PSI/Zambia was established in 1992 to empower at-risk and underserved Zambians to lead healthier lives in line with the Government of Zambia’s health priorities. PSI/Zambia’s current portfolio contains programs in HIV/AIDS, reproductive health, malaria, safe water.
In 2009, PSI/Zambia estimates that it averted more than 118,000 unwanted pregnancies, more than 922,000 episodes of diarrhea and more than 1,628,000 cases of malaria.
SFH relaunched Maximum male condoms as Maximum Classic and Maximum Scented in 2004. Scented condoms play a critical role in providing choice and encouraging non-users and lapsed users to adopt the use of condoms and they provide cost recovery. SFH is the key organization focusing on sales and marketing activities for the female condom in Zambia. Care is distributed through several channels, including pharmacies, drug stores, hair salons, barbershops, and VCT centers and in partnership with nongovernmental organizations.
Voluntary Counseling and Testing (VCT)
In 2002, SFH began offering VCT services by opening a New Start center in downtown Lusaka. New Start now operates fixed sites in Kitwe, Chipata, Mansa, Solwezi, Ndola, Livingstone and two sites in Lusaka, as well as nine mobile VCT units. Together these sites counsel and test over 10,000 clients per month. SFH will launch a mass media campaign in 2009 to encourage couples to seek VCT services.
Voluntary Medical Male Circumcision
Clinical trials in South Africa, Uganda and Kenya estimate that a circumcised man is approximately 60 percent less likely to contract HIV than an uncircumcised man. Since 2007, SFH has offered male circumcision services through a combination of fixed sites, private sector franchises and mobile MC services through government hospitals and rural health centers.
Oral Contraceptives and Injectables
SFH’s portfolio comprises of MyChoice Microgynon oral contraceptives, MyChoice Injectable contraceptives, and SafePlan oral contraceptives. SFH assures the re-supply of both MyChoice products using a cost-recovery model. SFH works with private and public sector service providers as well as community-based distributors and health communications partners to improve the availability of contraceptive products.
SFH seeks to improve reproductive, maternal and child health through improved access to and use of long-term family planning methods. Over the next few years, SFH will improve access to and use of IUDs and implants by supporting overburdened urban and under-supported rural MOH clinics, piloting immediate post-partum IUD insertion in collaboration with UTH and MOH, and improving the quality and range of RH services offered by private providers.
Prevention of Post-Partum Hemorrhage
Post-partum hemorrhage is the leading cause of maternal deaths in Zambia. Most deliveries take place at home or in a rudimentary clinic that does not have sufficient trained staff, drugs or equipment to deal with the post-partum hemorrhage that contributes to 34% of all maternal mortality. Conclusive field studies have proven that a three-pill dose of the drug misoprostol, given to a woman immediately after she delivers, will significantly reduce PPH incidence. In addition to implementing its own PPH intervention, SFH will support the MOH’s pilot PPH prevention program.
SFH partners with the National Malaria Control Center in a nationwide project to distribute Mama Safenite LLINs in an effort to prevent malaria. As a national implementer of the Malaria in Pregnancy program, SFH has rolled out the program to all nine provinces. The program is managed throughout District Health Management Team centers and then through ante-natal clinics at district and ward levels, making free nets easily accessible to pregnant women and children under five.
Contaminated water is a leading cause of diarrheal disease in Zambia, where only 64 percent of the population has access to safe drinking water sources. Among children under five, 21 percent have had diarrhea in the past two weeks, regardless of water source or location. Mortality among children under five is particularly high, as attempts to rehydrate children, usually with more contaminated water, often fail. SFH launched Clorin in 1998 to protect low-income Zambians from contaminated water. Clorin is an inexpensive and simple-to-use household water treatment – a sodium hypochlorite disinfectant developed by the U.S. Centers for Disease Control and Prevention. To date, the program has sold or distributed over 17 million bottles of Clorin, each of which protects a family of six for a month.
Products and Services
- Maximum condoms since 1992, with a 2004 relaunch as Maximum Classic
- Maximum Scented condoms since 2004
- Trust Studded male condoms since 2008
- Care female condoms since 1997, with a 2008 relaunch
- New Start voluntary counseling and testing (VCT) since 2002
- Male Circumcision since 2007
- SafePlan oral contraceptives since 1996
- MyChoice Microgynon oral contraceptives since 2007
- MyChoice Injectable since 2009
- Long-Term Method (IUD and Implant) service delivery since 2008
- Circle of Friends interpersonal communication (IPC) initiative since 2005
- Misoprostol for the prevention of post-partum hemorrhage since 2009
- Mama Safenite long lasting insecticide treated nets (LLINs) since 2001
- Clorin safe water system since 1998
- GoGo reading glasses since 2007
- Launch of MyChoice IUD
- Launch of MyChoice Implant
- Launch of MisoSafe misoprostol
- Launch of Diarrhea Treatment Kits (ORS/Zinc)
- U.S. Agency for International Development
- The Global Fund To Fight AIDS, Tuberculosis and Malaria
- President’s Emergency Plan for AIDS Relief
- Bill and Melinda Gates Foundation
- Global Women’s Health Project
- Zambian Ministries of Health and Education
- National AIDS Council
- National Malaria Control Center
- University Teaching Hospital
- Mwami Adventist Hospital
- Luapula Foundation
- Youth Alive
- Development Aid from People to People
- Comprehensive HIV/AIDS Management Program
- Zambia Health Education Communications Trust
- Health Communications Partnership
- Centre for Infectious Disease Research in Zambia
- Community-based NGOs such as CARE, Catholic Relief Services and Neighborhood Health Committees
- Expanding Access to HIV Self-Testing: A Market Development Approach
PSI envisions a healthy market for HIVST to be one that is supported by multiple buyers and suppliers and that delivers on the 5As (Availability, Assured Quality, Appropriate Design, Awareness, and Affordability) to achieve public health goals. Realizing this vision for the HIVST market will require consideration of two key markets- public and private sectors. While HIV testing has traditionally been driven by the public sector, HIVST opens up the possibility of utilizing private sector pharmacies to expand and extend the reach of testing.
- MSI Experiences of Task Sharing Tubal Ligation by Clinical Officers in Zambia and Uganda
Task-sharing is needed in Zambia to increase access to permanent FP methods by addressing the shortage of health providers who are able to provide
tubal ligations, especially in rural areas, reducing the burden on the doctors and hospitals, and making use of existing healthcare providers through affordable, in-service training. The Zambia study aimed to show that clinical officers can feasibly provide tubal ligation in Zambia, with similar rationale for the Uganda tubal ligation task-sharing study.
- Understanding Couple Communication and Family Planning in Zambia: Formative Research Study Findings and Recommendations
This report summarizes the results of a formative research study on the role of couple communication in family planning within the context of child marriages in Zambia.
- Effectiveness of an Electronic Dashboard for Supervising and Monitoring Community Health Workers (CHWs) to Scale-Up Voluntary Medical Male Circumcision (VMMC) in Zambia
The use of CHWs is a proven method for creating demand and promoting best practices for health services; however while effective, supervision of CHWs has also proven to be the most challenging program element to implement. To address this gap, Society for Family Health (SFH) designed and implemented an electronic dashboard tool with the aim to better evaluate, monitor and provide feedback on the performance of CHWs at health facilities under the Efficient, Effective and Innovative MC Service Delivery program (EEIMC).
- Evaluating Opportunities for Achieving Cost Efficiencies Through the Introduction of PrePex Device Male Circumcision in Adult VMMC Programs in Zambia and Zimbabwe
This study evaluated the cost drivers and the overall unit cost of voluntary medical male circumcision for a variety of service delivery models using current program data in Zimbabwe and Zambia.
- Safety and Efficacy of the PrePex Male Circumcision Device: Results From Pilot Implementation Studies in Mozambique, South Africa, and Zambia
This paper describes the results of pilot implementation studies conducted in Mozambique, South Africa, and Zambia to assess the safety of male circumcision procedures conducted by nurses and clinical officers using the PrePex device.
- Women’s Perceptions and Misperceptions of Male Circumcision: A Mixed Methods Study in Zambia
This mixed methods study conducted in Zambia explores the perceptions of women of male circumcision.
- Integrating Cervical Cancer Screening Within Family Planning Service Provision in Peri-Urban Zambian Setting
In Zambia, cervical cancer (CACX) screening was introduced in 2006. Since then over 189, 000 women have been screened for CACX. While incidence and mortality rates of cervical cancer have fallen significantly in developed countries, 83% of all new cases that occur annually and 85% of all deaths from the disease occur in developing countries. Family planning (FP) services in Zambia have traditionally been offered routinely in maternal and child health (MCH) settings. The Society for Family Health (SFH) provides FP services using a dedicated provider model in high volume public sector health facilities since 2008. The model emphasises long-acting reversible contraception (LARC), while assuring method choice.
- Market Trends for Malaria Blood Testing in Sub-Saharan Africa, 2009-2014
In 2012, the World Health Organization (WHO) launched the Test, Treat, Track initiative recommending confirmatory testing prior to antimalarial treatment. National malaria control programs (NMCP) across subSaharan Africa (SSA) subsequently aligned national guidelines with this recommendation. Strategies to scale up testing using malaria rapid diagnostic tests (mRDT) were introduced by NMCPs. We examine malaria testing availability, price and market share using national market survey data collected by the ACTwatch project.
- SP Availability and (Mis)Use in Sub-Saharan Africa: Antimalarial Market Data From 8 Countries
As evidence of reduced chloroquine efficacy against plasmodium falciparum mounted in the 1990’s, sulfadoxine-pyrimethamine (SP) became first-line malaria treatment in many endemic countries in sub-Saharan Africa (SSA). Between 2002-2005, countries in SSA adopted artemesinin combination therapies (ACT) as first-line treatment. SP is still recommended by the WHO and used across SSA for intermittent preventive treatment of malaria during pregnancy (IPTp). We examine availability and distribution of SP using national antimalarial market survey trend data collected by the ACTwatch project.