Building Resilience in the Health Supply Chain to respond to the COVID-19 pandemic

Since Zambia recorded its first confirmed COVID-19 case in March 2020, the transport and logistics industry has been under increasing pressure to maintain supply chains of essential goods and medicines across the country. Regional travel restrictions and border testing regimes, introduced to slow the spread of the virus, have disrupted the movement of health commodity cargo, leaving land-locked countries such as Zambia particularly vulnerable to commodity shortages and stock outs. There is growing concern that further disruption to vital supply chains would seriously undermine Zambia’s ability to maintain the distribution of essential medicines across the county whilst in parallel mounting a coordinated response to the COVID-19 pandemic.

In order to protect key workers, Transaid in partnership with the Industrial Training Centre (ITC), and supported by the Zambia Ministry of Health and UK industry, developed a communicable diseases training manual with a focus on COVID-19 awareness and preparedness. Transaid then conducted a Training of Trainers (ToT) programmes to equip ITC trainers with the skills required to deliver the COVID-19 training, and between September 2020 and February 2022, ITC trainers delivered the training to professional drivers and warehouse colleagues working in Zambia’s central and regional medical stores.

A total 101 health supply chain colleagues received the training and 120 packages of Personal Protective Equipment (PPE) were handed out. In addition, 2,158 printed factsheets were distributed and a further ~4,000 professional drivers received digital copies via the WhatsApp messaging platform.

Please click below to download the full technical brief.

Evidence brief: Scaling up Safe Motherhood Action Groups in Zambia

The Mobilising Access to Maternal Health Services in Zambia programme (MAMaZ) and its successor programme, MORE MAMaZ, supported the scaling up of the national Safe Motherhood Action Groups (SMAG) initiative between 2010 and 2016. Government efforts to roll SMAG activities out to new areas (horizontal scale-up) and to build institutional ownership, thereby placing the initiative on a sustainable footing (vertical scale-up) were supported. These scaling up experiences are highly relevant in a context where current global health policy gives high priority to accelerated implementation of evidence-based initiatives to ensure the survival of every newborn, mother and child.

This brief sets out to capture the changes that have occurred in communities where Safe Motherhood Action Groups (SMAGs) are operational.

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Evidence brief: Addressing Gender-based Violence through Safe Motherhood Action Groups in Zambia

The term gender-based violence (GBV) includes any form of violence against women. Despite a favourable policy environment with the introduction of the anti-GBV law, GBV statistics in Zambia remain high. Of women aged 15-49 years, 43% have experienced physical violence at some point in their lives, 37% in the previous 12 months. Moreover, 17% of women and girls have experienced sexual violence, and 10% have experienced violence while pregnant (2014 Zambia Demographic and Health Survey).

Continuing the work of a predecessor programme, MAMaZ (2010-2013), which was funded by UK aid from the UK government, the Comic Relief-funded MORE MAMaZ programme (2014-2016) took steps to integrate a focus on GBV into the training of Safe Motherhood Action Group (SMAG) volunteers.

The MORE MAMaZ GBV interventions resulted in transformative change for women. Intervention communities reported a very significant reduction in GBV. Some communities perceived that GBV had been eliminated, with these changes attributed to the work of the SMAG volunteers.

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Evidence brief: Key Results from MAMaZ Against Malaria – A Pilot Project Focused on Increasing Rural Communities’ Access to Rectal Artesunate

According to Zambia’s national Health Management Information
System (HMIS), a reported 1,851 Zambians died of malaria in
2016. Many other malaria deaths occur at community level and
go unrecorded. Reported malaria cases increased between 2015-
2016. If Zambia is to achieve the global target of a 40% reduction
in malaria incidence by 2020, a priority focus on areas of highest
mortality, including severe malaria in young children, will be
important.

This evidence brief presents the key results from the MAMaZ Against Malaria (MAM) project, a pilot focused on increasing rural communities’ access to rectal artesunate.

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Scaling up RAS in Zambia: Results from MAM@Scale – webinar slides

In this webinar, held on 01.02.2022, the project team and partners presented the final results from MAMaZ Against Malaria at Scale, a project that supported the roll-out of quality assured pre-referral RAS in Zambia.

The webinar traced how the project scaled up from a small single-district pilot in 2017 to a much larger-scale initiative that was implemented in ten districts by 2021. Experience and lessons learned along the way were shared by the team. This webinar was also an opportunity to hear the plans for further national scale-up within Zambia.

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Scaling up rectal artesunate in a community-based initiative in Zambia: Final results from MAM@Scale

As the global development agenda converges around the Sustainable Development Goals (SDGs) and aims for Universal Health Coverage (UHC), there is much emphasis on the need for an inclusive development approach. To achieve this, communities need to be at the centre of interventions and must have the knowledge and resources to drive their own development agenda according to their local needs. However, in rural Zambia, as in many other sub-Saharan African contexts, communities continue to face multiple barriers in accessing basic services. Underlying factors include geographical, financial and social constraints.

The MAMaZ Against Malaria (MAM) and MAM@Scale projects aimed to reduce preventable deaths from severe malaria by introducing and expanding the availability of an innovative pre-referral intervention at community level in remote rural districts in Zambia over the period 2017-2021. In this evidence brief, we share the final results of the MAM@Scale project.

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Trainer’s manual for delivering communicable disease awareness and preparedness training with a focus on COVID-19 for increasing resilience in Zambia’s health supply chains

Since Zambia recorded its first confirmed COVID-19 case in March 2020, the transport and logistics industry has been under increasing pressure to maintain supply chains of essential goods and medicines across the country. Regional travel restrictions and border testing regimes, introduced to slow the spread of the virus, have disrupted the movement of health commodity cargo, leaving land-locked countries such as Zambia particularly vulnerable to commodity shortages and stock outs. There is growing concern that further disruption to vital supply chains would seriously undermine Zambia’s ability to maintain the distribution of essential medicines across the county whilst in parallel mounting a coordinated response to the COVID-19 pandemic.

In order to protect key workers, Transaid in partnership with the Industrial Training Centre (ITC), and supported by UK industry, have developed a communicable diseases training manual with a focus on COVID-19 awareness and preparedness. The training is suitable for colleagues working at all levels of the health supply chain workforce, and includes additional modules aimed at Fork Lift Truck (FLT) operators and Heavy Goods Vehicles (HGV) drivers.

Click below to download the manual.

MAMaZ Against Malaria at Scale: Midline Survey Report

The MAM@Scale project is a scale up of the pilot project which was carried out in Serenje district between July 2017 and July 2018. The main objective of conducting the midline review was to gauge progress to date of the MAM@Scale activities. The results in this report reflect progress part way through implementation of the project (the current phase of the project ends on 30 November 2020). The review was carried out in selected project areas to review progress in achievements and assess the possible change that can be attributed to the project, particularly with regards to management of cases of severe malaria. The review was conducted in June and July 2020.

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Results of a community-driven intervention in rural Zambia to reduce child mortality – Evidence Brief

As the global development agenda converges around the Sustainable Development Goals (SDGs) and aims for Universal Health Coverage (UHC), there is much emphasis on the need for an inclusive development approach. To achieve this, communities need to be at the centre of interventions and must have the knowledge and resources to drive their own development agenda according to their local needs. However, in rural Zambia, as in many other sub-Saharan African contexts, communities continue to face multiple barriers in accessing basic services. Underlying factors include geographical, financial and social constraints.

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Importance of gender empowerment to reducing malaria mortality in Zambia – Evidence Brief

Gender equality and women’s empowerment are key to achieving universal health coverage. They are also important in their own right as a means to achieve sustainable development. Building on a successful gender mainstreaming approach used in three earlier projects, MAM@Scale integrated a focus on gender into the design of a severe malaria intervention in Zambia. Community health volunteers (CHVs) were trained to administer quality assured 100 mg rectal artesunate to children with severe malaria danger signs at community level and to refer patients to the health facility for further treatment. The project’s gender strategy aimed to address the wide range of social norms and gender stereotypes that prevented rural households from responding promptly to severe malaria and other child health emergencies.

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Adapting a severe malaria intervention in Zambia in the context of COVID-19 – Evidence Brief

In early March 2020, coronavirus (COVID-19) was declared a pandemic by the World Health Organization. Many countries had started to take steps to isolate suspected cases, ban mass gatherings and public events, close schools and universities and impose social distancing. At the time, MAMaZ Against Malaria at Scale (MAM@Scale) was implementing a community level intervention to address severe malaria targeted to young children in five districts of Zambia, working in partnership with district health teams. Responding to an urgent request by the Ministry of Health (MOH) for development partners to help build community preparedness and resilience, the project swiftly pivoted its activities to integrate a COVID-19 focus.

This evidence brief looks at how MAM@Scale adapted a severe malaria intervention in Zambia in the context of COVID-19.

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Scaling up rectal artesunate in Zambia – Evidence Brief

Over 7,500 malaria deaths occurred in Zambia in 2018 and children under six are the most susceptible due to their lack of immunity. MAM@Scale empowered Zambian families in five districts (Chitambo, Serenje, Chama, Manyinga and Vubwi) to reduce their mortality risk from severe malaria by introducing artesunate rectal capsules (known locally as rectal artesunate or ‘RAS’), a cutting-edge pre-referral intervention given at community level to children aged six months to six years old. The MAMaZ Against Malaria (MAM) pilot project (2017-2018) reported a reduction in severe malaria case fatality from 8% to 0.25% in intervention sites in Serenje district.

Building on this evidence base, MAM@Scale began implementation in December 2018 with funding from Grand Challenges Canada, Medicines for Malaria Venture and Transaid. Originally an 18-month intervention, additional funding from FIA Foundation, Grand Challenges Canada and a private donor extended the project by six months and enabled the inclusion of a COVID-19 focus. MAM and MAM@Scale built on a longer-term investment in community health systems strengthening by two earlier projects.

This evidence brief looks at scaling up progress so far and highlights some key lessons to guide wider national scale up of the innovation.

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