Situation Report Last updated: 15 Jun 2020

HIGHLIGHTS (15 Jun 2020)

The first imported COVID-19 case was reported on 18 March 2020 and as of 08 June 1,200 cases have been confirmed, including ten deaths.

Out of the country’s 119 districts, 27 have reported cases of COVID-19. Laboratory testing and reagents have been identified as key challenge.

On 8 May, the Government withdrew some of the initial measures and recommended opening of schools for student examination years, restaurants and gyms. During a food distribution in Siakasipa FDP, , people wait to receive assistance maintaining social On 1 June, examination classes in both primary and distancing. Photo: World Vision secondary re-opened on condition that all public health guidelines and regulations are enforced.

KEY FIGURES FUNDING CONTACTS

Laura Hastings 10.1M 6.2M $132.9M $6.7M Humanitarian Affairs Officer, Zambia people in need people targeted requested (May-Oct received [email protected] 2020) Guiomar Pau Sole 27 Communications & Information partners operational 7.8% Management, Regional Office for funded Southern & Eastern Africa [email protected]

BACKGROUND (15 Jun 2020)

Situation Overview

Zambia recorded its first case of COVID-19 on 18 March 2020 and, as 8 June, 1,200 cases had been confirmed and 10 deaths reported. Out of the 119 districts, 27 districts have reported COVID-19 cases. The Government of Zambia introduced a series of measures to mitigate against the spread of the virus including closure of regional airports, restrictions of public gatherings of more than 50 people, closures of religious institutes, bars and restaurants. On 8 May, the Government receded on some of the initial measures and recommended the COVID-19 cases by district

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opening of schools for student examination years and opening of restaurants and gyms subject to adhere to public health measures and to social distancing. The wearing of masks in public places became mandatory and all retail business are required to have handwashing/ sanitizers amenities at entrances of their businesses.

On 10 May, the District which borders became a COVID-19 hotspot with more than 609 cases (including 84 symptomatic cases), representing more than 50 per cent of the total cases in country. The confirmed cases widely related to cross border interaction with Tanzania this includes immigration officers, truck drivers, sex workers, health workers and known contacts. A 10-day lockdown was implemented to prevent the spread of COVID-19 within the district. Initial findings from the multi-sectoral response mission which deployed to Nakonde from 16 to 22 May highlighted the following urgent priorities for increased support: health workers capacity (personnel and resources) on infection prevention and control (IPC) and case management of patients with COVID-19 in designated hospitals; laboratory capacity to test and provide timely results; support to the district health office to implement home-based care approach with asymptomatic cases and ensure the availability of sufficient and appropriately trained community health volunteers to conduct house to house follow up; community sensitization on COVID-19 prevention, promotion of social distancing and advocating the wearing masks in public places especially in markets alongside regular handwashing. Further, there is a need to improve cross border collaboration to mitigate the risk of cross border transmission.

In May, the Government of Zambia COVID-19 Multisectoral Contingency & Response Plan and the UN and partners COVID-19 Emergency Appeal were officially launched by the Vice President . The UN and partners’ Appeal requires US$132.9 million to support the COVID-19 multisectoral response targeting 6.2 million people.

CLUSTER STATUS (14 Jun 2020)

Education

5,000 555K IEC material printed and distributed pupils targeted

Needs

Nation-wide school closure resulted in disruption of learning and critical services for more than 4.4 million children and adolescents including school feeding programs for disadvantaged children. Teachers face unprecedented challenges of ensuring the continuity of learning for their pupils while caring for their own and their families’ safety. Prolonged school closure puts children especially girls, at increased risk of teenage pregnancy, sexual abuse, child marriage and other harmful practices. Many schools in the rural area are under-resourced and ill-equipped to provide support to the students learning at home and parents are unable to support children’s learning, widening the equity gap between the well-off and worse- off in learning, potentially leading to life-long negative impact. The Ministry of General Education (MoGE) COVID-19 Response and Recovery Plan highlights the continuity of learning as its core priority and presents a series of education delivery options and strategies.

Response

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The sector supported the MoGE to coordinate partner activities through facilitating the Education in Emergency Working Group (EiEWG)to ensure partner resources are directed towards supporting COVID-19. Supported MoGE in developing COVID-19 Response and Recovery Plan that prioritizes the continuity of learning especially for the disadvantaged children and aims to systematically strengthen the alternative and distance learning for all children, and UN supported MoGE on the development of school opening guideline and supported schools re-opening for examination grades only (Grade 7, 9 and 12) with holistic support to learners and teachers. In collaboration with the MoGE developing radio learning contents for Grade 1 to 7 in three core subjects (Language, Math’s, Science) in all seven local languages. The scripts are ready for the 8-week long contents (3 weeks contents of school Term 1- and 5-weeks contents school Term 2) for all grades and the protocol to air the lesson is underway. Agencies supported the production and broadcasting of child-friendly radio messages in local languages on COVID- 19 on the national radio station, Zambia National Broadcasting Corporation, and is finalized the broadcasting of these messages to four community radio stations in Western, Southern, Copper belt and Eastern provinces. Supported the procurement of 3-in-1 radios (chargeable by electricity, solar and use batteries) for primary schools to continue accessing live school radio sessions broadcast on the national broadcaster and local radio stations. Developed child-friendly IEC materials in four local languages which have been printed and soft copies shared with partners and government for further reproduction. Over 2,000 posters on handwashing and COVID-19 messages and 4,000 booklets were distributed to the field offices. Additional 5,000 IEC materials on positive parenting during COVID- 19 are in the process of being developed for print. Supported the printing of easy to read literacy materials for children in non-examination classes to improve their reading skills; procurement of Smart Phones for Secondary school children in examination classes to access the E- Learning Portal while they are at home; printing of the modules for the secondary school children that are not in examination classes, procurement of WASH supplies (buckets with lids and stands); cleaning materials, soap, hand sanitizers and masks for schools after they open and procured 348 hand washing facilities and 6,000 hygiene kits for learners.

Gaps

Inadequate technical expertise and learning materials in local languages on distance and alternative education limited continued education support during COVID-19 school closure. Lack of adapted distance learning material to the needs of children with special education needs further disrupted special needs children learning process. Lack of communication infrastructure and electricity coverage in rural locations restricted distance learning coverage to urban and peri-urban area. Difficulty of remote support and monitoring of children’s learning progress will impact on the quality of education and needs further support.

CLUSTER STATUS (15 Jun 2020)

Health

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1,200 5M COVID-19 cases (as of 8 June) people targeted

Needs

Zambia recorded its first case of COVID-19 on 18 March 2020 and, as 8 June 1,200 cases had been confirmed and 10 deaths reported. Out of the 119 districts, 27 districts have reported COVID-19 cases. However, the laboratory system has not enough capacity to test for COVID-19. The which borders Tanzania is one of the main COVID-19 hotspots with more than 609 cases, more than 50 per cent of the total cases in country. The confirmed cases widely related to cross border interaction with Tanzania, including immigration officers, truck drivers, sex workers, health workers and known contacts. Border capacity to manage risk from ground crossings and un-manned border points has to be strengthened. Misinformation, and complacency by communities over time remain key concerns.

Response

Technical assistance and logistical support provided to the district health offices in managing event-based surveillance and field investigation continued in , Shibuyunji and districts. Four surveillance and IPC technical personnel were deployed to Nakonde and Copperbelt to support the national response. COVID-19 standard messaging guideline was developed, with the support of partners, on home care of asymptotic cases along with implementation tools. The Sector has increased the capacity of the call centre which receives calls from the community, addresses information needs, provides line to services, monitor rumours and myths, and monitors contacts and other persons of interest. Training of health workers, immigration officials and other personnel working at PoE’s in Eastern province was conducted. A comprehensive Risk Communication and Community Engagement (RCCE) Action Plan April to August 2020 is being reviewed. The Sector has provided support to call centres (an average of 800-1,500 calls received daily), and key messages on COVID-19 Guidance by MOH were developed and distributed to all partners engaged in public health messaging tailoring messaging to health care workers, immigration agents and personnel at POEs, truck drivers, service providers and general population. Over 400,000 IEC materials on COVID-19 in eight local languages were distributed including 50,000 awareness sessions. Approximately 8 million people have been reached through mass media, community mobilization of community-based volunteers and Neighbourhood Health Committees, call centres and social media outlets.

Gaps

Develop a national strategy to manage non-symptomatic confirmed cases in the community. Develop data and information management solution that eases information management across all pillars supporting the national public health operation centre.

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The number of sentinel sites for Influenza like symptoms in the country is not proportional to the population density. Thus, there is a need to establish new surveillance site in the country. There are inadequate health worker and technical personnel with capacity for case management in district other than Lusaka. The amount of money pledged for strengthening the public health surveillance is not adequate enough to support the government plan. Due to limited air transportation across the globe, WHO supply chains of medicine and essential kits are very low.

SECTOR STATUS (15 Jun 2020)

Nutrition

36 1.7M districts targeted for stunting reduction people targeted

Needs

Over 13,5000 children aged 6-59months in 17 districts are in need of nutritional supplements to prevent stunting. Need to maintain nutritional services and protect services providers during COVID-19 outbreak and minimize the disruption to services. Health facilities, including nutrition centres require the application of standard precautions for all service providers and the recipients of those services, while additional precautions are also needed for any cases where COVID-19 infection is suspected at facility and community levels.

Response

Nutrition services are currently provided through health centres, health posts, outreach sites and at community level districts across the country with varying degree of coverage targeting 11,000 children. While the integrated management of acute malnutrition programme are being implemented in the 58 drought affected districts the teams are also planning for the intensified multisectoral stunting reduction program in 17 districts targeting 13,500 children aged 6-59 months. As part of WHO’s Occupational Health Guidance, nutrition sector partners developed recommendations on the rational use of PPE in health facility and community settings for nutrition response in the context of COVID-19. Nutrition sector partners developed nutrition specific Standard Operating Procedures (SOPs) and IEC material in collaboration with Ministry of Health (MOH) for COVID-19 response. The sector is currently procuring supplies to ensure continued nutritional focused services for children and mothers whose nutrition status is affected by measures placed to control COVID outbreak.

Gaps

Suspended international flights impacted partners ability to procure and provide essential nutrition supplies.

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Inadequate stock pills of essential nutritional supplies in the health facilities needs to be addressed urgently to protect degradation of moderate malnutrition (MAM) children to severe acute malnutrition (SAM) status. Inadequate information system to monitor the nutritional status of children and vulnerable people.

SECTOR STATUS (15 Jun 2020)

Protection (GBV and Child Protection)

3,063 296k calls received at the Lifeline hotline people targeted

Needs

Due to travel and movement restriction, the number of reported GBV cases are low in the past three months raising concern on access to health facilities and access to service for GBV survivor. Despite social workers and health care workers being frontline workforce in COVID-19 response, limited PPE has exposed health workers for COVID-19 and limited effectiveness of response. Women of reproductive age and adolescent girls need dignity kits. Mama kits are also needed. Additional methods of family planning methods are needed.

Response

The Protection Sector developed referral pathway visual diagrams for Lunga and Gwembe Districts to support coordinated GBV prevention and response. Joint community radio program developed for covering child-related issues in community radio as well as coordinated distribution of messaging on sensitization of increased risk of violence during COVID-19 running in Nakonde, Kasumbal, Chirundi and Livingstone districts. A total of 3,063 calls received via the Lifeline hotline in first week of May (Girls: 388; Boys: 725; F 739; M 1,211). Over 50 per cent of all calls are about COVID-19 related concerns. Lifeline provided on spot phone consultation and also redirected requests to relevant sectors for immediate sport. Target households with persons with disabilities were provided with the following supports: over 614 households received food hampers; 422 face masks distributed to persons with disabilities and 23 washing buckets given to farms centres that house persons with disabilities. Twelve community radio programs on COVID-19 response have been aired and targeted persons with disabilities especially those who are visually impaired and physically challenged. COVID-19 centred Age, Gender and Diversity (AGD) participatory assessment conducted in Maheba and Mayukwayukwa refugee settlements, including the local integration area, to identifying any COVID-related negative impact and opportunities from the persons of concern.

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A total of 44 SGBV and GBV/Child and Youth Care (CYC) workers were trained on COVID-19 IPC and case management in Maheba Refugee Settlement, the Health Office provided the training with support from the UN Zambia. The sector engaged with Nakonde District Health Office staff one-stop centre to support that awareness raising interventions to dispel misinformation of communities, particularly women seeking maternal health and GBV response services from health facilities. In collaboration with Nakonde District Health Office, the sector commenced a targeted distribution of 40 dignity kits to the most vulnerable women and girls of reproductive age. Each kit comprised the following items: a face towel, a pack disposable sanitary pads, 2 metre chitenge (piece of cloth), 200 grams of soap, laundry bar soap big size, 20- litre bucket, cotton underwear, toothpaste, toothbrush, 250 grams of petroleum jelly, 400mls of hand sanitizer and standard size bath towel. As part of awareness raising efforts, the Nakonde District Health Officers staff were oriented on how to conduct dignity kits distribution which serves as an entry point for the engagement with women of the reproductive age. The sector provided 40 hand sanitizers to Nakonde District Health Office targeting midwives, nurses and clinical officers in 16 out of 18 health facilities in the district. Coordinated with provincial pharmacist and medical stores at national level to ensure that emergency order for stocked out items (jadalle, sayana press and implanon) is replenished. The sector provided capacity building support for 25 Nakonde district multi-sectoral team on Minimum Initial Service Package (MISP) in Humanitarian setting, GBV prevention and response and prevention of sexual exploitation and abuse (PSEA) during COVID-19 UN multisectoral response in Nakonde district. This was done to ensure that SRH, GBV and PSEA are integrated into all aspects of COVID-19 in the district since COVID-19 is expected to increase the risk of gender-based violence, sexual exploitation and abuse and exacerbates inequalities and existing vulnerabilities including limiting access to SRH services among the affected population. The sector engaged with Nakonde district health office (DHO) staff provided sexual reproductive health support targeting health facilities, POE, sex workers and other strategic locations in the districts.

Gaps

There is not enough sexual- and gender-based violence (SGBV) data in the context of COVID-19 to inform response. Stress baggers including women, children and person with disability are not provided with necessary support to prevent from the virus. Food hampers for target population under COVID-19 response are inadequate as the need far exceeds the supply available. There are limited IEC materials for inclusive messaging targeting people with disabilities and other vulnerable people with a wide variety of needs. In Nakonde district, COVID-19 response is mainly concentrated in Nakonde urban area and the population in rural areas have limited information and thus they are at risk of being left behind. There is lack of mental health and psycho-social support services for COVID-19 affected households and individuals. Inadequate surgical masks, hand sanitizers, hand washing facilities, soap for all the health care providers including midwives. Lack of the aforesaid items puts the lives of midwives and women who come for deliveries at risk of acquiring the virus. Orientation of sex workers on GBV and SEA prevention and availability of services is required. This would best be done within their networks. Orientation of multisectoral response teams in GBV and SEA, both health and non-health essential staff, is requiered.

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SECTOR STATUS (14 Jun 2020)

Water, Sanitation and Hygiene (WASH)

39,162 1.6M people provided with WASH supplies people targeted

Needs

According to Zambia Demographic and Health Survey (ZDHS) - 2018, more than 36 per cent per cent of Zambia’s population lacked access to basic drinking water services while more than 67 per cent lacked access to basic sanitation services in 2018. An estimated 10 per cent of the population practiced open defecation while 76 per cent of households did not have access to a handwashing facility with soap and water in 2018. Lack of adequate WASH services may pose serious challenge for effective prevention and control of COVID-19. For effective COVID-2019 response, it is, therefore, critical not only to sustain the existing water, sanitation and hygiene (WASH) services but also scale-up these to reach the un-served and under-served vulnerable population, as well as meet the increased demand. Against the above backdrop, the planned WASH response is meant to contribute to GRZ’s wider efforts aimed at reduction of exposure to and prevention of the human to human transmission of COVID-19 through strengthening IPC and sustaining and scale-up of WASH services and promotion of appropriate hygiene behaviours.

Response

A WASH Sector Response Plan for COVID-19 has been developed by the Ministry of Water Development, Sanitation and Environmental Protection with support from the UN and sector partners. A total of 141 health-care facilities and isolation centres benefitted from WASH and IPC improvement measures including rehabilitation of WASH infrastructure and/or provision of supplies such as chlorine, handwashing stations, soap, medical waste bins, menstrual hygiene management kits and other supplies in Kasama, , , Nakonde, Lusaka, , Shibuyunji, , Katete, Mambwe, Chipata, , , , , , , , Mbala, Mpulungu and Kasama districts. Over 1,909 healthcare facility staff were trained on Infection Prevention and Control in Nyimba, Shibuyunji, Mumbwa, Chipata, Katete, Kasama, Mbala, Mpulungu and Nakonde districts. Over 28,000 people were provided access to safe water in rural areas in Nyimba, Mumbwa and Shibuyunji districts. Over 39,162 people were provided with WASH supplies including soap or water containers in refugee settlements in , Kaoma and Kalumbila districts. In collaboration with the Risk communication and Engagement Sector, an estimated of one million people were reached with messages on safe hygiene practices. Hygiene supplies, including soap, chlorine, handwashing stations, were procured for 733 schools and distribution has commenced. These supplies will be distributed in the target schools in , Kalumbila (Meheba), Katete, , Nyimba, Chibombo, , Mumbwa, Monze, Mazabuka, Pemba, Namwala, Kalomo,

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Sinazongwe, Isoka, Nkeyema and Luampa.

Gaps

Planned activities to support commercial utilities in improvement and continuity of WASH services have not yet started due to funding gaps.

COORDINATION (14 Jun 2020)

General Coordination

The United Nations Resident Coordinators Office is co-leading the COVID-19 response in collaboration with the Government of Zambia Disaster Management and Mitigation Unit (DMMU) complementing the Governments response. A total of eleven sectors were identified for this response with line ministries as lead and UN agencies co-leading sector responses. WHO continues as the technical co-lead agency supporting the Ministry of Health and Zambia Public Health Institute (ZNPHI). All sectors are coordinated by DMMU in the intersectoral coordination meeting. The Disaster Management Consultative Forum (DMCF) chaired by the National Coordinator DMMU and UN Resident Coordinator attended by all sector leads and co-leads, co-operating partners, INGOs, NGOs and the private sector.

OCHA coordinates the global emergency response to save lives and protect people in humanitarian crises. We advocate for effective and principled humanitarian action by all, for all. https://www.unocha.org/southern-and-eastern-africa-rosea/zambia https://www.humanitarianresponse.info/en/operations/zambia

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