Literature Review: An Investigation into the Impact on Social Inclusion of High Volume Transport Corridors and Potential Solutions to Identifying and Preventing Human Trafficking

This report presents a literature review and annotated bibliography undertaken as part of the research project: An Investigation into the Impact on Social Inclusion of High Volume Traffic (HVT) Corridors, and Potential Solutions to Identifying and Preventing Human Trafficking. The literature review followed the core principles of a systematic literature review process. The review found that very little is known about the relationship between Trafficking in Persons (TIP) and HVT corridors, other major trade routes and border crossings along these routes. It also found that the role of transport sector operators within the human trafficking process is not well understood. This validates the choice of research topic and confirms the need to strengthen the evidence base on these issues.

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Report: Midline Survey Findings from the MAMaZ Against Malaria at Scale Programme

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

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

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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Case study: Chitambo District Health Office (DHO) partnering with MAM@Scale in the COVID-19 response

The collaboration between Chitambo District Health Office (DHO) and MAM@Scale has been very effective, not only in the treatment of severe malaria at community level using rectal artesunate, a pre-referral drug, but also developing strong preventative measures against COVID-19 in this transit town.

MAM@Scale uses a strong community engagement approach by establishing and strengthening community systems to uplift health standards at community level. It is an inclusive approach that engages people at all levels, from traditional leadership to members of the community. People who volunteer to work for the community are trained in health education and become the providers of basic health services at community level. Food banks and savings schemes are formed in the communities to fight affordability barriers. This has not only raised demand for health services in the facilities that MAM@Scale is supporting in Chitambo district, but it made it much easier to put up preventative measures against COVID-19.

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Case Study: Baron educates people on malaria, emergency transport systems and COVID-19 on air

Fwanta is a community in the Kabamba area of Serenje District, Zambia.  In the past, many people in Fwanta who developed medical complications, be it maternal or malarial related, died because people wrongly interpreted the danger signs.

A turning point happened when MAMaZ Against Malaria at Scale (MAM@Scale) began working with this community and the Kabamba Rural Health Centre. They trained Community Health Volunteers (CHVs) on the management of severe malaria at community level through the administering of a Rectal Artesunate Suppository (RAS). MAM@Scale also provided an emergency transport system (ETS), in the form of a bicycle ambulance, to Fwanta.  Baron Mupeta was one of the people selected to be trained as an ETS rider.

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Case Study: Brenda Kundo

Community Health Volunteers (CHVs) are the backbone of the health system in rural Zambia, where they provide invaluable health advice to their communities, which are located prohibitively far from health facilities. Before the pandemic, CHVs were a vital part of our MAM at Scale programme, combatting malaria in their community by educating families on the danger signs of severe malaria and administering RAS (rectal artesunate suppositories), a pre-treatment for children with suspected severe malaria.

CHVs are a trusted voice in their communities, so it was natural that they would form the cornerstone of MAM at Scale’s COVID-19 response. To meet the challenges of the pandemic, the MAM at Scale team has orientated nine Community Facilitators on COVID-19, who have in turn trained 1,379 CHVs, who will help keep their communities safe during the pandemic.

Brenda Kunda is a Community Facilitator with MAM at Scale. A tragic experience in Brenda’s life eventually led to a positive change, not only for her, but for her family and her entire community.

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Staying Safe in the Workplace – COVID-19 Information for the Health Supply Chain Workforce

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 vulnerable to commodity shortages and stock outs. With this in mind, it is vital that action is taken to build resilience in the health supply chain workforce, to ensure that preventative medicines and equipment continue to reach the most vulnerable people, especially at a time when the pandemic threatens to overwhelm an already fragile health system.

In an effort to protect Zambia’s health supply chain from shocks arising from the current COVID-19 pandemic and future pandemics, Transaid collaborated with the Industrial Training Centre (ITC) to develop a short training module to inform and sensitise the health supply chain workforce to work-related COVID-19 risks. In addition to this training, an illustrated factsheet featuring training-related memory aides was developed and included as part of a personal protective equipment (PPE) package distributed to the training recipients. The factsheet includes additional cleaning checklists to ensure that the specific needs of professional drivers and forklift truck operators are incorporated.

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Protect Yourself Against COVID-19 – Information for Professional Drivers Working in Zambia factsheet

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. Some professional drivers continue to endure challenging working conditions and possible increased road safety risks, while increased demand for emergency orders means that protecting keyworkers from exposure to the virus is more important than ever.

In response, Transaid, together with the Industrial Training Centre (ITC) in Zambia have developed a COVID-19 factsheet for professional drivers working in Zambia, which includes information about symptoms and context-related preventative measures, such as regular cab sanitisation, aimed at reducing the risk of exposure and transmission. Road safety advice is also included, with drivers being alerted to potential emerging road safety risks as well as the possible rise in theft from vehicles caught in long tailbacks at border crossings.

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The potential role of mobile phone technology in rural motorcycle and three-wheeler taxi services in Africa

Over the last two decades, motorcycle and motorised three-wheeler taxis have become important means of transport in many sub-Saharan African countries, including in rural areas. However, the emerging role of mobile phone technology in improving mobility in rural areas is currently under-explored in the literature.

This paper presents the findings of a small-scale research study that was undertaken into the use of mobile phone technology in the context of motorcycle and three-wheeler taxi use, and its potential to improve rural access. Informed by a literature review, the research focuses on four countries: Kenya, Rwanda, Tanzania and Uganda. Semi-structured interviews and focus group discussions were conducted with riders of motorcycle and motorised three wheeler taxis and the developers of mobile phone-enabled transport technologies.

Mobile technology linked to the utilisation of motorcycle and three-wheeler taxis is increasing, but ‘ride hailing’ applications (apps) are likely to be limited to urban areas for the foreseeable future due to various disincentives to their use in rural areas. The study identifies several promising innovations that combine the use of motorcycles and three-wheelers with mobile technology to increase rural people’s access to essential services and opportunities. These have the potential to be scaled up or expanded to other countries.

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