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Results / Africa / Zambia

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Having successfully acted as principal recipient for Global Fund grants for HIV, TB and malaria and strengthened national capacity in health programming, in 2015 UNDP transferred grant management to national entities.

Project overview

In Zambia, UNDP supported the implementation of Global Fund grants for HIV, TB, and malaria. UNDP assumed the role of interim Principal Recipient 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 Ministry of Health reassuming the Principal Recipients role again in 2015. Read more...
To expedite implementation of the new Global Fund grants, in 2015 the Ministry of Health in Zambia took the decision to appoint the country’s ten Provincial Health Offices to function as Sub Recipients, along with Zambia Flying Doctors Services, National Aids Council, Ndola Community Health Assistants School and the Tropical Diseases Research Centre. In November that year, the Ministry of Health 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 is running from January 2016 to March 2018.

Key results - HIV

793,000 people currently on antiretroviral therapy (2016)

Source: UNDP

875,000 deaths averted due to antiretroviral treatment of HIV between 2006 and 2016

Source: UNAIDS

216,000 HIV infections averted through prevention of mother-to-child transmission between 2006 and 2016

Source: UNAIDS

New HIV cases and AIDs related deaths

Source: UNAIDS

ART clinics and solar power

With support from the Global Fund and UNDP 38 new ART clinics have been opened across Zambia giving vital access to antiretroviral therapy for thousands of people. The investment of USD 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.

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Running health facilities in areas with poor infrastructure is however a challenge - according to a WHO study covering over 4000 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 NOREPs emergency preparedness funding, has piloted solar photo-voltaic power systems in three primary health care clinics offering antiretroviral treatment 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.

With UNDP support the Ministry of Health in Zambia resumed the role Principal Ricipient of the Global Fund HIV, TB and malaria grants in 2015

Key results - Malaria

With UNDP support the Ministry of Health in Zambia resumed the role Principal Ricipient of the Global Fund HIV, TB and malaria grants in 2015.

12 million insecticide treated bed nets distributed

Source: UNDP

Coverage of bed nets (2016)

Source: World Health Organization

8 million cases of Malaria treated

Source: UNDP

Key results - TB

UNDP is working with the National TB Program to expand Directly Observed Treatment, Short-course (DOTS), with a particular focus on HIV/TB co-infection and multi-drug resistant TB (MDR-TB) patients.

36,900 new smear positive TB cases detected and treated

Source: UNDP

Treatment success rate for all new cases of TB (2015)

Source: World Health Organization

TB incidence rate per 100,000 population

Source: WHO

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.

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A total of 121 supervisors from the headquarters, province, and districts 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, value for money for the use of public resources.

Audit and Risk Management Trainings

UNDP organised 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.

Financial Management

Installation of local area networks (LAN) infrastructure at Provincial Health Offices

After a needs assessment, UNDP is deploying LAN and backup power supply requirements to server rooms at each of the 10 Provincial Health Offices under the Ministry of Health (MoH).

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Installation and Training on NAVISION

Main features

  • Integrated & Real-time system,
  • Control environment,
  • Comprehensive modules (Finance, Pay-roll, Procurement, Asset Management, Programme Management).

Foreseen Benefits

  • Improved financial information of not only donor funding but also Government of the Republic of Zambia (GRZ) resources.
  • Clear business flow and better accountability

Financial Mentorship

UNDP worked with 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 Meetings (PIM), attended by not less than 100 people from various organs of the ministry in the provinces.

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Each PIM is concluded with an Action Plan which lists all the agreed actions for the coming period.

District Mentorship Visits

UNDP supported MoH to conduct field visit support to selected districts with persistent gaps in data quality and report completeness. A total of twenty districts (two in each province) and 20 health facilities were visited.

Data Analysis Training

UNDP and the MoH engaged UNZA DPS in 2017 to design and conduct a 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 PHOs; and a total of 102 district health information officers.

Supply Chain Management

eZICS (Enhanced Zambia Inventory Control System)

UNDP assisted Medical Stores Limited (MSL) with a pilot in 50 sites of eZICS to ensure that data is captured accurately, completely and in real-time, transmitted from any mobile network service provider and integrated with warehouse management System for seamless order processing.

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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 is responsible for the design and construction of 4 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 Ministry of Health 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 2 Incinerators at the ZAMRA premises. UNDP constructed an incineration compound that houses an incineration shed, offices, waste sorting areas, waste pit and other conveniences.