Justina Namukombo

Explaining Implementation Gap: Case of Zambian Art Programme Actors, Exclusion Mechanism, Cultural Beliefs Justina Namukombo

Since 2002 Zambia has been implementing ART for HIV/AIDS patients in the public sector. This programme was conducted within WHO '3 by 5'framework. Implementation of ART in Zambia that time faced serious problems of human resource shortages and other capacity constraints. Purpose of the study was to assess implementation aspects of ART in Zambia. The study found that the gap in meeting the target of putting 100,000 people living with HI/AIDS on treatment by 2005 that time was not only caused by capacity problems but more complex issues. The study uses an actor approach to analyse implementation. Actors involved in implementing ART programme are guided by their values. CHAZ, a major health service provider and government health workers were not implementing the programme according to national guidelines. People living with HIV/AIDS have their own perceptions about ART intervention due to lack of acceptance, cultural beliefs and misinformation. There are also mechanisms of exclusion caused by poverty, gender inequality and stigma which make it difficult for people living with HIV/AIDS to seek ART. Study concludes that capacity alone is not enough to explain implementation success or failure.