Ndola Demonstration Project (NDP)

Category 3

The Ndola Demonstration Project (NDP) efforts in PMTCT tested the operational feasibility of an integrated MTCT risk-reduction approach in low-resource ANC/MCH clinic settings, where women do not have access to short-course ARVs such as nevirapine or AZT to reduce vertical transmission. The NDP Project involved a combination of promotion of exclusive breastfeeding, Counseling and Testing, and educational and behavioral change strategies.

Goal of the Practice
  • To develop guidelines for the National Policy on Breastfeeding Practices and HIV/AIDS Transmission from Mother to Child.
  • To pilot the integration of infant feeding and HIV counseling and testing (CT) in maternal and child health (MCH) and community services.
Core Components
  • Counseling and Testing in MCH and community services.
  • Exclusive breastfeeding for the first 6 months.
  • Expressing, heat treating, and cup feeding breastmilk.
  • Wet nursing by an HIV-uninfected woman.
  • Transitioning (early cessation) from breastfeeding to replacement feeding by cup with commercial or home-prepared formula.
Noteworthy Results
  • By 2005, scale-up extended to 60 communities in six districts across three provinces.
  • Increased uptake of HIV counseling and testing (CT) from 5 percent in 2000 to 46 percent in 2004 in Ndola.
  • Increased optimal infant feeding practices: exclusive breastfeeding rose from 57 percent in 2000 to 74 percent in 2004 in Ndola.
  • Developed formative research, M&E, advocacy, assessment and strengthening community organization, training and behavior change communication materials and tools for use in PMTCT programs.
  • Focused attention on the importance of ensuring quality MCH care in PMTCT programs by retraining midwives and counselors in antenatal, labor and delivery, and post-partum care.
Lessons Learned
  • Taking services to scale and improving quality may be incompatible goals without a significant addition of personnel and financial resources.
  • Partnering is critical but complex.
  • Community involvement in PMTCT requires greater commitment from the health system.
  • Models are needed for engaging men to support reproductive health and safe infant feeding practices.
  • Training isn't the end-all; good supervision and mentorship must follow.
Focus Areas
PMTCT
Implemented By
AED/LINKAGES
Participating Organization
  • Central Board of Health
  • Ministry of Health (MOH)
  • National Food and Nutrition Commission (NFNC)
  • Zambia Integrated Health Package (ZIHP)
  • Hope Humana and Horizons
  • Ndola District Health Management Team (DHMT)
Region
Africa
Country
Zambia
Environment
Community/Household
Setting
Urban
Target Population
  • Infants (newborn to 24 months)
  • Females
  • People Living with HIV (PLWH)
Scope
> 50000
Implementation Years
01/1997 - 12/2005