Lusaka – To toughen bag entry to to sexual and reproductive health and rights (SRHR) services, including family planning and safe abortions, Zambia is training health workers in values clarification and perspective transformation (VCAT).
Kids and childhood progressively face boundaries when seeking family planning services or safe abortions at health facilities. These boundaries may well perchance furthermore furthermore be rooted in stigma and discrimination, which foster disapproval and negative perceptions against folks seeking or providing these services.
VCAT is a job that helps health workers understand their core values and how these influence their choices and behaviours. It involves examining one’s possess beliefs, attitudes and assumptions and using that understanding to invent extra informed choices and rob meaningful action. This job can consequence in non-public development, improved resolution-making and determined commerce.
“In Zambia, deeply rooted cultural, non secular and societal beliefs influence folks’s views on SRHR, in particular on matters worship abortion, contraception, adolescent sexuality and bag entry to to services,” says Dr Samson Chisele, Obstetrician-Gynaecologist at Lusaka’s College Teaching Scientific institution and sexual and reproductive health and rights advocate.
These values, attitudes and perceptions can furthermore be held by neighborhood health assistants, who present a must maintain health information and express main health services to communities.
To better equip these frontline health companies, the Ministry of Health, with technical and financial reinforce from World Health Group (WHO) and companions, organized a four-day VCAT training in March 2025. This initiative brought together 30 individuals, including neighborhood health assistants and provincial neighborhood health focal folks from the 10 provinces in Zambia.
The important thing just of the training became as soon as to address personal biases that act as boundaries to indispensable SRHR services, in particular safe abortion and family planning, including contraception.
“During one session, we stumbled on that whereas most neighborhood health assistants maintain been satisfied providing contraceptives to married folks, they maintain been reluctant to carry out so for childhood,” says Dr Chisele, who led the facilitation of the workshop. “VCAT helped them separate personal beliefs from their legit tasks, aligning their work with authorities coverage.”
The comprehensive training programme supplied correct exact and medical information, addressed stigma and showcased personal studies that humanize childhood’s experiences. It emphasised the principles of providing non-judgmental and empathetic care to adolescent ladies and younger girls folks.
Round 760 girls folks in Zambia died during being pregnant or childbirth in 2024, according to the Ministry of Health’s Maternal and Perinatal Knowledge Surveillance and Response (MPDSR) system. An estimated 5.1% of these deaths are attributed to unsafe abortion. That is despite provisions in Zambia’s 1972 Termination of Pregnancy Act: if the physical or psychological health of the pregnant lady is in threat, or the health of the foetus is in threat, or below certain socio-financial instances, abortion is allowed by regulation.
Individuals realized the plot to express safe, effective and client-centred abortion care, including comprehensive counselling and acceptable referrals, finally encouraging health customers to inspect care without distress of misconceptions or stigma.
The elemental ingredients of abortion-related counselling encompass being pregnant alternate solutions, job alternate solutions and ensuring the shopper’s potential to invent voluntary, informed want and present consent after receiving this information.
“My facility has two functioning childhood-friendly corners which maintain helped the neighborhood and childhood to bag entry to information, resembling family planning systems on hand, who to bag if from and the build to find it,” says Hamatanga Gwangai, a health employee from Mululu rural health put up in Chibombo, a town in the Central Province of Zambia. “We confronted some resistance from fogeys but after sharing some experiences they agreed to enable their childhood to bag entry to those services.”
A key ingredient of the training involved encouraging health workers to replicate on their personal values and societal norms, fostering a deeper understanding of how these can affect worship health customers.
“VCAT has helped,” says Helen Mwape, a neighborhood health assistant from James Milambo Memorial Health Publish in Lufwanyama District, in the nation’s central Copperbelt Province. “I received one adolescent for family planning and after asking the build she obtained the information, she pointed one in every of the neighborhood-primarily based volunteers… so it is working.”
Following the training, individuals’ main role is to behave as commerce agents within their communities, orient fellow health workers at their respective facilities and lead inaugurate discussions on family planning and abortion. Neighborhood health focal folks from the Ministry of Health are anticipated to orient neighborhood health assistants in VCAT during their supervisory visits in their assigned provinces.
“Following my action opinion, I in truth maintain taken plenty of steps,” says Danny Kasongo from Misenga rural health put up in Mansa district of Luapula province, located in the northern part of the nation. “I in truth maintain oriented fellow staff on VCAT, performed meetings with stakeholders, including the neighborhood, engaged neighborhood-primarily based volunteers and created a younger individual safe home the build sexual and reproductive health points are talked about and services on hand.”
VCAT represents a cultural shift within Zambia’s health system. “WHO is proud to reinforce this initiative,” says Dr Clement Peter Lasuba, WHO Marketing consultant in Zambia. “By targeting the foundation of stigma and empowering health companies, this programme is helping to be certain that no one is became away or shamed when they inspect care.”
According to Dr Chisele, VCAT desires to be integrated into health and schooling systems: nursing and medical colleges, instructor training colleges and public service induction programmes. “We furthermore want localized, co-created modules with local leaders and marginalized groups to be certain relevance. Digitizing and modernizing VCAT delivery may well perchance furthermore attract younger audiences and tech-savvy healthcare workers. In this formulation we be certain sustainability and longevity to in truth remodel service delivery,” he says.
