OVERVIEW
The Strengthening TB, AIDS and Malaria Prevention Programmes (STAMPP) is a European Union funded programme that consists of targeting 900,000 members of resource-poor/vulnerable households through community mobilization, social marketing, research and practices such as good nutrition, psychosocial support, and the avoidance of infections like HIV, TB, malaria and STIs to increase human resource capacity against these epidemics. Working with government institutions, health professionals and identified community members, STAMPP is a five-year project implemented in Zambia through a partnership of three NGOs (Kara Counseling and Training Trust (KCTT), CARE Zambia and Zambia AIDS Related TB (ZAMBART) Project). The project covers six provinces in Zambia, these include: Central, Copperbelt, Eastern, Luapula, Lusaka and Southern.
STAMPP PARTNERS
The STAMPP partnership includes the following NGOs:
CARE International in Zambia came into Zambia in 1992, at the invitation of the Zambian government. Activities initially focused on emergency relief in response to the severe drought of the early 1990s, and on interventions to mitigate the effects of escalating inflation and extreme poverty in urban areas. The emphasis of programming has now shifted to long-term, community-based development encompassing several sectors including health, HIV/AIDS, economic development, local capacity building and education.
The Zambia AIDS Related TB (ZAMBART) Project is a Zambian NGO formed in 2004 from a collaboration between the University of Zambia’s School of Medicine and the London School of Hygiene and Tropical Medicine that spans more than 20 years. From the initial studies of the impact of HIV on the clinical presentation and outcome of tuberculosis, the scope and partnership of the research have expanded widely. ZAMBART staff form an interdisciplinary team with a range of expertise including epidemiology, clinical science, social science, laboratory, operations research, health systems and services research, health policy analysis, health economics, development communication and counseling.
ACTIVITIES
STAMPP focuses on the following activities:
Household Counselling (HHC) & Mobile Voluntary Counselling & Testing (VCT)
The collaborative TB/HIV package includes encouraging HIV testing; intensified TB case-finding and effective treatment for TB and sexually transmitted infections (STIs); preventive therapy against TB and other opportunistic infections and basic clinical care. Referral networks have developed between youth friendly programmes, programmes for the prevention of mother to child transmission (PMTCT), ART delivery programmes as well as with community based organisations providing ongoing support and care.
One of the innovative approaches introduced in this project is that of bringing collaborative TB/HIV services closer to individuals using mobile VCT, increasing the activities of treatment supporters and expanding household counseling. Household counseling utilises the fact that the family is the main support and decision making structure for an individual and allows for TB and HIV care to be conducted at household level.
Promoting behaviour change through community health education on HIV/AIDS, TB and malaria
All STAMPP interactions with communities provide a window of opportunity for promoting behaviour change. This applies equally to urban and rural communities as well as specific groups within these. The methodologies, techniques and approaches from previous work by the partnership in promoting behaviour change will be utilised when working in the communities targeted by STAMPP, i.e. primarily those with which one or more of the STAMPP partners is already engaging with through a complimentary activity.
Piloting the integration of TB screening in mobile VCT units
The project links previously trained household counselors with mobile VCT units to increase the number of people opting to test for both HIV and TB.
Strengthening and forming community-based support groups
STAMPP works with communities and households already involved in HIV/AIDS and TB programming across KCTT's, CARE and ZAMBART’s areas of operation. As these organization's expand to new areas, the communities are organized to form support groups for affected households. These support groups and volunteer networks promote treatment adherence, provide counseling, referral for treatment and psycho-social support.
Anti-Stigma Education
Running from 2007 through 2011, STAMPP’s Anti-Stigma Education programme has taken hold in STAMPP areas of operation. There are currently 27 anti-stigma Trainers of Trainers (TOT) and 249 anti-stigma facilitators trained throughout the country. The STAMPP Anti-Stigma Education programme has also broadcast features on radio programmes, held mini-workshops with community leaders, church groups, traditional leaders, youth groups, health workers and workplaces as well as focus group discussions and quiz shows on TB and stigma. Country-wide, 18,066 people have been reached during STAMPP TB Anti-Stigma sensitization activities.
Conducting research on gender barriers to timely health care
Gender and TB research has been carried out by ZAMBART through STAMPP and it consists of three components: (a) an epidemiological quantitative study; (b) a broader qualitative study looking at the perspective of Community TB Supporters on gender and TB at community level; and (c) an in-depth qualitative household study looking at factors affecting who gets ill, particularly with TB, and factors affecting responses to ill-health. The results of the gender research through STAMPP are now being analyzed.