ZAMBIA ANNUAL REPORT | 2019 FULFILLING THE PROMISE © YWCA/Zambia UNFPA WORKS TO END… 1. UNMET NEED FOR FAMILY PLANNING 2. PREVENTABLE MATERNAL DEATHS 3. GENDER BASED VIOLENCE AND ALL HARMFUL PRACTICES, INCLUDING CHILD MARRIAGE 1 © UNZambia/Georgina Smith ZAMBIA ANNUAL REPORT | 2019 3 | MESSAGE FROM THE REPRESENTATIVE 5 | FLASHBACK! ON THE ROAD TO THE NAIROBI SUMMIT ON ICPD25 7 | TOWARDS ENDING UNMET NEED FOR FAMILY PLANNING 11 | TOWARDS ENDING PREVENTABLE MATERNAL DEATHS 17 | TOWARDS ENDING GENDER-BASED VIOLENCE AND HARMFUL PRACTICES 20 | TOWARDS ENDING SEXUAL TRANSMISSION OF HIV 22 | PROGRAMME ENABLERS 28 | LOOKING AHEAD IN 2020 2 © UNZambia/Georgina Smith IN THE PICTURE: UNFPA Representative Ms. Gift Malunga (M) during a visit to a maternity ward at Solwezi General Hospital in North- Western Province. “I decided to become a midwife to save mothers and newborns” - says Levy [R] as he proudly introduces pre-term baby *John to Ms. Malunga and UNFPA staff. Thanks to skilled midwives trained with support from UNFPA, baby *John is well and thriving. © UNFPA/Zambia MESSAGE FROM THE REPRESENTATIVE In 2019, the 25-year review of the Key strategic engagements International Conference on included the participation of the Population and Development Office of the First Lady, Minister of (ICPD25) revealed what the world, Development Planning, Minister of and indeed what Zambia can Health, Parliamentarians, achieve if it focuses on rights and Cooperating Partners, Donors and choices for all, including a renewed Traditional Leaders at the triple commitment towards sexual launch of the ICPD25, UNFPA@50 reproductive health and rights. and 2019 State of World Population Report; the high-level Throughout the year, UNFPA outreach to George Clinic in sustained strategic engagements Lusaka; and the 2019 World with key decision makers and Population Day, among others. partners towards accelerating the ICPD agenda. 3 Delivering a world where every pregnancy is wanted every childbirth is safe and every young person’s potential is fulfilled The engagements culminated in the Thank you to each and every national participation of various stakeholders at partner working with UNFPA, as well as our the Nairobi Summit on ICPD25 held in donors, whose contribution at national and November 2019, under the leadership of sub-national level enabled us to deliver the Ministry of National Development results for women and young people in Planning. The Minister of National Zambia. Development Planning presented Zambia's commitments to achieving the In 2020, we look forward to strengthening ICPD Programme of Action results by our collective efforts as the global 2030. Further, an action plan for community embarks on the Decade of operationalizing the commitments has Action for the Sustainable Development been developed and is being rolled out Goals (SDGs); as well as marks the 25th starting in 2020. anniversary of the Beijing Declaration and Platform for Action, aimed at accelerating Two and a half decades since the 1994 the realization of gender equality and the commitments made in Cairo, Zambia has empowerment of all women and girls, seen tremendous progress in the health everywhere. and development of its population; with preventable maternal deaths declining by Our work will remain focused on fostering more than half - from 649/100,000 live strategic partnerships to advance the ICPD births in 1996 to 278/100,000 live births in agenda; and to contribute towards 2018; increase in the use of modern achievement of Zambia’s development contraceptives - from 9% in 1992 to aspirations as articulated in the 7th National 47.5% in 2018 (ZDHS 2018); and Development Plan and Zambia’s Vision heightened national attention to violence 2030 of becoming a prosperous middle- against women and girls as the income country. Government of Zambia continues to create an enabling environment that promotes gender-equality and human rights. The 2019 UNFPA Zambia Annual Report highlights key results recorded in 2019 under the Government of Zambia - UNFPA 8th Country Programme of Corporation; in line with the UNFPA Ms. Gift Malunga global Transformative Results of Ending UNFPA Representative Unmet Need for Family Planning; Ending Preventable Maternal Deaths; and Ending Gender-Based Violence and Harmful Practices; and the regional target of ending sexual transmission of HIV by 2030. 4 ZAMBIA’S COMMITMENTS FOR THE ICPD25 We commit to invest in primary health care, 1. particularly health promotion, robust and sustainable healthcare financing mechanisms. 2. We also commit to position Family Planning as a key development agenda for Zambia to Harness the Demographic Dividend. ICPD in 3. We commit to eliminate all forms of discrimination, Action! High- and strengthen humanitarian preparedness and level outreach response. to George Clinic in 4. We further commit to strengthen equitable access to Lusaka resources to reach the most vulnerable of our population. 17 April 2019: To kick-start the ICPD25 commemorations 5. We commit to end all forms of discrimination against in 2019, the Office of the First Lady, Minister of Health, women and girls by domesticating international and European Union, DFID and the UN Zambia Country Team regional instruments such as the CEDAW and SADC held a high-level outreach to George clinic in Lusaka, protocol on gender and development. during which mothers and their newborn babies received mama-packs containing essential health and hygiene 6. We further strongly commit to end child marriage by items donated by UNFPA and Esther Lungu Foundation taking all necessary measures to accelerate Trust. implementation of the National Strategy and other policy and legislative frameworks to end child marriage by 2030. 7. We commit to promoting meaningful participation of adolescents and young people in national development by including them in development planning and implementation, monitoring and evaluation. 8. Our Government further commits to promote people centered development in all sectors by integrating population dynamics into development planning at the national and sub-national levels, and enhance rural industrialization and development by advancing implementation as enshrined in our Vision 2030. 9. We commit to promote generation and use of data to Triple Launch of ICPD25, UNFPA@50 and achieve sustainable development and make climate change a core part of economic development. 2019 State of World Population Report 6 June 2019: The Government of Zambia in collaboration 10. We want to provide financing for the outlined commitments, and as such we pledge to create fiscal UNFPA held a high-level event to commemorate the space by broadening our tax base, exploring ICPD@25 and UNFPA’s 50th anniversary, and to launch alternative financing mechanisms, and the 2019 State of World Population Report. implementation of the debt sustainability strategy. 5 Inclusion in Sport: Young People with Disabilities Participate in the 2019 UN Zambia’s Participation at All Africa Games The Nairobi Summit on ICPD25 11 October 2019: More than 100 children and 12-14 November 2019: The Minister of National young people with disabilities put on their running Development Planning led the Zambian delegation shoes and ran alongside United Nations staff from to the Nairobi Summit on ICPD25, where he read over 14 African Countries, during the official Zambia’s commitments on behalf of H.E President opening of the 12th UN All Africa Games hosted Edgar Lungu. The voices and representation of by Zambia from 11-12 October 2019. With a Zambian stakeholders, women, young people and special 50 meters marathon route set up for the persons with disabilities affirmed progress towards children and young people, the marathon aimed to Zambia’s commitments to the ICPD Programme of encourage a more inclusive society through sport, Action; as well as the critical need to invest in key as well as advocate for enhanced actions to actions that will ensure no one is left behind in the ensure no one is left behind as Zambia moves quest to achieve Zambia’s Vision 2030 towards fu lfilling the promise of ICPD. 6 CONTEXT ACTION In 2019, UNFPA continued to support the Specific actions by UNFPA and the Government of the Republic of Zambia in Government of Zambia included the following: the implementation of the National Family Planning Scale-up Plan (2013 to 2020), which aims to contribute towards o UNFPA’s procurement of an estimated increasing the national contraceptive 50% of targeted commodities for the prevalence from 33% to 58% and reduce public sector, among others. unmet need for Family Planning from 22% to 14% by the year 2020. o Capacity building of supply chain managers, healthcare providers and community based distributors to improve Trends in Use of Family demand, supply and access to family Planning planning commodities. o National rollout of the Subcutaneous Results from the 2018 Zambia Depot Medroxyprogesterone Acetate Demographic and Health Survey revealed (DMPA-SC), through Community Based significant improvements in family Distributors (CBDs) and the propagation planning indicators. Unmet need for family of self-injection, which are expected to There are 60,000 new HIV planning reduced from 21% to 20%, while significantly contribute to meeting the the use of modern methods of national commitments. infections per year; and 21, contraception increased from 45% to 48%. 000 new HIV infections among However, teenage pregnancy increased o Strategic engagements towards the young people aged 15-24 from 28.5% to 29.2%,