In Zambia, UNDP supported the implementation of Global Fund grants for HIV, tuberculosis and malaria. UNDP assumed the role of interim PR of Global Fund grants in Zambia in 2010. In addition to implementing the grants for HIV-AIDS, TB and malaria, UNDP was responsible for strengthening national capacity in key functional areas under Phase 1 of the Capacity Development and Transition Action Plan. These efforts were successful, with Zambia’s Ministry of Health reassuming the PR role in 2015.Read more...
To expedite implementation of the new Global Fund grants, in 2015 the Ministry of Health (MoH) in Zambia took the decision to appoint the country’s 10 Provincial Health Offices to function as Sub-Recipients, along with the Zambia Flying Doctors Services, the National AIDS Council, the Ndola Community Health Assistants School and the Tropical Diseases Research Centre. In November that year, the MoH in collaboration with UNDP, conducted assessments of these Sub-recipients, using tools aligned to the Global Fund minimum standards for grant implementers. This was followed, in January 2016, by an assessment of the capacity of the MoH for management and oversight of the designated sub- recipients. The results of the assessments informed the preparation of Phase 2 of the Capacity Development and Transition Action Plan for UNDP support to Zambia’s capacity to oversee and implement Global Fund grants. Phase 2 was running from January 2016 to March 2018.
Key results - HIV
793,000 people currently on antiretroviral therapy (2016)
461,000 deaths averted due to antiretroviral treatment of HIV between 2006 and 2016
102,805 HIV infections averted through prevention of mother-to-child transmission between 2006 and 2017
New HIV cases and AIDS related deaths
ART clinics and solar power
With support from the Global Fund and UNDP 38 new antiretroviral therapy (ART)clinics have been opened across Zambia giving vital access to ART for thousands of people. The investment of US$4.8 million in the prefabricated clinics means more people living with HIV across Zambia can now access the medication necessary to manage the disease and lead productive lives.Read more...
Running health facilities in areas with poor infrastructure is however a challenge; according to a WHO study covering over 4,000 clinics and hospitals in sub-Saharan Africa, about one in four health facilities have no access to electricity, and those with access report having an unreliable supply. Expensive and often unreliable diesel generators have traditionally powered off-grid facilities, whilst also serving as back-up for those on the grid. UNDP, with Norwegian Emergency Preparedness System's (NOREPS) emergency preparedness funding, has piloted solar photo-voltaic power (PV) systems in three primary health care clinics offering ART in Mpepo, Mulekatembo and Kazembe in Eastern Zambia. This reliable source of electricity means medicines, vaccines and laboratory reagents can now be stored safely and that water can be pumped and purified. This has improved equipment sterilization and allowed cold-chain storage for vaccines to be maintained.
Key results - malaria
12 million insecticide treated bed nets distributed
Coverage of bed nets (2016)
Source: World Health Organization
8 million cases of Malaria treated
Key results - TB
36,900 new smear positive TB cases detected and treated
Treatment success rate for all new cases of TB (2015)
Source: World Health Organization
TB incidence rate per 100,000 population
Capacity development and transition
In 2015 the Ministry of Health (MoH) in Zambia appointed the country’s ten Provincial Health Offices (PHOs) as sub-recipients (SRs), along with Zambia Flying Doctors Services, National AIDS Council, Ndola Community Health Assistants School and the Tropical Diseases Research Centre. The aim was to improve implementation of future Global Fund grants in future funding allocations. In order to achieve the transition, the SRs were assessed against the minimum standards required by the Global Fund for grant implementers and a programme of work to develop their capacity was drawn up (Capacity Development and Transition Action Plan - Phase II). The following section highlights the results of this programme of work from January 2016 to present.
Leadership and programme management
Integrated Mentorship and Technical Supervision Guidelines
UNDP supported the development of the Integrated Mentorship and Technical Supervision Guidelines in 2014 and its validation. During Phase II, the guidelines were updated and rolled out.
A total of 121 supervisors from the headquarters, province, and district health offices were trained in the new integrated guidelines.
Leadership Training for Senior Staff
UNDP organized a leadership training for key MoH Sub-Recipient managers to maximize productivity, share positive culture, strengthen fiduciary control, accountability and value-for- money for the use of public resources.
Audit and Risk Management Trainings
UNDP organized a four-day comprehensive training package on integrated project and risk management, a five-day internal auditing training on risk and performance based auditing as well as a three day training on fraud and corruption prevention for non-finance health programme managers of the Ministry of Health and its Global Fund sub-recipients.
SR Risk Registers
A key output from the risk management training was the development of the SR risk registers, as “living” reference documents which required periodic update, a requirement for all Global Fund recipients.
Installation of local area network (LAN) infrastructure at Provincial Health Offices
After a needs assessment, UNDP is deploying local area network (LAN) and backup power supply requirements to server rooms at each of the 10 Provincial Health Offices under the Ministry of Health (MoH).
Installation and Training on NAVISION
- integrated & real-time system
- control environment
- comprehensive modules (finance, pay-roll, procurement, asset management, programme management)
- improved financial information of not only on donor funding but also Government resources
- clear business flow and better accountability
UNDP worked with the MoH to provide financial mentorship to each SR, including: the process and preparation of documents for grant management, accounting and planning; reporting requirements; and internal and external communications.
Monitoring and Evaluation
Support Provincial Integrated Planning Meetings
In 2016 and 2017, UNDP supported each of the 10 provinces in Zambia to hold a Provincial Integrated Planning Meeting (PIM), attended by not less than 100 people from various organs of the ministry in the provinces.
Each PIM is concluded with an Action Plan which lists all the agreed actions for the coming period.
District Mentorship Visits
UNDP supported the MoH to conduct field visit support to selected districts with persistent gaps in data quality and report completeness. A total of 20 districts (two in each province) and 20 health facilities were visited.
Data Analysis Training
UNDP and the MoH engaged University of Zambia Department of Population Studies (UNZA-DPS) in 2017 to design and conduct five days of customized training on data analysis, interpretation and use of data for informed strategic decision-making for 24 senior health information officers and planners of MoH and primary health organizations (PHOs) and a total of 102 district health information officers.
Supply Chain Management
Enhanced Zambia Inventory Control System (eZICS)
UNDP assisted Medical Stores Limited (MSL), with a pilot in 50 sites, in eZICS to ensure that data are captured accurately, completely and in real time, transmitted from any mobile network service provider and integrated with warehouse management systems for seamless order processing.
Construction of new Dispatch Area MSL
UNDP led the construction of a new loading dock for MSL and 3,000m² additional warehouse space, bringing the total floor space to 10,000m². UNDP also installed cooling equipment in trucks and plastic strips at the dispatch bays to protect the goods against elements such as dust, wind and rain.
Construction of Regional Pharmaceutical Warehouses (hubs)
UNDP was responsible for the design and construction of four regional pharmaceutical warehouses in Mansa, Mpika, Chipata and Choma in 2017 and the foundation for Luanshya in 2018. The funding for this comes through the MoH and the Churches Association of Zambia, as Principal Recipients of the Global Fund.
Construction of ZAMRA Incinerators
UNDP supported the Zambia Medicines Regulatory Authority (ZAMRA) with the installation of two Incinerators at the ZAMRA premises. UNDP constructed an incineration compound that houses an incineration shed, offices, waste sorting areas, a waste pit and other conveniences.