Dataset Information

Experience and lessons from health impact assessment guiding prevention and control of HIV/AIDS in a copper mine project, northwestern Zambia.

ABSTRACT:

Background

To avoid or mitigate potential project-related adverse health effects, the Trident copper project in Kalumbila, northwestern Zambia, commissioned a health impact assessment. HIV was identified a priority health issue based on the local vulnerability to HIV transmission and experience from other mining projects in Africa. Hence, an HIV/AIDS management plan was developed, including community and workplace interventions, with HIV testing and counselling (HTC) being one of the key components. We present trends in HTC data over a 4-year period.

Methods

In 13 communities affected by the Trident project, HTC was implemented from 2012 onwards, using rapid diagnostic tests, accompanied by pre- and post-test counselling through trained personnel. In addition, HTC was initiated in the project workforce in 2013, coinciding with the launch of the mine development. HTC uptake and HIV positivity rates were assessed in the study population and linked to demographic factors using regression analysis.

Results

In total, 11,638 community members and 5564 workers have taken up HTC with an increase over time. The HIV positivity rate in the community was 3.0% in 2012 and 3.4% in 2015, while positivity rate in the workforce was 5.2% in 2013 and 4.3% in 2015. Females showed a significantly higher odds of having a positive test result than males (odds ratio (OR) = 1.96, 95% confidence interval (CI): 1.55-2.50 among women in the community and OR = 2.90, 95% CI: 1.74-4.84 among women in the workforce). HTC users in the 35-49 years age group were most affected by HIV, with an average positivity rate of 6.6% in the community sample and 7.9% in the workforce sample. These study groups had 4.50 and 4.95 higher odds of being positive, respectively, compared to their younger counterparts (15-24 years).

Conclusions

While HTC uptake increased five-fold in the community and almost three-fold in the workplace, the HIV positivity rates were insignificantly higher in 2015 compared to 2012. Our data can be used alongside other surveillance data to track HIV transmission in this specific context. Guided by the health impact assessment, the HIV prevention and control programme was readily adapted to the current setting through the identification of socioeconomic and environmental determinants of health.

SUBMITTER: Knoblauch AM

PROVIDER: S-EPMC5496403 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Experience and lessons from health impact assessment guiding prevention and control of HIV/AIDS in a copper mine project, northwestern Zambia.

Knoblauch Astrid M AM Divall Mark J MJ Owuor Milka M Nduna Kennedy K Ng'uni Harrison H Musunka Gertrude G Pascall Anna A Utzinger Jürg J Winkler Mirko S MS

Infectious diseases of poverty 20170704 1

<h4>Background</h4>To avoid or mitigate potential project-related adverse health effects, the Trident copper project in Kalumbila, northwestern Zambia, commissioned a health impact assessment. HIV was identified a priority health issue based on the local vulnerability to HIV transmission and experience from other mining projects in Africa. Hence, an HIV/AIDS management plan was developed, including community and workplace interventions, with HIV testing and counselling (HTC) being one of the key ...[more]

PMID: 28673329

Similar Datasets

Project description:Large projects in the extractive industry sector can affect people's health and wellbeing. In low- and middle-income countries (LMICs), women's health is of particular concern in such contexts due to potential educational and economic disadvantages, vulnerability to transactional sex and unsafe sex practices. At the same time, community health interventions and development initiatives present opportunities for women's and maternal health.Within the frame of the health impact assessment (HIA) of the Trident copper mining project in Zambia, two health surveys were conducted (baseline in 2011 and follow-up in 2015) in order to monitor health and health-related indicators. Emphasis was placed on women residing in the mining area and, for comparison, in settings not impacted by the project.All measured indicators improved over time, regardless of whether communities were affected by the project or not. Additionally, the percentage of mothers giving birth in a health facility, the percentage of women who acknowledge that HIV cannot be transmitted by witchcraft or other supernatural means and the percentage of women having ever tested for HIV showed a significant increase in the impacted sites but not in the comparison communities. In 2015, better health, behavioural and knowledge outcomes in women were associated with employment by the project (or a sub-contractor thereof), migration background, increased wealth and higher educational attainment.Our study reveals that natural resource development projects can positively impact women's health, particularly if health risks are adequately anticipated and managed. Hence, the conduct of a comprehensive HIA should be a requirement at the feasibility stage of any large infrastructure project, particularly in LMICs. Continued monitoring of health outcomes and wider determinants of health after the initial assessment is crucial to judge the project's influence on health and for reducing inequalities over time.

Project description:BackgroundThailand has achieved global acclaim for its response to HIV/AIDS. However, the success of some of the country's most well-known initiatives was by no means a foregone conclusion. Policy entrepreneurs on the periphery of power had to achieve buy-in from stakeholders in state and society to scale and mainstream their ideas. This paper offers a comparative and historical understanding the process by which three of the country's most well-known initiatives came into being: a civil society campaign to promote condom usage; a Ministry of Public Health program that aimed to prevent the spread of Human Immunodeficiency Virus (HIV) by targeting high-risk populations (the 100% condom program); and a universal Prevention of Mother-To-Child Transmission (PMTCT) program.MethodsThe research relied on existing literature and interviews with high-ranking ministerial officials, representatives from international and non-governmental organizations, professors, and philanthropic organizations, in addition to a review of the existing literature. Taking a comparative and historical approach that is common within political science and sociology, we analysed the in-depth qualitative interviews in relation to the literatures and used an inductive cross-case analysis aimed to draw out critical features that the initiatives shared in common.ResultsCommon factors in HIV/AIDS prevention that cut across the three key cases include policy entrepreneurs who championed the programs, successful demonstration projects that produced a credible evidence base for policy adoption, and a diverse set of institutional partners that played critical roles in helping to mainstream their initiatives into national HIV/AIDS policy and scale programs nationally. The findings from this comparative research project have implications not only for the building of understanding related to one single project, but for broader theoretical understanding related to the mainstreaming of health policy from peripheral spaces of power.ConclusionsThis analysis draws out the role that demonstration projects played in building a credible evidence base for policy adoption and the role that a diverse set of institutional partners played in elevating the profile of policy entrepreneurs' ideas and helping to scale them nationally as state policy. Success was contingent on entrepreneurs first identifying and then taking advantage of different political opportunities that arose during each of the historical periods. Over time, these initiatives have evolved from vertical programs into an integrated program, in parallel with the evolution of the HIV/AIDS landscape at the global level.

Project description:Understanding the level of heavy metal contamination coupled with the assessment of environmental and human risks associated with mine waste dumpsites is an important step to initiating efficient measures for mine wasteland restoration, stabilization, and bioremediation. In the present study, concentration of the heavy metals; Copper (Cu), Cobalt (Co), Iron (Fe), Lead (Pb), Manganese (Mn), and Zinc (Zn) in soil from mine waste dumpsites around Kitwe (Sites: TD25 and TD26) and Mufulira (Site: TD10), Zambia, was assessed to determine the level of contamination, ecological risks, and progress made in reclamation. The mine waste dumpsites in the two towns are located in the vicinity of residential areas. Therefore, there is need to provide information for optimization of protocols for post-mining landscape in Zambia and elsewhere to limit soil, river, and groundwater contamination and to accelerate the restoration process . Mean values for soil pH, electrical conductivity, and organic matter varied between 5.9-8.4, 2534.8-538.6 μS/cm, and 0.90-2.75%, respectively. The mean concentrations of heavy metals of TD25, TD26, and TD10 decreased in order of Fe > Cu > Co > Mn > Pb > Zn across all sites. However, the order of overall degree of heavy metal contamination computed using control soil as a baseline in TD25, TD26, and TD10 was Cu > Co > Fe > Pb > Mn > Zn. The pollution load index was 0.355 at TD25, 0.329 at TD26, and 0.189 at TD10, indicating high soil pollution at TD25 and TD26. The Potential Ecological Risk Index for all heavy metals tested at TD25, TD26, and TD10 showed low ecological risk in the vicinity of the studied dumpsites. Furthermore, the present study also showed that the polluted soils around smelter sites and mine waste dumpsites are susceptible to dispersion by wind and water. Additionally, results from TD10 revealed that the initiated remediation of the tailings dam was somewhat successful. Finally, this study provided an updated status regarding the accumulation of heavy metals in mine waste dumpsites of Kitwe and Mufulira, Zambia and baseline information necessary to enhance post-mining landscape reclamation.

Dataset Information

Experience and lessons from health impact assessment guiding prevention and control of HIV/AIDS in a copper mine project, northwestern Zambia.

Background

Methods

Results

Conclusions

Publications

Experience and lessons from health impact assessment guiding prevention and control of HIV/AIDS in a copper mine project, northwestern Zambia.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets