laws and manage GBV cases, a pre – assessment of the GBV service providers was planned. This will assess the knowledge and skills of the GBV care providers. The Terms of References (TORs) for the assessment were developed and are awaiting approval by USAID. This will be conducted in the next quarter.

IR 4.1.2. Review of the In-service curricula for health care providers and psychosocial counselors

The project through WiLDAF engaged the MoH on the review of the in–Service Curricula for the health care providers and Psychosocial Counsellors to include GBV and its management. MoH highlighted that it has four other curricula on GBV, which are Pre - Service Curricula

namely: Enrolled Nurses Curriculum, Registered Nursing Curriculum, Public Health Curriculum for Public Health Nurses and the Medical Curriculum. The project will continue to engage MoH so that these documents are reviewed in the next quarter.

Sub IR 4.2 Strengthened capacity of legal and law enforcement personnel to implement laws and policies related to GBV and gender equality.

IR 4.2.1. Establish links with the Paralegal Alliance Network (PAN) During the period under review, the project established links with Paralegal Alliance Network (PAN) which facilitated timely identification of the paralegals that were trained through the Technical Education, Vocation and Entrepreneurship Training Authority (TEVETA).

The Legal Aid Board11 (LAB) appointed WiLDAF and PAN as the only CSOs to be part of the Technical Working Group that is reviewing the Legal Aid Act, Chapter 34 of the Laws of Zambia. This will enable the accreditation of the paralegals, including the paralegals on the project to the Government structure and enable a law that will provide for access to justice for victims of GBV

IR 4.2.2. GBV OSC Paralegals recruited The project is in process of recruiting paralegals. This process will be concluded in the next quarter. Given the recommendations from the community leaders, some paralegals currently working in the OSCs on purely voluntary basis may need to be taken on by the project. This means the project may have to cover costs for their certification as they have demonstrated sustainability.

IR 4.2.3. Synergies with legal Practitioners to prioritise pro bono cases capacitated As a startup activity on this result area, the project through WiLDAF participated in the Technical Working Group on reviewing and amending the Legal Aid Act. Some key outcomes of this meeting were that; • LAB was engaged on the zoning of paralegal services. • The meeting agreed that LAB will supervise all the Paralegals in accordance with the provisions of the Legal Aid Policy. • Once the paralegals are recruited and WiLDAF is accredited as a CSO to the LAB, the lawyers under the LAB can be engaged to supervise the paralegals. The process has started but not concluded until the Paralegals have been re- oriented

Sub IR 4.3 Increased congruence of customary law with national law regarding GBV and gender equality.

IR 4.3.1: ToT for Traditional and Community Leaders on the Concepts of Gender and GBV WiLDAF gathered community leaders in Lusaka district from the 24th – 25th June, 2019 to share information on GBV and related laws. The participants included section/ward chairpersons, teachers, Religious Leaders and Youth Leaders from Chawama, Kanyama,

11 The Legal Aid Act provides for the granting of legal aid in civil and criminal matters and causes persons whose means are inadequate to engage practitioners to represent them; hence enhancing the provision of legal aid services.

Matero and Chilenje communities. The participants were selected through the Local Council under the office of the Town Clerk. The training aimed at improving access to justice for the adults and children survivors of GBV; increase GBV knowledge and its related laws among the community leaders; ensuring retention and application of knowledge gained by the trained cadres to the communities under their leadership; strengthening capacity of Community Leaders in GBV case management and effective implementation of laws. A total of 14 Community Leaders were engaged during the two-day training. The immediate outcomes of the meeting were: • Identification of the roles that community leaders will play in the fight against GBV. • Commitment by the 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. The training did not include the traditional leaders as WiLDAF was advised by MoCTA that Lusaka district does not have traditional leaders and this was spelt out by the city boundaries. Following the training, the project will support the trained cadre of community leaders to conduct sensitisations in their respective communities.

Sub IR 4.4 Strengthened laws, policies, and implementation regarding GBV, gender equality and female empowerment by national and local traditional structures.

IR 4.4.1. Conduct advocacy and lobbying meetings with the line government agencies on the effective operationalization of the GBV Committee

The project conducted advocacy and lobbying meetings with the Ministry of Gender (MoG) on the effective operationalization of the GBV Committee12. During the meeting, it came to light that the tenure of office for the committee members came to an end two years ago. The Minister has since been engaged on the revised TORs for the appointment of the committee for approval to enable the appointment of the new committee members and the operationalisation of the GBV Committee.

IR 4.4.2. Conduct consultative meetings with line government agencies on the current state of the Anti-GBV Act, the Gender Equity and Equality Act and other gender related Acts

The project engaged the MoG on the current state of the Anti – GBV Act and it was highlighted that the Anti – GBV Act is currently going through some reviews although the process halted a few months ago due to lack of funding to support the process. The review is being spearheaded by the Zambia Law Development Commission (ZLDC).

12 The Committee’s mandate is to monitor the activities of all the relevant institutions on matters connected with GBV; make recommendations for a national plan of action against GBV; monitor and report on the progress of the national plan of Action; advise the Minister on policy matters connected with GBV; propose and promote strategies to prevent and combat GBV; recommend guidelines for disbursements from the Fund; and deal with any matter relating to GBV.

The project is advocating for the move of the mandate for GBV Fund management from the Ministry of Community Development and Social Services (MCDSS) to MoG. MoG is currently the ministry mandated to deal with GBV programmes.

IR 4.4.3. Conduct advocacy meetings with the Ministries of Justice and Gender on the operationalization of the Gender Equity and Equality commission

The project engaged MoG on the operationalization of the Gender Equity and Equality Commission13. The structure and functions of the Commission have been worked on but awaits approval from the Minister then thereafter, Cabinet will need to approve.

Project Monitoring and Data Quality During the period under review, the monitoring was done mainly on the programmatic aspects. The monitoring was conducted in all the districts with the aim of mentoring the newly recruited community volunteers. The focus of the project M&E activities was to ensure the quality documentation which resulted in the strengthening of the following: - 1. Development and revision of data tools. 2. Consolidation, cleaning, analysis and reporting of data from the districts. 3. Continuous support to the programme staff on data quality issues. The M&E Department is almost at full capacity. The focus for the next quarter will be to conduct DQA in all the districts.

Challenges Below are the challenges and how they would be addressed.

Challenges How they have been Addressed Late approval of workplan and implementation The project embarked on rapid implementation has affected attainment of targets for the of activities. quarter and quality may be compromised.

There has been transport challenges The project has budgeted to procure motor at district level. This has affected coverage of bikes for project staff in year 2. activities. Lack of print materials for distribution to The project is working on developing the IEC communities and partners. materials but these materials will need to be pretested. This will happen in year two.

13 The Committee’s mandate shall be to ensure, in liaison with the Ministry responsible for Gender, that gender equality and equity is attained and mainstreamed in public and private affairs and structures; monitor, investigate, research, educate, lobby, advise and report on issues concerning gender equity and equality; recommend, to appropriate authorities, any measures that need to be taken to ensure gender equity and equality; and take steps, in liaison with appropriate authorities, to secure redress for complaints relating to gender equity and equality.

Inadequate supply of test kits and condoms. An agreement was made with Medical Store Limited (MSL) to allow project to access the kits at district level. Where kits are not available, the project will support transport to collect these from MSL. Capacity gaps among the community The project will train and certify all community volunteers volunteers as a way of building capacity in them. Victims keep requesting the courts/police to There is need 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. SRHR services for adolescents in schools, The project will advocate with both ministries there is still a controversy in terms of policy on how they can complement each other. between the MoGE and the MoH. The MoGE only allows for information dissemination to the learners but not service provision. Most teachers felt that not until these two policies are harmonized, we will continue to experience the challenge of SRHR services for the learners.

With the implementation of ZESCO load The project is in the process of procuring back shedding, the call Centre for up handsets and a genset. LifeLine/ChildLine has been affected due to power cut.

Lessons Learnt

• There are a lot of knowledge gaps and myths surrounding HIV in the communities. For example, during some dialogues conducted in Mufulira district, some participants were of the view that HIV positive clients who adhere to medication become negative again.

• The lesson from the meetings with the community leaders is that addressing GBV requires capacity building of key focal point persons who influence further engagement with their communities. • Engaging key stakeholders at project inception results in project support during implementation and sustainability beyond the project.

Recommendations

• Partner Collaboration: There is need to maximize resources by leveraging with like-minded partners. • Continuous Community engagement: In order to sustain behavioral change in the community, there is need for continuous community involvement and engagement.

List of Upcoming Events Plan for the next quarter - July to September 2019 Activity Implementation Partner Period 1. Quarterly project review meeting 12th -16th Aug All (led by ZCCP) 2. DQAs Aug/Sep All (led by ZCCP) 3. Stakeholders meeting at the Kuta in July/August Barotse Royal Western Province Establishment 4. Kulamba Traditional Ceremony of 25th August 2019 Kulamba the Chewa People 5. SASA! trainings for 5 new districts August/September All (ZCCP) and refresher for 11 6. HTCT Day 16th August All