Here is the scenario: You were just hired as a community health educator by FHI 360. FHI 360 works in more than 70 countries and is a major international nonprofit. FHI 360 is known for its expertise in family and reproductive health, and HIV/AIDS. Your assignment is located in Zambia to work on the Zambia-led Prevention Initiative (ZPI). Your generic job duties are to provide both intimate partner violence prevention and HIV/AIDS community education in rural Zambia to at risk populations. At risk is defined as rural Goba women, from the ages of 12 to 99 years old. As part of your job orientation, your employer was kind to have you read the document – ZAMBEZI GOBA. The reason you were given this article to read is because Chet used to be the FHI 360 Zambian Country lead. Chet is now in academia and not affiliated with FHI 360. You do not have access to Chet anymore.
You read the article, and FHI 360 has arranged for your travel to highlands town (e.g., Terrytown) with a population of 50,000 people. Terrytown is a former diamond mining town. You are the only FHI 360 employee in this highland town, Terrytown. You are housed in the local hotel. That hotel room is your home and your office. You are not placed in the local health center. The health center is suspicious of your work, and does not want to collaborate with FHI 360. Welcome to what it is like in public health! I have been in a similar situation. This is hard work. As part of your country orientation, your employer gave you a country profile to assist you with your job duties. In the last decade the Zambian highlands has repeatedly been described as area with high HV rates and intimate partner violence. The homicide rate reached an average of 55 murders per 50,000 people between 2000 and 2019, which is more than double the average rate for Zambia and more than three times the average global figure.
According to Zambian national health data, HIV rates for Terrytown remain one of the lowest in Zambia. Moreover, half of Terrytown’s Goba women (49.3 per cent) consider crime and insecurity to be the main regional problem. In addition, in recent years a noticeable drop in intimate partner violence has been seen, but Terrytown’s health center health data indicate that HIV rates remain one of the highest in Zambia. That is odd, and I would ask why is that the case? Key excerpts from your job description are: “The objective of your intimate partner violence prevention and HIV/AIDS community education program is to strengthen local capacities for the prevention and reduction of violence and HIV prevention. The Zambia-led Prevention Initiative (ZPI) is aligned with the Zambian government’s Five-year Development Plan and with the Municipal Plan for Coexistence and Citizen Security developed by the FHI 360. The strategy was based around three main areas: Strengthening the capacity and effectiveness of regional rural civil society organizations to prevent and reduce violence and HIV. Creating safe, sustainable and inclusive public spaces to contribute to the reconstruction of the social fabric of Terrytown. Increasing the capacities of young people in Terrytown municipality and their opportunities for personal and community development.” Instructions: write a full 2-page reflective paper on the following questions: On your first day in Terrytown, what would you do? What strategies would you employ to collaborate with Terrytown’s health center? Why do you think there is a decrease of intimate partner violence? Why is there an increase of HIV locally? What public health core competencies would you rely on to do your job?
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