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 is focused on supporting the national public health strategic agenda with programs that reduce the HIV/AIDS prevalence rate through HIV prevention initiatives, improving access to family and reproductive health services, and increasing maternal and child survival through social marketing, to promote quality products and healthy behavior practices.
PSI/Zambia estimates that in 2015, its products and services helped avert 289,282 DALYs, including, by health area:
- 229,431 HIV DALYs
- 56,526 FP DALYs
- 3,326 WASH DALYs
PSI/Zambia’s family planning programs also provided 142,878 couple-years protection.
HIV/AIDS
Society for Family Health (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 female condoms in Zambia. The Maximum Diva woman’s condom is distributed through several channels, including pharmacies, drug stores, hair salons and barbershops.
Voluntary Medical Male Circumcision (VMMC)
In 2007, SFH used unrestricted seed funding to demonstrate the feasibility of scaling-up the provision of VMMC services through public-private partnerships. Between 2009 and 2015, additional funding enabled the program to grow, supporting 185,477 males. This resulted in over 60% circumcised males countrywide. Currently, the focus has shifted to the most impactful age group, which is the 15 to 29 year age bracket. SFH has been using innovative methods of demand generation to reach this targeted population.
HIV counseling and testing: From 2009 to 2014, SFH operated 10 static and several outreach sites across ten provinces in Zambia. This was under the SFH-owned franchise, New Start, to generate demand for HIV testing services. New Start also developed campaigns aimed at encouraging couple counselling which led to more than 1 million people being tested. In 2015, SFH introduced HIV self-testing (HIVST) in Zambia as a pilot to generate crucial information on how to distribute HIVST products effectively, ethically and efficiently.
Reproductive Health and Family Planning
SFH has provided 10.5 million SafePlan and MyChoice oral contraceptives, as well as increased advocacy for long-acting reversible contraception and integrated service delivery from 2009 to date. This was achieved through direct provision of services in private stand-alone clinics and using our dedicated provider model in public settings. Since 2015, a total of 534 community based distributors have been trained on family planning service provision including injectables. Recognizing the increase in pregnancies and HIV amongst adolescents, SFH has repositioned itself to provide adolescent-friendly services.
Malaria
From 2009 to 2014, SFH partnered with the National Malaria Control Center in a nationwide, USAID-funded project, to distribute Mama Safenite long-lasting insecticide nets (LLIN). As a national implementer of the Malaria in Pregnancy program, SFH rolled out the program to all ten provinces. The program was managed throughout district health management team centers and then through antenatal clinics at district and ward levels, making free nets easily accessible to pregnant women and children under five.
Safe Water
In 1998, SFH launched a water treatment solution branded as Clorin. Today this brand is a nationally recognized product used for household water purification. From its launch to date, SFH has distributed 15.1 million bottles; using social marketing across the country and treating over 9.8 billion liters of water for the prevention of diarrheal diseases. SFH sits on the disaster management unit to facilitate the prevention of waterborne diseases such as cholera in vulnerable locations in Zambia.
Condom and Social Marketing
SFH works through private, public and non-governmental channels to increase access to HIV prevention products and services. Since 2009, SFH has worked to strengthen HIV awareness, and increase correct and consistent condom use. Over 129 million male condoms and 1.9 million female condoms have been distributed so far. SFH male condom brands include Maximum Classic, Maximum Scented and Maximum Combat. SFH recently launched the new woman’s condom which is branded Maximum Diva.
Products and Services
- Maximum condoms since 1992, with a 2004 re-launch as Maximum Classic
- Maximum Scented condoms since 2004
- Trust Studded male condoms since 2008
- Care female condoms since 1997, with a 2008 re-launch
- 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 (intrauterine device or 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
- HIV self-testing since 2016
- Maximum Diva since 2016
Future Plans
- Launch of Sayana® Press (three month progestin-only, all in-one injectable contraceptive)
Donors
- U.S. Agency for International Development (USAID)
- United Nations Children’s Fund (UNICEF)
- The Global Fund to Fight AIDS, Tuberculosis and Malaria
- President’s Emergency Plan for AIDS Relief (PEPFAR)
- Bill & Melinda Gates Foundation
- Global Women’s Health Project
- United Nations Population Fund (UNFPA)
- Alere
- Swedish International Development Cooperation Agency (Sida)
- UNITAID
Partners
- Zambian Ministries of Health and Education
- National AIDS Council
- National Malaria Control Centre
- 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
- Zambia AIDS Related Tuberculosis (ZAMBART)
- Woman Care Global
- International Center for Research on Women
- Child Fund
- Expanding Effective Contraceptive Options in Zambia and Malawi: Understanding the Consumer
Expanding Effective Contraceptive Options (EECO) is a USAID-funded project led by WCG with PSI and other partners to support the introduction of new contraceptive and dual protection methods. This case study presents EECO’s analysis of consumer insights and market data to develop a marketing strategy for the Woman’s Condom in Malawi and Zambia. - Costs of Facility-Based HIV Testing in Malawi, Zambia and Zimbabwe
We sought to explore the costs of providing these services across three southern African countries with high HIV burden. Primary costing studies were undertaken in 54 health facilities providing HIV testing services (HTS) in Malawi, Zambia and Zimbabwe. The mean cost per individuals tested was US$5.17 in Malawi, US$4.24 in Zambia and US$8.79 in Zimbabwe. The mean cost per HIV-positive individual identified was US$79.58, US$73.63, and US$178.92 in Malawi, Zambia and Zimbabwe respectively. Both cost estimates were sensitive to scale of testing, facility staffing levels and the costs of HIV test kits. - Do anti‑malarials in Africa meet quality standards? The market penetration of non quality‑assured artemisinin combination therapy in eight African countries
This paper uses national and sub-national medicine outlet surveys conducted in eight study countries (Benin, Kinshasa and Kantanga [Democratic Republic of the Congo, DRC], Kenya, Madagascar, Nigeria, Tanzania, Uganda and Zambia) between 2009 and 2015 to describe the non-QAACT market and to document trends in availability and distribution of non-QAACT in the public and private sector. - Shaping the Family Planning Market by Strengthening the Public Sector
PSI considers total market approaches to be critical for achieving universal health coverage, especially when it comes to contraception. This program brief presents cases, supported by several different donors, which take into consideration the total family planning market. - 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.