Gender Integration Strategy for the Eradicate Tuberculosis Project in Zambia

The project's primary objectives are to increase the number of individuals screened for TB by 50 percent and to increase the TB treatment success rate to 85 percent and beyond in the target provinces. To achieve these objectives, the project aims to address gaps in health-seeking behaviors and gender-related barriers that lead to late presentation and poor treatment outcomes. The project operates in six provinces in Zambia, including Northern, Luapula, Muchinga, Copperbelt, Central, and North-Western. The project's design takes a gender-aware approach, emphasizing the need for gender-sensitive activities and monitoring and evaluation (M&E) approaches. The project's gender integration strategy is based on the United States President's Emergency Plan for AIDS Relief (PEPFAR) definition of gender, which includes a culturally-defined set of economic, social, and political roles, responsibilities, rights, entitlements, obligations, and power relations between and among women and men, boys and girls. The project's gender analysis identified several key findings, including the impact of gender-based cultural norms, beliefs, and behaviors on TB stigma and health-seeking behaviors. The analysis also highlighted the importance of addressing gender dimensions of TB stigma related to HIV, traditional beliefs regarding causes of TB, and social costs of TB stigma for women. Additionally, the analysis examined male gender norms and behaviors, gender roles, responsibilities, and time-use, patterns of power and decision-making, and access to and control over assets, employment, income, and other sources of cash. The project's gender integration strategy involves several key activities, including pursuing high-quality DOTS expansion and enhancement, addressing TB/HIV and MDR-TB and the needs of poor and vulnerable populations, engaging all categories of care providers, and enabling and promoting operational research. The project also emphasizes the importance of gender-sensitive M&E and performance indicators, as well as gender in project management, including staffing and budgeting for gender integration, stakeholder coordination, and adaptive management. The project's approach to gender integration is based on the understanding that gender inequalities affect how an activity is implemented, and that project managers must address these issues on an ongoing basis. The project's gender integration strategy is designed to ensure that the project's activities are locally appropriate, gender-equitable, and sustainable, and that the project's objectives are achieved in a way that addresses the needs of both males and females.