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Family Health Trust - Zambia
   Last updated: 16.08.02
Implementers
The Family Health Trust (FHT) is a Zambian NGO dedicated to preventing the spread of HIV/AIDS while offering care and support to those already affected. The group was formed in 1987 and focuses most of its efforts on programmes for young people.

The Anti-AIDS Project was established in 1987 as a one-person operation and has since expanded to include 9 full-time staff and 77 part-time community-based peer educators. Students themselves at David Kaunda Secondary School generated the idea of an Anti-AIDS club after hearing a talk by a doctor about HIV/AIDS.

Students who are trained as peer-educators lead the Anti-AIDS clubs and are supervised by adult facilitators under the direction of Zonal Co-ordinators and a central office.

Background
The HIV/AIDS epidemic has had a particularly devastating effect on children living in Africa. Many have been left orphans. They are especially vulnerable since the communities that traditionally provided support have also been weakened. There is also an alarming increase of new infections among young people.

The decision to scale up the Anti-AIDS Club programme was based on the need to educate young people about the spread of HIV/AIDS and empower them to take control of their own lives. The success of the original programme and the growing desire among young people to take positive action prompted FHT co-ordinators to expand the project.

The specific objectives were to reach more young people by building Anti-AIDS clubs throughout the country.

Objectives and main activities
The clubs rely on peer-educators to promote interactive learning through the use of role-playing, focus group discussions, games and individual discussions.
The objectives of the scaling up were:
• To intensify outreach to non-members and to retain interest among existing members.
• To develop effective new educational materials.
• To consolidate the field support to the clubs through a programme of training and supervision based on the development of Regional Co-ordination and Zonal Leaders.

Resources and timeframe
The peer education approach has proved the most effective way of reaching young people. The adult facilitators are volunteers, either teachers or leaders of church, youth or community groups. They co-ordinate club activities with the Anti-AIDS Project and ensure that the clubs are registered. They act as a link between the school administrations and the clubs and help club members develop action plans. They may also help develop links between the clubs and other local or government organisations.

The FHT central office provides training to Regional Co-ordinators at least twice a year. It also encourages participation in workshops organised by collaborating organisations.

FHT receives funding and other resources for all its programmes from NORAD, CIDA-SAT, UNICEF and Christian Aid, HIVOS, and the World Food Programme.
Funding is given on a three year contract for NORAD and a one year contract for CIDA-SAT and UNICEF. These contracts are renewable depending on satisfactory performance of the projects. The Peer Education Programme receives funding mainly from UNICEF and CIDA-SAT. Christian Aid funds the production of IEC materials.

Outputs/outcomes
There are now 2,561 clubs registered with the Anti-AIDS Project. 45% of the clubs are in Primary/Basic and Secondary /High Schools, 43% are serving out of school youth and young adults and 12% are in community schools.

Internal organisational implications
An increase in community participation has strengthened the sense of community ownership.

Since peer-educators are paid per diem, the budget has been stretched to supply educators to all the new clubs.

New clubs are often widespread within zones, especially in rural areas, so Zonal Co-ordinators find it difficult to reach them all, as they travel primarily on bicycles.

The growth of the Peer Education Programme has always depended on the willingness of the donors to increase the funding to enable increased coverage. However, there has been an extension each year since 1995 when the programme was initiated. The number of active clubs has increased from 251 in 1995 to 717 in the year 2000. The programme has also grown from one to three regions in the country.

Evaluation
Because the Anti-AIDS clubs were a new programme, there was little upon which to base an initial evaluation. Since the scaling up began, FHT has seen an increase in community participation. More young people are involved in the initiation and formation of new clubs. There has been in increase in the variety of educational activities, and in youth participation of the club newsletter. More young people now report to health centres for screening and treatment of STDs. There is more direct support given to orphans and other vulnerable children by Anti-AIDS clubs. For instance, in Kasusu, 22 orphans are being supported by income generated through club activities. It is difficult to determine how much funding the clubs generate because they are not accountable to the project for this activity. The project only monitors the performance of these programmes and ensures that they are running effectively and at an acceptable standard.

Lessons learned
• Peer education is an extremely effective way to educate young people about ways to prevent HIV/AIDS.
• Continued support is needed after clubs are formed, to maintain activities and prevent boredom.
• It is difficult to organise out of school youths because there are no monetary rewards.
• There are other clubs that offer material incentives that lure young people away.
• Gender imbalance remains high in the clubs, with more boys than girls on average.
• Community involvement is essential.

Source: A Question of Scale
This is an extract from A Question of Scale: The challenge of expanding the impact of non-governmental organisations’ HIV/AIDS efforts in developing countries,
by Jocelyn DeJong, published by the Horizons Project of the Population Council with the International HIV/AIDS Alliance in 2001. To view the whole report follow this link.

To download, complete with graphics, in pdf format (which requires Adobe Acrobat software to read it) follow this link (file size 1.43 Mbytes).