The Zambia Education Network for Implementation Science Training in Health (ZENITH) is designed around commitment to strengthening Zambia’s capacity to conduct research, evaluate health programs, and translate evidence into practice – all of which requires investing in the people who understand the country’s health challenges firsthand.

A D43 NIH-funded capacity-building initiative, ZENITH provides training in implementation science through an intensive course called the Implementation Science Institute, graduate-level education, and support for PhD studies. The program is a collaboration involving the University of Maryland, School of Medicine (UMSOM), the University Teaching Hospital (UTH) in Lusaka and partners in Zambia.

For Linah Mwango, Technical Director at Ciheb Zambia and a ZENITH scholar, the program has provided an opportunity to build skills that extend well beyond the classroom.

Linah participated in ZENITH's intensive one-month implementation science course as part of its third cohort and is pursuing a master's degree in Implementation and Dissemination Science at UMSOM graduate school with funding from ZENITH. She describes ZENITH as an investment in developing Zambian researchers who can grow from early-career investigators into experienced scientists capable of generating evidence for their own communities.

For Dr. Danielle Engamba, a medical doctor who leads HIV prevention at UTH and a member of ZENITH's second cohort, the program has changed how she thinks about the work she does every day.

As a clinician, Dr. Engamba said she had traditionally focused on the delivery of health services. ZENITH introduced her to the work that happens before an intervention is implemented—examining how evidence can be adapted, evaluated, and ultimately translated into practice.

“There’s actually a preparatory work that has to be done for an evidence, or for work to be done by us,” Dr. Engamba explained.

That perspective is central to implementation science: understanding not only whether an intervention works, but how evidence can be effectively integrated into real-world health systems and communities. 

Connecting Research to Zambia's Health Priorities

A defining feature of ZENITH is its connection to Zambia's health system. The program works closely with the Ministry of Health and brings together health professionals from a range of disciplines and sectors.

According to Linah, the cohorts have included physicians, policymakers and other stakeholders, with later cohorts expanding to include nurses, pharmacists and social scientists. That diversity allows participants to approach HIV prevention and treatment from different perspectives while developing a shared understanding of implementation science.

The partnership also gives trainees an opportunity to apply what they learn within existing health systems.

At UTH, Dr. Engamba sees that connection firsthand. Health programs frequently draw on evidence generated elsewhere, but that evidence must be understood and adapted within the local context.

“It's not just in the Ministry, which looks at the country-wide implementation of evidence,” she said. “But also for facilities, like the University Teaching Hospital, where we had to borrow from existing information from all over the world, which we had to integrate in our system and see how it works within our setting.”

The involvement of government and local institutions also helps create a network that extends beyond the formal coursework. Linah noted that UTH provides facilities and support for the intensive Implementation Science Institute, while ZENITH scholars interact with colleagues from different sectors and organizations throughout the program.

For Dr. Engamba, those connections have become one of the program's most valuable outcomes.

Participants learn about one another's research, professional backgrounds and areas of expertise, creating relationships they can draw on after the training ends.

“We are creating a network around ourselves,” Dr. Engamba said.

From Training to Funding

The impact of that network is already extending into new research opportunities. Linah said ZENITH strengthened her skills in proposal development and scientific publication while also giving her greater confidence in seeking funding. During the program, trainees heard from funders about what they look for when supporting early-career researchers and were encouraged to develop proposals that could eventually be submitted for funding.

For Linah, that training has translated into tangible results.

With support from UMSOM and Zambian mentors, she successfully secured a $500,000 Gilead grant to conduct an implementation science study evaluating the delivery of lenacapavir at the community level among key populations and adolescents She also recently received a $35,000grant from the International AIDS Society to develop a curriculum focused on person-centered care for key populations.

For her, those successes demonstrate how ZENITH can extend beyond formal academic training.

“That knowledge from the ZENITH has really also strengthened my writing capacity,” Mwango said.

Dr. Engamba has experienced a similar trajectory. A proposal she developed during the intensive course was initially rejected, but mentors helped advance the work toward another funding opportunity, where it was ultimately funded. She said the experience illustrated the strength of the network created through ZENITH.

A research proposal, she noted, can begin as an individual's work but ultimately become the work of a much larger community of mentors and collaborators.

Building Locally Led Evidence

For ZENITH, capacity building is ultimately about more than individual academic achievement. The goal is to develop a sustainable community of Zambian researchers who can generate evidence and help inform the country's HIV response.

Mwango said ZENITH scholars are beginning to apply their training to HIV prevention and treatment programs and to generate locally relevant evidence that can contribute to policy discussions.

The program's structure is designed to support that long-term goal. In addition to the intensive implementation science training and master's-level education, ZENITH supports Zambian students pursuing PhD studies in implementation science-related fields.

Mentorship is another important component. Scholars have access to both local and international mentors, creating opportunities for feedback on research proposals, publications and career development.

That model reflects a broader principle behind ZENITH: sustainable research capacity comes not only from transferring knowledge, but from developing relationships that allow that knowledge to grow locally.

A Growing Community

The ZENITH network continues to develop through monthly capacity-building presentations, where scholars share their work and engage with experts. Linah noted that the meetings provide another opportunity for scholars to strengthen their connections and learn from one another.

Interest in the program is also growing. Dr. Engamba said that after two master's cohorts, more professionals have been inquiring about becoming ZENITH scholars.

The next intensive Implementation Science Institute is expected to take place in February, providing another opportunity to expand the community of researchers receiving implementation science training in Zambia.

For the scholars already participating, however, the value of ZENITH extends beyond degrees, courses and grants.

It is creating a network of professionals who can learn from one another, pursue research together, and apply evidence to the health challenges facing their communities.

As Dr. Engamba put it, the support provided through ZENITH is significant—but so is the network it creates.

“This is just where a submission stops being your personal work. It becomes a whole group, a whole network.”

And that may be one of ZENITH's most important contributions: helping ensure that the next generation of HIV implementation research in Zambia is increasingly shaped, conducted and sustained by Zambian researchers themselves.