Catalytic Project Initiative for Scaling up Access to CT, ART, Care and Prevention for People with Disabilities in Zambia – VCT for People with Speech and Hearing Disabilities

Problem statement

People with Disabilities (PWD), especially those with speech and hearing disabilities (i.e. the deaf) have inadequate access to HIV and AIDS intervention services in Zambia.

A survey[1] carried out by Disability HIV and AIDS Trust (DHAT) in October and November 2007 involving Zambia Federation of the Disabled (ZAFOD), Zambia Association of the Deaf, Zambia National Association of Women with Disabilities (ZNAWD), Disacare, Zambia Association of the Blind, among other disabled people’s organisation (DPOs) established that people with disabilities face many challenges and limitations in accessing interventions for HIV and AIDS. For example, most Counselling and Testing (CT), Anti-retroviral Treatment (ART) and other services are offered in physical infrastructures and presentations that are not accessible to the blind and people with physical disabilities. People with deaf and speech disabilities (the deaf) can hardly access CT, PMTCT and ART services due to communication barriers between them and service providers. In acknowledging the inadequacy of HIV and AIDS intervention services to meet the needs of PWD who constitute about 10% of the Zambia population[2] the former Health Minister Brig Gen Dr Brian Chituwo pointed out that AIDS Service Organisations (ASOs) and other implementers had not made sufficient efforts to both alert policymakers and resource providers as well as provide such services.     


This project, therefore, seeks to respond to the above problem.

The goal of the project is “to Scale up access to HIV and AIDS intervention services for People with Disabilities in Zambia”

Objectives, Activities and Results

Objective 1: To establish 4 Counselling and Testing (CT) centres – in Lusaka (2), Livingstone (1) and Kitwe (1) – specialising in providing services for the deaf, other PWD and the general public by August 1, December  31, 2009 and March 31 respectively.

Each of the centres will offer VCT to the deaf and other PWD (estimated to be more than 20 persons monthly) and the general public (at least 100 persons monthly). The centres will also provide Information, Education and Communication (IEC) materials in Braille as well as other disability-specific information needs in relation to HIV and AIDS. In addition to offering required services to people with special needs, this rights-based intervention will also play a role as a catalytic project that will seek to encourage other service providers (both state and non-state organisations/institutions) to start or scale up such interventions for the deaf and people with other disabilities. The CVT services will serve the role of an entry point for ART, PMTCT as well as other related care and support interventions, all of which will be resource mobilised for and ultimately established.

Implementing Partners

The project will seek to and work closely with the MOH, NAC structures especially DATFs and PATFs, ZNAN, ASOs as well as civic and traditional leaders at local levels.

Implementers comprise 3 Partners

  • Frontline Development Trust (known as Frontline, in short): A local Non Governmental Organisation (NGO) providing comprehensive HIV and AIDS interventions in Lusaka, Chibombo and Kaoma (about to start). The head office of Frontline is located on 28 Eucalyptus Road, Old Avondale, in Lusaka. The management of the organisation have track record in providing leadership in HIV and AIDS intervention programming, particularly counselling, testing, prevention, care and support.
  • Zambia National Association of the Deaf (ZNAD):   The Zambia National Association of the Deaf (ZNAD) is a well-established Disabled People’s Organisation (DPO) whose head office is located in the populous compound of Kanyama in Lusaka. ZNAD has tens of thousands of individual members countrywide. Lusaka is estimated to have the greatest numbers of people with hearing and speech disabilities, hence ZNAD head office is well positioned.      
  • Disability HIV and AIDS Trust (DHAT) Zambia: Established in Zambia in June 2008, the organisation is part of DHAT regional operating in Botswana, Malawi, Zambia and Zimbabwe. Currently, DHAT Zambia is housed in within Frontline head office premises. DHAT promotes HIV and AIDS disability-sensitive and focused interventions. It advocates for interventions that promote disability transformation and increased participation of PWD. DHAT is an initiative of PWD, who know and have wide experience in disability work. DHAT Zambia is housed in the same premises as Frontline Development Trust, at 28 Eucalyptus Road, Avondale Lusaka. It is in its nascent.

Project Strategy

In order to provide service delivery, raise awareness and initiate advocacy for increased support and service delivery for disability sensitive (in general) and “deaf and dumb” (in particular) HIV and AIDS interventions in , the project will establish VCT facility for the deaf at 2 sites: 1 at Frontline and another at ZNAD, using existing personnel and facilities of ZNAD and Frontline. Currently DHAT Zambia does not have its own personnel and facilities. Besides providing service delivery, the Frontline site will also be the centre for training people with hearing and speech disabilities in counselling, while the ZNAD site will also be the centre for training counsellors in sign language. Having VCT facilities at each of the 2 locations will therefore ease practical training. DHAT Zambia, through DHAT Regional, will be requested to provide minimum funds to facilitate start-up and 6 months operation. During the first 6 months, Frontline as provider of technical support to the collaboration will scale-up resource mobilisation, aimed at sustaining the project services in Lusaka and scaling-up to Livingstone and Kitwe, as well as getting DHAT Zambia become resourced and firmly established. This project will therefore facilitate DHAT Zambia to become fully established and stand on its own.

The project will work closely with the Zambia Federation of the Disabled 9who have already expressed their commitment to the collaboration, the Ministry of Health, Ministry of Community Development and social Services, Zambia Disability Agency as well as other stakeholders such as community Based Rehabilitation Centres (CBRC), DPOs, and community groups. Through the broad-based networking, the project will scale-up sensitisation and mobilisation of PWD to access HIV/AIDS interventions, as well as bringing about effective advocacy. Through DHAT Regional and contacts of Frontline, the project will be involved in service delivery-focussed research locally and regionally in order to facilitate evidence-based programming.  DHAT Zambia and DHAT regional will provide disability related technical support to the project.

Besides providing personnel, Frontline and ZNAD will also provide office facilities as noted above. Frontline office will require some minor repairs and modifications in order to be disability friendly.   

Frontline VCT coordinator will be responsible for ensuring proper supervision and management of VCT services both at Frontline and ZNAD. The Executive Director of Frontline will be responsible for training of sign language communicators in counselling skills, while the ZNAN technical advisor will be responsible for training counsellors in sign language.

Project Activities

The project will carry out a number of activities such as (a) VCT service delivery (b) development and dissemination of IEC materials (c) Translating IEC/key information materials into Braille and dissemination of the same (d) ART and PMTCT support for PWD and (e) Research, Networking and Advocacy. However for the purposes of this application to DHAT to cover initial project operation, the project will dwell mainly on (a) training of counsellors in sign language (b) training Sign language communicators and people with speech and hearing disabilities in counselling (c) VCT service delivery. This will ensure a meaningful starting point. 

The activities of this catalytic Project Initiative will therefore be as follows:

  1. Training of Counsellors in Sign Language:During the period of July to December 2009 ten (10) people who already have counselling skills will be trained in sign language. These people will serve as a pool of VCT counsellors.
  2. Training of Sign Language Communicators and Deaf People in Basic Counselling Skills: During the period of July to December 2009 16 people (including sign language translators and at least 10 people with speech and hearing disabilities) will be trained in Basic Counselling skills.  These people will also serve as a pool of VCT counsellors for people with speech and hearing disabilities.
  3. VCT Service Delivery:the project will provide VCT services to people with speech and hearing disabilities. At any given time, each VCT centre will be staffed with at least 1 counsellor who is a sign language translator and another with speech and hearing disability.
  4. Exploration survey in Livingstone and Kitwe for Scaling up and Advocacy:The project will also undertake exploration visits to Livingstone and Kitwe for purposes of paving way for advocacy for disability sensitive HIV and AIDS interventions. Two (2) people will undertake the survey visits. The survey in these two locations, plus Lusaka where the project will already be operating, will provide a simple baseline for advocacy and scaling-up.  At the end of the survey, a comprehensive report will be prepared and shared with DHAT Regional, SAT and other stakeholders.
  5. Training Counsellors in HIV Rapid testing:All the 26 counsellors above will require to be trained in HIV Rapid Testing. The training will be conducted by the Zambia VCT Services, based at the University Teaching Hospital in Lusaka. This number of volunteers will provide realistic rota system, ensuring and bearing in mind the volunteers’ other time-commitments.

Monitoring and Evaluation: The project will monitor and collect data on monthly basis and provide reports to DHAT, Frontline and ZNAD on quarterly basis.  The data collection and reporting system shall be harmonized to suite donor requirements.

Estimated Project Cost The total cost for 2009 is estimated at K—million (about USD…). This includes costs for sign language counsellor training, establishment and providing service delivery of CT in 2 centres; initial repairs as well as exploratory survey in Livingstone and Kitwe.

[1] Penny Marapara and Ignatius M Kayawe – Report of Findings on HIV/AIDS Intervention Services for People with Disabilities in Botswana, Malawi, Zambia and Zimbabwe carried out for Disability HIV and AIDS Trust (DHAT), November 2007.

[2] WHO estimates that roughly about 10% of any country’s population comprises of PWD of some sort.

Facilitate development, harmonization and review of policies and legislations related to disability, HIV and AIDS interventions