Sustaining the capacity of provincial health offices (PHO) to coordinate and provide quality, comprehensive and sustainable HIV/aids prevention, care and treatment services in zambia under pepfar -…

Sustaining the capacity of provincial health offices (PHO) to coordinate and provide quality, comprehensive and sustainable HIV/aids prevention, care and treatment services in zambia under pepfar - eastern province is one of the ten (10) administrative provinces in the republic of zambia with a total land area of 51,476 KM (19,875 SQ MI) and shares international borders with malawi to the east and mozambique to the south. IT is further divided into 15 administrative districts (chama, chadiza, chasefu, chipangali, chipata, kasenengwa, katete, lumezi, lundazi, lusangazi, mambwe, nyimba, petauke, sinda, and vubwi) with total projected (2022) population of 2,173,240. The province has an overall HIV prevalence of 8.1% (zamphia, 2016). The estimated number of people living with HIV is 112,603 (all ages) with the highest proportion being in the provincial capital chipata district (27%) followed by petauke district (14%) and katete district (12%) and vubwi contributing the least at 1%. Eastern provincial health office (epho) is a government department under the ministry of health (MOH) of the republic of zambia. Epho has been implementing pepfar projects through cooperative agreements (CA) with the centers for disease control and prevention (CDC) since october 1, 2006. The project started with coordination and health systems strengthening activities in a few program areas and progressed over time to becoming the sole direct service delivery (DSD) partner by the beginning of FY2018 covering the whole cascade of HIV prevention, treatment and care services across all districts and health facilities (except military). As at close of FY2021, a total of number of 100,915 plhiv were known to be alive and active on treatment in the province (all ages and sexes) representing 89.6% coverage and 96% were virally suppressed (datim, 2021). Although eastern province has made tremendous progress towards achieving the unaids fast track targets, this achievement is not across all age/SEX and other subgroups. There are populations left behind in treatment coverage as well as VL suppression. These groups include children, adolescent girls and young women (agyws), young adults, men and key populations. The project endeavors to achieve the following broad objectives at the end of five years: (1)to optimize HIV testing and treatment strategies to reach undiagnosed populations living with HIV, especially young adults, men, and key populations (KP); (2) to provide effective HIV prevention services focusing on children, adolescents, young adults, and members of vulnerable and key populations; (3) to support surveillance activities and programs, along with information systems, that improve understanding of HIV epidemiology, remaining gaps, and informed future programming; (4) to actively use epidemiologic, program, and financial/cost data to ensure implementation of high quality, cost-effective programs to improve performance and increase epidemiologic impact; (5) to support to maintain quality for laboratory systems and activities, including diagnostics and viral load measurement; (6) support activities, interventions, and programs to find, treat, and prevent TB among plhiv and to identify and treat HIV among people infected with TB; and (7) to support efforts to prevent, detect, respond, and treat infectious and non-infectious diseases that impact plhiv and populations affected by HIV. IT is expected that the project interventions will achieve the following long-term outcomes: (1) reduced HIV-related morbidity and mortality (including from common CO- morbid conditions; (2) reduced HIV prevalence; (3) improved availability of HIV epidemiological data; and (4) sustained financial management that conforms with accounting standards and U.S. Government (USG) rules and regulations. The project period is from october 1, 2022 through to september 30, 2027. The geographical coverage is all the 15 districts in eastern province. Key words: closing gaps; HIV epidemic CO