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Zambia
Zambia, with notable contributions from the Joint Team continued to improve its HIV response. The Government finalized the 2022 Zambia Consolidated Guidelines for Treatment and Prevention of HIV Infection which recommended the utilization of long-acting injectable Cabotegravir for HIV prevention; Tenofovir alafenamide to treat hepatitis B; resistance testing for people living with HIV who could not achieve viral suppression and use of baseline viral load testing. The National Health Care Package (NHCP) further integrated HIV with other essential universal health coverage services (WHO). Additionally, the newly developed paediatric HIV data dashboard was implemented in five provinces improving real time monitoring and use of data needed to scale up coverage and quality of paediatric HIV services (UNICEF, WHO).
The implementation of differentiated service delivery models for pregnant and breastfeeding adolescent girls and young women as well as strengthening the capacity of youth-friendly spaces in healthcare facilities yielded encouraging results, including higher rates of HIV testing and treatment service coverage and retention in care (UNICEF).
A standard package of youth-friendly health services and referral mechanisms to specialist care and support services were included in school health facilities improving uptake and utilization of services (UNFPA). Sexual and reproductive health rights, gender-based violence awareness initiatives, capacity building programmes for peer mentors and staff, HIV and sexually transmitted infection (STI) counselling and testing, and student support services were also implemented in 12 higher and tertiary education institutions benefitting 28 236 students across the country (UNESCO). Furthermore, community-based mental health counselling and psychosocial support services were widely rolled out in Central, Eastern, Lusaka, Southern and Northwestern provinces and 22 188 adolescents and young people received psychosocial support through government health facilities and schools (UNFPA).
A situation analysis of young people aged 10-29 years from key population groups revealed several barriers, including stigma and discrimination in health facilities, limited access to legal and health services and exclusion of young people from this group from education, economic, social and political opportunities (UNDP). Intense advocacy and technical support also led to the inclusion of displaced persons in the National Health Insurance Scheme (NHIMA) paving the way for these populations to access health services in all public healthcare facilities in Zambia (UNHCR, IOM). A new prison assessment helped update existing information on HIV, hepatitis B and C, STI and tuberculosis among prisoners and implement appropriate services in prisons. Representatives from the Drug Enforcement Commission, Zambia Correctional Services, the immigration department, and police were also trained improving their understanding of injectable drug use and harm reduction programmes (UNODC).