Ndola Demonstration Project (NDP)
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
