DOCSLIB.ORG

ZAMPHIA Final Report 2-26-19

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text

Load more

Zambia Population-based HIV Impact Assessment (ZAMPHIA) 2016 ZAMPHIA 2016 COLLABORATING INSTITUTIONS Ministry of Health, Zambia Zambia National Public Health Institute National HIV/AIDS/STI/TB Council, Zambia University of Zambia Central Statistical Office, Zambia Tropical Diseases Research Centre University Teaching Hospital, Zambia The United States President’s Emergency Plan for AIDS Relief (PEPFAR) The United States Centers for Disease Control and Prevention (CDC) WESTAT ICAP at Columbia University DONOR SUPPORT AND DISCLAIMER This project is supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through CDC under the terms of cooperative agreement #U2GGH001226. The findings and conclusions are those of the authors and do not necessarily represent the official position of the funding agencies. SUGGESTED CITATION Ministry of Health, Zambia. Zambia Population-based HIV Impact Assessment (ZAMPHIA) 2016: Final Report. Lusaka, Ministry of Health. February 2019. ACCESS THIS REPORT ONLINE The PHIA Project: http://phia.icap.columbia.edu CONTACT INFORMATION The Ministry of Health Ndeke House, Haile Selassie Avenue P.O. Box 30205 Lusaka Zambia 1 CONTENTS Glossary of Terms 6 List of Abbreviations 8 List of Tables and Figures 9 Summary of Key Findings 12 Chapter 1 Introduction 16 1.1 Background 16 1.2 Overview of ZAMPHIA 2016 16 1.3 Specific Objectives 16 Chapter 2 Survey Design, Methods, and Response Rates 18 2.1 Sample Frame and Design 18 2.2 Eligibility Criteria, Recruitment, and Consent Procedures 19 2.3 Survey Implementation 19 2.4 Field-Based Biomarker Testing 22 2.5 Laboratory-Based Biomarker Testing 24 2.6 Data Processing and Analysis 27 2.7 Response Rates 28 2.8 References 29 Chapter 3 Survey Household Characteristics 30 3.1 Key Findings 30 3.2 Background 30 3.3 Household Composition 30 3.4 Prevalence of HIV-Affected Households 34 Chapter 4 Survey Respondent Characteristics 37 4.1 Key Findings 37 4.2 Background 37 4.3 Demographic Characteristics of the Adult Population 37 4.4 Demographic Characteristics of the Adolescent Population 38 4.5 Demographic Characteristics of the Pediatric Population 39 Chapter 5 HIV Incidence 41 5.1 Key Findings 41 5.2 Background 41 5.3 HIV Incidence Among Adults 42 5.4 Gaps and Unmet Needs 43 5.5 References 43 Chapter 6 HIV Prevalence 44 6.1 Key Findings 44 6.2 Background 44 6.3 Adult HIV Prevalence by Demographic Characteristics 44 2 6.4 Adult HIV Prevalence by Age and Sex 47 6.5 Adult HIV Prevalence by Province 49 6.6 Gaps and Unmet Needs 50 Chapter 7 HIV Testing 51 7.1 Key Findings 51 7.2 Background 51 7.3 Self-Reported HIV Testing Among Adults 51 7.4 Gaps and Unmet Needs 56 Chapter 8 HIV Diagnosis and Treatment 57 8.1 Key Findings 57 8.2 Background 57 8.3 Self-Reported Diagnosis and Treatment Status Among HIV-Positive Adults 57 8.4 Reliability of Self-Reported Treatment Status versus Laboratory ARV Data 61 8.5 Gaps and Unmet Needs 63 8.6 References 63 Chapter 9 Viral Load Suppression 64 9.1 Key Findings 64 9.2 Background 64 9.3 Adult Viral Load Suppression by Demographic Characteristics 64 9.4 Adult Viral Load Suppression by Age and Sex 65 9.5 Adult Viral Load Suppression by Provence 67 9.6 Gaps and Unmet Needs 69 Chapter 10 UNAIDS 90-90-90 Targets 70 10.1 Key Findings 70 10.2 Background 70 10.3 Status of the 90-90-90 UNAIDS Targets 71 10.4 Gaps and Unmet Needs 74 10.5 References 74 Chapter 11 Clinical Perspectives on People Living with HIV 75 11.1 Key Findings 75 11.2 Background 75 11.3 CD4 Counts and Immunosuppression 75 11.4 Late HIV Diagnosis 74 11.5 Retention on Antiretroviral Therapy 78 11.6 Transmitted Resistance to Antiretroviral Therapy 78 11.7 Viral load Suppression and Severe Immunosuppression 81 11.8 Gaps and Unmet Needs 82 11.9 References 84 Chapter 12 Prevention of Mother-to-Child Transmission 85 12.1 Key Findings 85 12.2 Background 85 12.3 Antenatal Care Attendance 85 12.4 Breastfeeding 86 12.5 Awareness of Mother’s HIV Status 87 3 12.6 Antiretroviral Therapy Among HIV-Positive Pregnant Women 86 12.7 Early Infant Diagnosis 89 12.8 Mother-to-Child Transmission 90 12.9 Gaps and Unmet Needs 91 12.10 References 91 Chapter 13 Adolescents and Young Adults 92 13.1 Key Findings 92 13.2 Background 92 13.3 Sex Before the Age of 15 Years 92 13.4 Knowledge About HIV Prevention 93 13.5 HIV Incidence and Prevalence 98 13.6 HIV Testing, Treatment, and Viral Load Suppression 98 13.7 Status of the 90-90-90 UNAIDS Targets 98 13.8 Gaps and Unmet Needs 99 13.9 References 99 Chapter 14 Children 100 14.1 Key Findings 100 14.2 Background 100 14.3 HIV Prevalence 101 14.4 Viral Load Suppression 101 14.5 Status of the 90-90-90 UNAIDS Targets 101 14.6 Nutrition Status 104 14.7 Gaps and Unmet Needs 105 Chapter 15 HIV Risk Factors 106 15.1 Key Findings 106 15.2 Background 106 15.3 HIV Prevalence by Sexual Behavior 106 15.4 Condom Use at Last Sex with a Non-marital, Non-Cohabitating Partner 107 15.5 Male Circumcision 112 15.6 Gaps and Unmet Needs 113 Chapter 16 Intimate Partner Violence 114 16.1 Background 114 16.2 Prevalence of Recent Intimate Partner Violence 114 16.3 Gaps and Unmet Needs 116 16.4 References 116 Chapter 17 Discriminatory Attitudes Toward People Living with HIV 117 17.1 Key Findings 117 17.2 Background 117 17.3 Discriminatory Attitudes Toward People Living with HIV 117 17.4 Gaps and Unmet Needs 119 17.5 References 119 Chapter 18 Tuberculosis, Syphilis, HBV, STI Symptoms, and Cervical Cancer Screening 120 18.1 Key Findings 120 18.2 Background 120 4 18.3 Tuberculosis 121 18.4 Syphilis 122 18.5 Hepatitis B 124 18.6 Self-Reported Symptoms and Diagnosis of Sexually Transmitted Infection 124 18.7 Cervical Cancer Screening Among HIV-Positive Women 127 18.8 Gaps and Unmet Needs 128 18.9 References 128 Discussion and Conclusions 129 Appendix A Sample Design and Implementation 130 Appendix B HIV Testing Methodology 136 Appendix C Estimates of Sampling Errors 147 Appendix D Survey Personnel 158 Appendix E Household Questionnaire 169 Appendix F Adult Questionnaire 191 Appendix G Adolescent Questionnaire 251 Appendix H Survey Consent Forms 269 5 GLOSSARY OF TERMS 90-90-90: An ambitious treatment target to help end the AIDS epidemic. By 2020, 90% of all people living with HIV (PLHIV) will know their HIV status; 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy (ART); and 90% of all people receiving ART will have viral load (VL) suppression (VLS). Acquired Immunodeficiency Syndrome (AIDS): AIDS is a disease caused by infection with HIV. AIDS is the result of severe damage to the immune system that leaves the body vulnerable to life-threatening conditions such as infections and cancers. Antiretroviral Therapy (ART): Treatment with antiretroviral drugs that inhibit the ability of HIV to multiply in the body, leading to improved health and survival among people living with HIV. CD4+ T-Cells: CD4+ T-cells (CD4) are white blood cells that are an essential part of the human immune system. These cells are often referred to as T-helper cells. HIV attacks and kills CD4 cells leaving the body vulnerable to a wide range of infections. The CD4 count is used to determine the degree of weakness of the immune system from HIV infection. De Facto Household Resident: A person who slept in the household the night prior to the survey. Enumeration Area (EA): A limited geographic area defined by the national statistical authority and the primary sampling unit for the Population-based HIV Impact Assessment (PHIA) surveys. Head of Household: The head of household is defined as the person who is recognized within the household as being the head and is 18 years of age or older or, in special cases, a person between the ages of 15 and 17 years who is either married, has one or more children or living alone. This person may be acknowledged as the head on the basis of age (older), sex (generally, but not necessarily, male), economic status (main provider), or some other reason. Human Immunodeficiency Virus (HIV): HIV is the virus that causes AIDS. The virus is passed from person to person through blood, semen, vaginal fluids and breast milk. HIV attacks CD4 cells in the body, leaving the infected person vulnerable to illnesses that would have otherwise been eliminated by a healthy immune system. HIV Incidence: A measure of the frequency with which new cases of HIV occur in a population over a period of time. The denominator is the population at risk; the numerator is the number of new cases that occur during a given time period. HIV Prevalence: The proportion of living persons in a population who are infected with HIV at a specific point in time. HIV Viral Load (VL): The concentration of HIV in the blood, usually expressed as copies/milliliter (mL). 6 HIV Viral Load Suppression (VLS) or Suppressed Viral Load: An HIV VL of less than 1,000 copies/mL. Household: A person or group of persons, related or unrelated to each other, who live in the same compound (fenced or unfenced), share the same cooking arrangements, and have one person whom they identify as head of that household.
Recommended publications
  • Zambia National Programme Policy Brief

    Zambia National Programme Policy Brief

    UN-REDD ZAMBIA NATIONAL PROGRAMME POLICY BRIEF DRIVERS OF DEFORESTATION AND POTENTIAL FOR REDD+ INTERVENTIONS IN ZAMBIA Jacob Mwitwa, Royd Vinya, Exhildah Kasumu, Stephen Syampungani, Concilia Monde, and Robby Kasubika Background Deforestation and poor forest stewardship reduce carbon stocks and the capacity for carbon storage in Zambian forests. Forest loss is caused by a mix of factors that are not well understood, and their combined effects act to either directly drive forest cover loss or interact with other or influences. In order to understand the drivers and their interactions a study was commissioned to provide a preliminary understanding of drivers of deforestation and the potential for forest types (Fanshawe 1971; White 1983); to differ REDD+ in Zambia; to assess the extent of current substantially in the key drivers of deforestation consumption of forest products, forest production (ZFAP 1998); and have diverse cultural and socio- and development trends as well as potential future economic settings. Sample selection of districts shifts in these patterns that may affect deforestation was based on review of statistics from isolated case levels; to draw conclusions on which actions/trends studies and on analysis of land cover maps and would likely have the worst consequences in terms satellite images. of causing additional deforestation and how these could be reduced in future; and finally to outline the potential for REDD+ in these circumstances. Vegetation Types Of Zambia An interdisciplinary data gathering approach was Zambia has three major vegetation formations. The adopted which integrated literature search, policy closed forests are limited in extent, covering only level consultancy, community level consultations, about 6% of the Country.
  • Can Design Thinking Be Used to Improve Healthcare in Lusaka Province, Zambia?

    Can Design Thinking Be Used to Improve Healthcare in Lusaka Province, Zambia?

    INTERNATIONAL DESIGN CONFERENCE - DESIGN 2014 Dubrovnik - Croatia, May 19 - 22, 2014. CAN DESIGN THINKING BE USED TO IMPROVE HEALTHCARE IN LUSAKA PROVINCE, ZAMBIA? C. A. Watkins, G. H. Loudon, S. Gill and J. E. Hall Keywords: ethnography, design thinking, Zambia, healthcare 1. Background ‘Africa experiences 24% of the global burden of disease, while having only 2% of the global physician supply and spending that is less than 1% of global expenditures.’ [Scheffler et al. 2008]. Every day the equivalent of two jumbo jets full of women die in Childbirth; 99% of these deaths occur in the developing world [WHO 2012]. For every death, 20 more women are left with debilitating conditions, such as obstetric fistula or other injuries to the vaginal tract [Jensen et al. 2008]. In the last 50 years, US$2.3 trillion has been spent on foreign aid [Easterly 2006]; US$1 trillion in Africa [Moyo 2009]. Despite this input, both Easterly and Moyo argue there has been little benefit. Easterly highlights that this enormous donation has not reduced childhood deaths from malaria by half, nor enabled poor families access to malaria nets at $4 each. Hodges [2007] reported that although equipment capable of saving lives is available in developing countries, more than 50% is not in service. Studies have asked why this should be so high [Gratrad et al. 2007], [Dyer et al. 2009], [Malkin et al. 2011] the majority focussing on medical equipment donation. They suggest that it is not feasible to directly donate equipment from high to low-income settings without understanding how the receiving environment differs from that which it is designed for.
  • Zambia Health Sector Public Expenditure Tracking and Quantitative Service Delivery Survey

    Zambia Health Sector Public Expenditure Tracking and Quantitative Service Delivery Survey

    Public Disclosure Authorized Zambia Health Sector Public Expenditure Tracking and Quantitative Service Delivery Survey Public Disclosure Authorized Collins Chansa Thulani Matsebula Moritz Piatti Dale Mudenda Chitalu Miriam Chama-Chiliba Bona Chitah Oliver Kaonga Chris Mphuka Public Disclosure Authorized April 2019 Public Disclosure Authorized © 2019 International Bank for Reconstruction and Development / The World Bank 1818 H Street NW, Washington, DC 20433 Telephone: 202-473-1000; Internet: www.worldbank.org Some rights reserved 1 2 3 4 19 18 17 16 This work is a product of the staff of The World Bank with external contributions. The findings, interpretations, and conclusions expressed in this work do not necessarily reflect the views of The World Bank, its Board of Executive Directors, or the governments they represent. The World Bank does not guarantee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgment on the part of The World Bank concerning the legal status of any territory or the endorsement or acceptance of such boundaries. Nothing herein shall constitute or be considered to be a limitation upon or waiver of the privileges and immunities of The World Bank, all of which are specifically reserved. Rights and Permissions This work is available under the Creative Commons Attribution 3.0 IGO license (CC BY 3.0 IGO) http://creativecommons.org/licenses/by/3.0/igo. Under the Creative Commons Attribution license, you are free to copy, distribute, transmit, and adapt this work, including for commercial purposes, under the following conditions: Attribution—Please cite the work as follows: World Bank.
  • Zambia Poverty Assessment

    Zambia Poverty Assessment

    Report No. 81001 - ZM Public Disclosure Authorized Zambia Poverty Assessment Public Disclosure Authorized Stagnant Poverty and Inequality in a Natural Resource-Based Economy Public Disclosure Authorized December 2012 Poverty Reduction and Economic Management Africa Region Public Disclosure Authorized Abbreviations and Acronyms ARVs Antiretroviral Drugs BIA Benefit Incidence Analysis CCT Conditional Cash Transfer CSO Central Statistical Office, Government of the Republic of Zambia CSP Community, Social and Personal Services FISP Farmer Input Support Program FSP Fertilizer Support Program FSPP Food Security Pack Program GCE General Certificate of Education HDI United Nations Human Development Index ILO International Labor Organization IOB Policy and Operations Evaluation Department, Netherlands Ministry of Foreign Affairs ISIC International Standard Industrial Classification LCMS Living Conditions Monitoring Survey LFPR Labor Force Participation Rate LFS Labor Force Survey MACO Zambian Ministry of Agriculture and Cooperatives MoFNP Zambian Ministry of Finance and National Planning MDG Millennium Development Goal MoH Zambian Ministry of Health NGO Nongovernmental Organization SSA Sub-Saharan Africa WDI World Bank World Development indicators WHO World Health Organization ZMK Zambian Kwacha ii Acknowledgements This report is the product of a team effort between the World Bank and the Government of Zambia. The report incorporates papers prepared by several World Bank staff members and consultants. Roy Katayama, Sean Lothrop, Julio Revilla, Monica Beuran, Nobuo Yoshida, Shivapragasam Shivakumaran and Louise Fox collaborated at different stages of a long but fruitful process, which incorporated advanced methodological discussions with government representatives including the Central Statistical Office (CSO) and the Ministry of Finance and National Planning (MoFNP). The inputs provided by these organizations are reflected in the detailed description of Zambian poverty dynamics presented in the first two chapters.
  • Zambia Project

    Zambia Project

    STRENGTHENING EDUCATIONAL PERFORMANCE – UP (STEP-UP) ZAMBIA PROJECT QUARTERLY PROGRESS REPORT FY 2014 Q3: APRIL 1 – JUNE 30, 2014 Contract No. AID-611-C-12-00001 JULY 31, 2014 This publication was produced for review by the United States Agency for International Development. It was prepared by Chemonics International Inc. The author’s views expressed in this publication do not necessarily reflect the views of the United States Agency for International Development or the United States Government. Cover photo: A Grade One learner demonstrates her literacy skills in front of provincial and district educational officers at the provincial launch of the Let’s Read Zambia campaign in Southern Province. Though she is a Grade One student, she is able to read from a Grade Two textbook. STEP-UP ZAMBIA FY2014 Q3 PROGRESS REPORT ii TABLE OF CONTENTS I. EXECUTIVE SUMMARY 1 II. KEY ACCOMPLISHMENTS 2 A. INTEGRATE AND STRENGTHEN SYSTEMS FOR IMPROVED DECISION-MAKING (TASK 1) 6 B. PROMOTE EQUITY AS A CENTRAL THEME IN POLICY DEVELOPMENT AND EDUCATION (TASK 2) 9 C. INSTITUTIONALIZE THE MESVTEE’S MANAGEMENT OF HIV AND AIDS WORKPLACE POLICIES (TASK 3) 9 D. STRENGTHEN DECENTRALIZATION FOR IMPROVED LEARNER PERFORMANCE (TASK 4) 15 E. ENGAGE ZAMBIAN INSTITUTIONS OF HIGHER EDUCATION IN THE MESVTEE POLICY RESEARCH AND ANALYSIS (TASK 5) 24 F. MANAGEMENT, MONITORING, AND EVALUATION 28 III. GOALS FOR NEXT QUARTER 30 ANNEX A: SUCCESS STORY 32 ANNEX B: STATUS OF M&E INDICATORS 35 ANNEX C: ACTIVE DATA MANAGEMENT COMMITTEES 39 STEP-UP ZAMBIA FY2014 Q3 PROGRESS REPORT iii
  • Final Report Final Report Vsummaryolume Iii Volume Iii Pre-Feaibility Study of Priority Project Pre-Feaibility Study of Priority Project

    Final Report Final Report Vsummaryolume Iii Volume Iii Pre-Feaibility Study of Priority Project Pre-Feaibility Study of Priority Project

    MINISTRY OF LOCAL GOVERNMENT AND HOUSING (MLGH) LUSAKAMINISTRY CITY OF LOCALCOUNCIL GOVERNM (LCC) ENT AND HOUSING (MLGH) LUSAKA CITY COUNCIL (LCC) JAPAN INTERNATIONAL COOPERATION AGENCY (JICA) JAPAN INTERNATIONAL COOPERATION AGENCY (JICA) THE STUDY ON COMPREHENSIVE URBAN DEVELOPMENT PLAN THE STUDY ON COMPREHENSIVEFOR URBAN DEVELOPMENT PLAN THE CITYFOR OF LUSAKA THE CITY OFIN LUSAKA THE REPUBLICIN OF ZAMBIA THE REPUBLIC OF ZAMBIA FINAL REPORT FINAL REPORT VSUMMARYOLUME III VOLUME III PRE-FEAIBILITY STUDY OF PRIORITY PROJECT PRE-FEAIBILITY STUDY OF PRIORITY PROJECT MARCH 2009 MARCH 2009 JAPAN INTERNATIONAL COOPERATION AGENCY JAPAN INTERNATIONAL COOPERATION AGENCY KRI INTERNATIONAL CORP. KRINIPPON INTERNATIONAL KOEI CO., LTD.CORP. JAPAN ENGINEERINGNIPPON KOEI CONSULTANTS CO., LTD. CO., LTD. JAPAN ENGINEERING CONSULTANTS CO., LTD. EXCHANGE RATE USD 1 = ZMK 3,582 = JPY 106.53 ZMK: Average rate of Bank of Zambia, from January 2008 to October 2008 JPY: Average rate of JICA rate, from January 2008 to October 2008 PREFACE In response to a request from the Government of the Republic of Zambia, the Government of Japan decided to conduct the ‘‘Study on Comprehensive Urban Development Plan for the City of Lusaka in the Republic of Zambia’’ and entrusted it to the Japan International Cooperation Agency (JICA). JICA selected a study team consisting of the Joint Venture (JV) of KRI International Corp., Nippon Koei Co., Ltd., and Japan Engineering Consultants Co., Ltd. The team, headed by Mr. Isamu Asakura of the KRI International Corp., was dispatched to Zambia during the period from August 2007 and March 2009. The team conducted field surveys and formulated the comprehensive urban master plan of Greater Lusaka based on the consensus built in a series of discussions with concerned officials of the Government of the Republic of Zambia, donor community members, citizens, and other stakeholders through workshops, seminars, and exhibitions.
  • Chiefdoms/Chiefs in Zambia

    Chiefdoms/Chiefs in Zambia

    CHIEFDOMS/CHIEFS IN ZAMBIA 1. CENTRAL PROVINCE A. Chibombo District Tribe 1 HRH Chief Chitanda Lenje People 2 HRH Chieftainess Mungule Lenje People 3 HRH Chief Liteta Lenje People B. Chisamba District 1 HRH Chief Chamuka Lenje People C. Kapiri Mposhi District 1 HRH Senior Chief Chipepo Lenje People 2 HRH Chief Mukonchi Swaka People 3 HRH Chief Nkole Swaka People D. Ngabwe District 1 HRH Chief Ngabwe Lima/Lenje People 2 HRH Chief Mukubwe Lima/Lenje People E. Mkushi District 1 HRHChief Chitina Swaka People 2 HRH Chief Shaibila Lala People 3 HRH Chief Mulungwe Lala People F. Luano District 1 HRH Senior Chief Mboroma Lala People 2 HRH Chief Chembe Lala People 3 HRH Chief Chikupili Swaka People 4 HRH Chief Kanyesha Lala People 5 HRHChief Kaundula Lala People 6 HRH Chief Mboshya Lala People G. Mumbwa District 1 HRH Chief Chibuluma Kaonde/Ila People 2 HRH Chieftainess Kabulwebulwe Nkoya People 3 HRH Chief Kaindu Kaonde People 4 HRH Chief Moono Ila People 5 HRH Chief Mulendema Ila People 6 HRH Chief Mumba Kaonde People H. Serenje District 1 HRH Senior Chief Muchinda Lala People 2 HRH Chief Kabamba Lala People 3 HRh Chief Chisomo Lala People 4 HRH Chief Mailo Lala People 5 HRH Chieftainess Serenje Lala People 6 HRH Chief Chibale Lala People I. Chitambo District 1 HRH Chief Chitambo Lala People 2 HRH Chief Muchinka Lala People J. Itezhi Tezhi District 1 HRH Chieftainess Muwezwa Ila People 2 HRH Chief Chilyabufu Ila People 3 HRH Chief Musungwa Ila People 4 HRH Chief Shezongo Ila People 5 HRH Chief Shimbizhi Ila People 6 HRH Chief Kaingu Ila People K.
  • Zambia Annual Harvest Assessment Report

    Zambia Annual Harvest Assessment Report

    ZAMBIA ANNUAL HARVEST ASSESSMENT REPORT October 2004 Summary For the second consecutive season, Zambia produced a good harvest after the two bad seasons of 2000/01 and 2001/02, both drought years. Although the growing season started poorly in many parts of the country in terms of rainfall distribution and quantities, as the season progressed, crops showed great improvement, even in the south. In line with the surplus harvest, the price of maize dropped noticeably in May and June. However, in July, prices in rural areas rose as a result of the price distortion (Government floor price) and FRA purchase program. Despite this, the maize prices so far have been relatively low, due to the surplus harvest, and are still below the ten year average. Although this will guarantee improved access to staple food for the majority of the population, the low prices put the small scale farmers who are the major maize producers at risk of failing to engage in meaningful production in the coming season. Background: Zambia’s production system Zambia’s crop production is largely rain dependent with a distinct production season running from November to April. Rainfall performance is the major determinant of the crop performance in any given year. The country is divided into three distinct agro ecological zones differentiated by the rainfall pattern and soil type-see figure 1. Region 1 covers the valley areas located in the Figure 1 : Zambia Agro-ecological Zones extreme southern and western parts of the country. This is generally a dry area with less than 800mm annual rainfall and best suitable for production of N small grains and livestock rearing.
  • Selection of Target Districts Revised Report

    Selection of Target Districts Revised Report

    SYSTEMS FOR BETTER HEALTH Project Implementation Working Paper Selection of Target Districts Revised Report March 2016 This project implementation working paper was produced for review by the United States Agency for International Development. It was prepared by Abt Associates for the USAID Systems for Better Health activity. Selection of Target Districts Contract/Project No.: Task Order No. AID611-TO-16-00001 Contract No. AID-OAA-I-14-00032 Submitted to: William Kanweka, Contracting Officer’s Representative USAID/Zambia Prepared by: Abt Associates In collaboration with: American College of Nurse-Midwives Akros Inc. BroadReach Institute for Training and Education Initiatives Inc. Imperial Health Sciences Save the Children DISCLAIMER The author’s views expressed in this publication do not necessarily reflect the views of the United States Agency for International Development or the United States Government USAID Systems for Better Health ▌pg. i Selection of Target Districts USAID Systems for Better Health ▌pg. ii Selection of Target Districts Table of Contents Acronyms ...................................................................................................................................... iv 1. Introduction ......................................................................................................................... 5 1.1 Background regarding target districts ................................................................................................... 5 1.2 SBH activities at each level of the health system
  • In Zambia a Review of the Biggest REDD+ Project in Africa Financed by the Italian Oil and Gas Company ENI the Luangwa Community Forests Project (LCFP) in Zambia

    In Zambia a Review of the Biggest REDD+ Project in Africa Financed by the Italian Oil and Gas Company ENI the Luangwa Community Forests Project (LCFP) in Zambia

    The Luangwa Community Forests Project (LCFP) in Zambia A review of the biggest REDD+ project in Africa financed by the Italian oil and gas company ENI The Luangwa Community Forests Project (LCFP) in Zambia A review of the biggest REDD+ project in Africa financed by the Italian oil and gas company ENI Author: Kelvin Mulungu Commissioned by: Greenpeace Italy May 2021 INDEX 1. Introduction 4 1.1 Zambia and the Luangwa Community 4 1.2 Introduction to the review of Luangwa Community Forests Project (LCFP) 5 1.3 Mechanisms of the Luangwa Community Forests Project (LCFP) 7 2. Partners and Players in the LCFPs 11 3. Methodology 13 4. General Issue: Voluntary Carbon Markets (VCMs) 14 5. ENI’s Promise of Carbon Offsets in the LCFP 17 6. Issues with the LCFP 23 6.1 Choice of the reference area 23 6.2 Projected deforestation 25 6.2.1 Reported baseline deforestation rate 26 6.2.2 Choice of the baseline approach 27 6.2.3 Fire risk 28 6.2.4 Forests biomass 29 6.3 Other issues with the LCFP 30 6.4 Potential community problems of the LCFP 30 7. Conclusion 33 8. Appendix I: Lusaka and Eastern Provinces of Zambia 34 9. Appendix II: Questions posed to ENI S.p.A. 36 10. References 38 3 1. INTRODUCTION This is a report commissioned by Greenpeace Italy to review the Luangwa Communi- ty Forests Project (LCFP) in Zambia with a special interest in checking for any inconsi- stencies in terms of assumptions, projected carbon credits to be generated, and any unintended effects on the community.
  • Case Study: Lusaka District Health Office, Zambia

    Case Study: Lusaka District Health Office, Zambia

    Learning from international experience on approaches to community power, participation and decision-making in health. Case Study: Lusaka district health office, Zambia Key features: This case study of work by the Lusaka District Health Office tells the story of sustained participatory approaches used since 2005 in urban Lusaka on participatory priority setting, planning, budgeting and health action by communities and frontline health workers on local health committees and on community health literacy that is now scaling up to national level. Features of the work that could potentially be adapted elsewhere, include The use of participatory reflection and action (PRA) approaches to organise community experience, analysis and action in health literacy and in mechanisms for dialogue between communities and health workers. Facilitating PRA in health committees for joint community and service planning and action. Building joint health services and community identification of needs and actions, with support for voluntary community roles and for community champions and voice to sustain the process. The work has sustained and spread due to various factors, including the social power and confidence built within communities from the PRA processes; a horizontal, rather than top down, spread; facilitating participation mechanisms involving elected community members and frontline health workers; providing forums for wider sharing of experience across localities; accessible online reporting of the work; and a committed leadership able to sustain and advance the processes. Introduction to the site and its practices: The Zambia government has had a commitment post 1990 to participation of stakeholders, including local communities, in health service planning and delivery. Sustained participatory approaches have been used in Lusaka urban, institutionalized to national level.
  • Zambia Zambia

    Zambia Zambia

    THE EUROPEAN UNION-FUNDED MILLENNIUM DEVELOPMENT GOAL INITIATIVE (MDGi) IN ZAMBIA THE EUROPEAN UNION-FUNDED MILLENNIUM DEVELOPMENT GOAL INITIATIVE (MDGi) IN ZAMBIA ZAMBIA > ABOUT MDGi > NEXT STEPS The Millennium Development Goal With more than 90 per cent of all planned programme inputs completed, the focus for the remaining life of the programme initiative is a programme that is being is on optimizing end-of-programme results, securing their sustainability, and consolidating a platform for the scale-up of implemented over a five-year period successful interventions beyond the 11 participating districts. The following are therefore the key strategic next steps: (2013–2018) and aims to accelerate the reduction of maternal, neonatal and child mortality in Zambia. The ADDRESSING RECURRENT COSTS FOR CONTINUITY programme is implemented by the Ministry of Health with the technical • Developing input into the annual Medium • Continue and enhance engagement support of UNICEF and UNFPA. Term Expenditure Framework (MTEF) with the Joint Reproductive, Maternal, Its geographic coverage includes budgeting guidance for districts to Newborn and Child Health (RMNCH) Ndola, Luanshya, Kitwe, Mufulira, Chingola and Masaiti districts in adequately capture all recurrent costs for Steering Committee to leverage support Copperbelt Province, and Lusaka, key interventions in their annual plans to for sustaining and scaling up best practices Kafue, Chilanga, Chongwe and Rufunsa ensure sustainability of best practices. at Ministry of Health national level and in districts in Lusaka Province. UNICEF districts beyond the current MDGi support is responsible for managing the funds through other RMNCH funding streams that from the European Union. are working with the Ministry. MAINTENANCE FOR EQUIPMENT/INFRASTRUCTURE • Through support to the annual MTEF • Continued collaboration between the planning process, support adequate United Nations and the Government to budgeting for maintaining equipment and establish a framework to have the Northern infrastructure.