Involving Young People in the Care and Support of People Living with HIV in Zambia: An Evaluation of Programme Sustainability

This 4-page research summary, published by Horizons, presents the results of a 2005 study conducted to assess the extent to which anti-AIDS clubs in rural Zambia previously supported by Horizons continued caregiving activities, sustained and expanded partnerships with local organisations, and mobilised human and material resources to support the programme. Study findings indicated that, despite decreased support from Horizons, trained youth caregivers were able to meet a range of needs of people living with HIV (PLHIV) and orphans and vulnerable children (OVC) to the satisfaction of their clients and that their efforts continued to contribute to decreased isolation and stigmatisation of AIDS-affected families.

In 2002, Horizons conducted a study in Zambia that found that youth could be trained to help meet the care and support needs of PLHIV and their families, including OVC. Youth participating in the study belonged to anti-AIDS clubs. Horizons developed a care and support curriculum which was used to train youth club members. To facilitate caregiving by its members, each club received kits that included gloves, disinfectant, cotton wool, and other supplies, as well as 2 bicycles and identifying badges and aprons. Horizons found that trained youth caregivers were able to meet a range of needs of PLHIV and to provide a broad range of services.

A follow-up phase of the project aimed to strengthen local capacity to manage and sustain the care and support activities in the face of decreased inputs from Horizons. District-level management committees were established to run the programme, and remaining funds were channelled through a local organisation and used for capacity building and partnership development. In 2005, Horizons conducted a follow-up study to assess the sustainability of the programme. 256 male and 218 female anti-AIDS club members completed questionnaires. A total of 73 in-depth interviews were also conducted with adult club leaders, youth club leaders, youth caregivers, and PLHIV or their family members. In addition, 4 focus group discussions were conducted with PLHIV beneficiaries and their family members.

Overall, results indicated that youth caregivers could count on help from the beneficiaries' families and from community members in caring for PLHIV and OVC. According to the report, about two-thirds of club members surveyed reported receiving support from community leaders. More than two-thirds noted that family and community members were involved in the youth caregiver programme. The study found that clubs had also expanded their partnerships with organisations and services in order to continue programme activities. These expanded partnerships resulted in the provision of materials and resources for care activities, as well as training opportunities for club members. According to the report, more than two-thirds of respondents reported receipt of HIV information materials, and 40% obtained materials for medical care of PLHIV. In addition, more than half reported receiving training from Horizons, and more than one-third received training from other sources.

The study also found that the average number of people cared for by club members increased over time, despite a reduction in funding. In 2005, males reported caring for an average of 5.5 PLHIV and 7.0 OVC, as compared to 4.0 and 5.0, respectively, in 2002. Females reported caring for an average of 5.7 PLHIV and 4.0 OVC, up from 4.0 and 4.0, respectively, in 2002.

In addition, income-generating activities (IGAs) and proposal writing were the main ways clubs tried to raise money. The study notes that 10 clubs wrote proposals, of which 3 were funded at the time of data collection. Leaders of 17 clubs (out of the 24 interviewed) had started IGAs. Money and food generated from IGAs were used for various purposes, including assisting PLHIV, buying materials for OVC, providing transport money, and repairing bicycles. Approximately 40% of these activities were viable after 6 months. The study also found that both PLHIV and caregivers remained positive about the programme and had been positively influenced by it.

The study concluded that the anti-AIDS clubs were able to mobilise resources to sustain their programmes and their dedication to caregiving activities, even in the face of limited resources. Although support from Horizons decreased, clubs were able to sustain and expand partnerships with other organisations. Challenges that will need to be addressed include gaps in the availability of supplies, medication, and transportation for PLHIV and OVC.