AEGiS-14IAC: The Journey of Going to scale from 28 communities to 1000 communities in Eastern Zambia: A systems thinking approach and Lessons Learned in 2002.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

The Journey of Going to scale from 28 communities to 1000 communities in Eastern Zambia: A systems thinking approach and Lessons Learned in 2002.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. LbOr07)

Chikunjiko G, Orobaton N, Mukuka-Chilaika, Mutonyi S, Mukwakwa C, Mlewa A, Daka D
Thandizani NGO, Lundazi, Zambia

ISSUE: In October 2001, Lundazi District Government in Eastern Zambia requested Thandizani NGO to take its highly successful community-based HIV/AIDS prevention and care program to scale. The district government cited that it was no longer equitable for the program to remain in one area of the district given that 10% of adults 15-45 years in Thandizani areas have used VCT services compared to less than 1% in non-Thandizani areas. The NGO decided to utilize a systems-thinking approach to implement scale up.

DESCRIPTION: Thandizani NGO was formed in March 1999.The NGO empowers communities and mobilizes tacit knowledge for community action. Thandizani also supports community care networks of care and support as franchises. A systems map including all key players, partners, structures of influence, and the interconnections and patterns of collective behavior that make VCT and people-centered care possible, was developed. Lundazi District took the unprecedented step to appoint the Thandizani Director as HIV/AIDS coordinator for the entire district, creating a new public-private partnership. Briefing seminars for all 11 traditional chiefs were held and commitments were secured. New measurements were developed to foster interconnections between actors and a system-wide focus on results. Rapid test kits were selected over laboratory testing and new supervisory roles and relationships with community-care networks were designed.

ISSUES: Systems thinking can be a very useful tool for avoiding fragmented implementation. Used properly, it can promote innovation and creativity. It also can promote the maximum use of indigenous tacit knowledge, vital to address cultural factors that increase vulnerability. It requires trust, respect and transparent partnerships. RECOMMENDATION: Systems thinking is compatible with how communities think about issues. Given the needs for innovation and resource mobilization, its wider use for experimentation is strongly encouraged.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, Community Networks, HIV Infections, Consumer Participation, Government, Zambia, Adult, classification

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