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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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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Many government supply chains operate with limited transport capacity, which limits their ability to make last mile deliveries, and results in health workers collecting commodities from the next tier in the supply chain. Outsourcing is often used as a means to improve efficiencies, access new capabilities or access additional capacity, which has yielded successful results in some cases. Outsourcing is also an option when financing for an asset is not available which this is becoming an increasingly important issue now as donors are reluctant to pay for warehouses and trucks for Central Medical Stores (CMS).
This report focuses on how to outsource the physical distribution of vaccines and medical products to a private sector Logistics Service Provider (LSP) in sub-Saharan Africa. It analyses existing approaches to outsourcing, the challenges encountered and lessons learned. A number of outsourcing examples have been identified within the focus countries of Uganda, Zambia, Mozambique, Senegal, Nigeria, Ghana, Kenya, Tanzania and Malawi. These primarily focus on the distribution of ambient medical products, and incorporate many elements of vertical supply chains such as those part of the government operated CMS supply chain. There are just two examples of outsourced vaccine logistics that have been identified, a public private partnership in South Africa, and one in Nigeria.
The framework has been designed specifically to assist government operated CMS vaccine and medical supply chains in outsourcing distribution services. The report uses templates and documents to describe how to manage an outsourcing in a structured manner. It also includes a practical toolkit to assist government operated CMS vaccine and medical supply chains in the outsourcing of distribution services. The Outsourcing Framework begins with a list of considerations for outsourcing and explains the process from creating a project plan and RFP, through contracting to implementation and business as usual.
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This technical case study outlines the methodology and outcomes from an activity delivered with the Clinton Health Access Initiative (CHAI) in Zambia to establish a referral system through the deployment of a rural motorcycle ambulance service (using eRangers).
CHAI, with funding from the Swedish International Development Cooperation Agency (SIDA) is implementing a health system strengthening programme to reduce maternal and new-born mortality in 14 districts in Muchinga, Northern and Luapula Provinces, Zambia. The programme aims to strengthen four key health system weaknesses; the skills of providers through training and mentorship; the availability of equipment in facilities; the use of data to improve service delivery and the improvement of the referral system.
This tool is to be used to help decide the optimal placement of vehicles at district level and should be used as part of overall vehicle operational management. The tool helps health teams justify the positioning of new health vehicles using a series of criteria such as distance, terrain, communications coverage and catchment population. It was originally designed for placement of motorcycle ambulances as part of a Clinton Health Access Initiative (CHAI) maternal health programme but it can be adapted depending on need.
CHAI, with funding from the Swedish International Development Cooperation Agency (SIDA) is implementing a health system strengthening programme to reduce maternal and new-born mortality in 14 districts in Muchinga, Northern and Luapula Provinces, Zambia. The programme aims to strengthen four key health system weaknesses; the skills of providers through training and mentorship; the availability of equipment in facilities; the use of data to improve service delivery and the improvement of the referral system.
This report presents key findings and recommendations from a recent intervention where Transaid partnered with the Directorate of Road Traffic and Safety Services (DRTSS), to develop the capacity of HGV and PSV driver trainers in Malawi.
Transaid’s Professional Driver Training Programme builds the capacity of driver trainers to deliver training to internationally recognised standards and in so doing, to reduce the number of road fatalities and injuries. Road crashes are fast becoming the leading cause of death for people in Sub-Saharan Africa. The Malawi Professional Driver Training Programme was carried out with the support of several professional volunteers from the transport and logistics sector in the UK. Silvio Sorrentino Rodriguez (seconded from National Express) coordinated the in-country programme which included technical training inputs supported by Hoyer, DHL, National Express and the Road Haulage Association. In addition to training, a review of processes including licensing, driver training, and donor support for road safety was carried out with a view to identifying next steps to achieving the objectives as set out in Malawi’s National Road Safety Strategy 2015-2020.
This technical brief outlines the strategy, policy implications, results and lessons learned from the SMAG initiative for an integrated and comprehensive community approach targeting social exclusion of women in the More MAMaZ programme.
The MORE Mobilising Access to Maternal Health Services in Zambia (MORE MAMaZ) Programme is a partnership initiative between the Government of the Republic of Zambia (GRZ) and a consortium comprising of; Transaid, Health Partners International (HPI), Development Data, and Disacare. MORE MAMaZ is funded by Comic Relief. The programme expanded activities of the MAMaZ Programme which was implemented by HPI between 2010 and 2013 and funded by DFID. More MAMaZ began in April 2014 and ran for 30 months to the 30th of September 2016.
This technical brief outlines the strategy, policy implications, results and lessons learned from the SMAG initiative to empower women and girls under the More MAMaZ programme in Zambia.
The MORE Mobilising Access to Maternal Health Services in Zambia (MORE MAMaZ) Programme is a partnership initiative between the Government of the Republic of Zambia (GRZ) and a consortium comprising of; Transaid, Health Partners International (HPI), Development Data, and Disacare. MORE MAMaZ is funded by Comic Relief. The programme expanded activities of the MAMaZ Programme which was implemented by HPI between 2010 and 2013 and funded by DFID. More MAMaZ began in April 2014 and ran for 30 months to the 30th of September 2016.
This technical brief outlines the key findings of MORE MAMaZ’s community empowerment initiative, detailing the strategy, findings, recommendations and lessons learned during the duration of the programme.
The MORE Mobilising Access to Maternal Health Services in Zambia (MORE MAMaZ) Programme is a partnership initiative between the Government of the Republic of Zambia (GRZ) and a consortium comprising of; Transaid, Health Partners International (HPI), Development Data, and Disacare. MORE MAMaZ is funded by Comic Relief. The programme expanded activities of the MAMaZ Programme which was implemented by HPI between 2010 and 2013 and funded by DFID. More MAMaZ began in April 2014 and ran for 30 months to the 30th of September 2016.
This policy brief highlights how MORE MAMaZ’s approach to community monitoring systems (CMS) was cost-effective, self-sustaining and empowered communities.
The MORE Mobilising Access to Maternal Health Services in Zambia (MORE MAMaZ) Programme is a partnership initiative between the Government of the Republic of Zambia (GRZ) and a consortium comprising of; Transaid, Health Partners International (HPI), Development Data, and Disacare. MORE MAMaZ is funded by Comic Relief. The programme expanded activities of the MAMaZ Programme which was implemented by HPI between 2010 and 2013 and funded by DFID. More MAMaZ began in April 2014 and ran for 30 months to the 30th of September 2016.
This technical brief outlines the strategy, policy implications, results and lessons learned from the implementation of an Emergency Transport Scheme (ETS) in rural Zambia to improve access to maternal health services in the MORE MAMaZ Program.
The MORE Mobilising Access to Maternal Health Services in Zambia (MORE MAMaZ) Programme is a partnership initiative between the Government of the Republic of Zambia (GRZ) and a consortium comprising of; Transaid, Health Partners International (HPI), Development Data, and Disacare. MORE MAMaZ is funded by Comic Relief. The programme expanded activities of the MAMaZ Programme which was implemented by HPI between 2010 and 2013 and funded by DFID. More MAMaZ began in April 2014 and ran for 30 months to the 30th of September 2016.
This presentation was presented at the End of Programme Dissemination event in Zambia on 8th September 2016.
The MORE Mobilising Access to Maternal Health Services in Zambia (MORE MAMaZ) Programme is a partnership initiative between the Government of the Republic of Zambia (GRZ) and a consortium comprising of; Transaid, Health Partners International (HPI), Development Data, and Disacare. MORE MAMaZ is funded by Comic Relief. The programme expanded activities of the MAMaZ Programme which was implemented by HPI between 2010 and 2013 and funded by DFID. More MAMaZ began in April 2014 and ran for 30 months to the 30th of September 2016.