Because TB-HIV co-infection is such a huge problem in Zambia, it makes sense to tackle these conditions together. TB Alert’s Community TB-HIV Advocacy in Zambia (COTHAZ) project ran from 2010 to 2014, and involved seven local NGOs working across six areas of the country, to raise awareness of TB-HIV. The project was funded by the Department for International Development and reached over 6 million people in the Kabwe, Katete, Luanshya, Masaiti, Lusaka and Kitwe districts.
The COTHAZ project worked at three levels:
- community TB awareness raising
- local advocacy for better TB services
- national government engagement to secure funding and support for improved TB services.
Local awareness raising
COTHAZ raised local community awareness of TB through outreach visits by trained project volunteers. Many of these volunteers had TB, and are living with HIV, so they were able to show people firsthand that TB and HIV can be successfully treated.
As part of their training, the volunteers were given current medical information about TB and HIV to help them counter the many myths that surround TB. They were also trained to help people identify symptoms, and to refer suspected cases for further testing.
Staff and volunteers worked with religious and local leaders to make sure each COTHAZ activity met the needs of the community. Film, drama and music were used to convey complex messages in an engaging way to a population with low literacy levels.
Combining door-to-door visits and group discussions gave people the opportunity to discuss their concerns privately, whilst creating a more tolerant environment by breaking down taboos. In areas that were too remote for volunteers to easily visit, radio broadcasts reached large numbers of people.
A COTHAZ volunteer helped save Patrick Mubanga’s life.
Championing better local services
Through their community outreach work, COTHAZ staff and volunteers gained valuable insights into the issues local people face in accessing and using TB services. The project provided training in advocacy for staff and volunteers, enabling them to represent these communities at local government level to seek better TB services. They advocated for improved conditions in local clinics, including adequate staffing and effective infection control. Improved ventilation, for instance, made it less likely for TB to be passed on in the busy waiting rooms of clinics, like the one in Kamitondo.
Find out how local advocacy helped patients at Kamitondo Clinic.
Engaging with national government
COTHAZ led a growing network of TB-HIV non-governmental organisations to urge the national government to make funding for TB prevention and treatment a priority. To achieve this, COTHAZ participated in ministerial meetings with the government. It also produced media campaigns and public petitions to generate wider support for the cause. For instance, COTHAZ called for better access to isoniazid preventative therapy for people living with HIV, to reduce their risks of developing TB.
During the project, COTHAZ reached:
- 5.9 million people through radio programmes
- 102,475 people through door-to-door awareness raising and cultural activities
- 1,109 local leaders and health stakeholders with TB training