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Zambia: Better Health through Better Systems

Abt Associates has helped improve the health and well-being of Zambians for nearly two decades.
 
Beginning in 1999, Abt has led eight projects that strengthened health systems, prevented the spread of disease, and evaluated the effectiveness of food security programs – among other work – and reached people in 81 of Zambia’s 103 districts.
 
“Abt Associates works closely with our partners in Zambia to develop, implement, and evaluate lasting solutions to challenges facing the health system and the professionals and volunteers who deliver critical health services,” said Ellen Pierce, an Abt principal associate who has extensive experience in Zambia.
 
Read vignettes about selected Abt-led projects in Zambia below.

Partnering to Strengthen Health Systems, Provide Improved Services

Read more about Abt's work in Zambia

Abt led the Zambia Integrated Systems Strengthening Program (ZISSP), which focused on strengthening health systems and improving services to address HIV and AIDS, malaria, family planning, and maternal, newborn, and child health (MNCH). This four-and-a-half year, USAID-funded program strengthened Zambia’s health systems at many levels.
 
ZISSP exceeded quantitative targets in the majority of the project’s implementation areas: human resources for health; maternal, newborn and child health (MNCH) and nutrition; clinical care; management and leadership; malaria; and community involvement.
 
“The Zambian Ministry of Health values Abt as a true partner in achieving their priorities,” said Kathleen Poer, ZISSP project director at a principal associate at Abt. “Over more than 15 years, Abt has helped the ministry to build and refine many of the systems that it uses today.”
 
Learn more about ZISSP.
 
Following ZISSP is the Systems for Better Health (SBH) project, a five-year, Abt-led effort that began in 2015. The project is assisting the Zambian Ministry of Health (MOH) across five provinces to increase:

  • Retention of HIV and AIDS patients an antiretroviral therapy;
  • The use of modern contraceptives;
  • The proportion of deliveries assisted by a medically trained provider; and
  • The proportion of fully immunized children aged 12 to 23 months.

SBH in its first year already has reached 300 health facilities in 12 districts.
 
Learn more about SBH.

Protecting Families from Malaria

A worker reports indoor residual spraying data through a cell phone. Abt Associates is implementing the PMI AIRS project, which has protected more than 2.6 million people in Zambia from malaria. Photo credit: Abt Associates
A worker reports indoor residual spraying data through a cell phone. Abt Associates is implementing the PMI AIRS project, which has protected more than 2.6 million people in Zambia from malaria.
Photo credit: Abt Associates

Despite documented improvements in the prevention of malaria, the disease continues sicken and kill in Zambia.
 
The President's Malaria Initiative Africa Indoor Residual Spraying (PMI AIRS) projectis reducing this disease burden through indoor residual spraying (IRS), the application of insecticide on the walls, ceilings, and other indoor resting places of mosquitoes that transmit malaria. PMI AIRS – funded by the USAID-led President’s Malaria Initiative and implemented by Abt Associates – manages IRS operations and logistics in 12 endemic countries.
 
PMI AIRS’ IRS campaigns began in Zambia in 2014 and have protected more than 2.6 million people, including 69,118 pregnant women and 399,362 children under five years old – those who are most vulnerable to malaria. The initiative sprayed 559,550 structures through 2016. Abt has been the main partner to Zambia’s National Malaria Control Center for IRS since 2006.

A woman discusses contraceptive pills with a nurse at a rural clinic in Zambia. The Scaling Up Family Planning in Zambia (SUFP) project, led by Abt Associates and funded by UKAid from the U.K. government, helped nearly 300,000 additional women and girls access family planning services. Photo credit: Jessica Scranton
A woman discusses contraceptive pills with a nurse at a rural clinic in Zambia. The Scaling Up Family Planning in Zambia (SUFP) project, led by Abt Associates and funded by UKAid from the U.K. government, helped nearly 300,000 additional women and girls access family planning services.
Photo credit: Jessica Scranton


 


PMI AIRS also monitors the impact of IRS operations on selected entomological indicators and collects data on insecticide resistance.
 
Learn more about PMI AIRS and the project’s work in Zambia.

Improving Delivery of Family Planning and Reproductive Health Services

Abt has led multiple projects focused on strengthening the provision of family planning services in Zambia. The Scaling Up Family Planning (SUFP) program – funded by U.K. Aid from the U.K. government – focused on these issues in particular. SUFP improved health outcomes for Zambian women and children through the sustained delivery of high-quality family planning (FP) services – especially for the country’s poor, underserved, and vulnerable populations.
 
SUFP, which ran from 2012 to 2016, expanded access to modern family planning methods by mobilizing communities, building service delivery capacity in public health facilities, and strengthening commodity distribution in targeted districts. The project, working through the Ministry of Health, also trained 462 health care providers in long-term FP methods, reaching a total of 578,241 health centers by the project’s end in 2016.
 
These programmatic achievements led to an additional 295,104 women and girls to use FP. This generated a total of 578,241 couple years protection (CYP), an estimate of how long couples using modern contraception could avoid accidental pregnancies.
 
Abt also is leading the follow-on project, SUFP II, which is working to institutionalize the SUFP model in Zambia and support its implementation in new provinces and districts. The expected outcomes are the full ownership and implementation of the SUFP model by the Ministry of Health, and significant contribution towards achievement of the FP2020 targets.

Abt-led projects in Zambia

• Zambia Integrated Health Package (ZIHP) 1999-2004
• Health Services and Systems Program (HSSP) 2004-2010
• Zambia Integrated Systems Strengthening Program (ZISSP) 2010-2014
• Systems for Better Health (SBH) project (2015-2020)
• Strengthening Health Outcomes through the Private Sector (SHOPS) project 2010-2013
• AgResults 2013-2019
• Scaling Up Family Planning (SUFP) program 2012-2016
• President's Malaria Initiative Africa Indoor Residual Spraying (PMI AIRS) project 2014-present
• Systems for Better Health (SBH) Project 2015-present

Learn more about SUFP.

Evaluating Innovative Agricultural Pilot Projects to Improve Nutrition

Approximately 870 million people around the world were chronically undernourished in 2012, partly because agricultural markets in many developing countries are underdeveloped or non-existent. This lack of markets limits private investment and slows technological innovation.
 
AgResults is a $118 million multilateral initiative addressing this gap through the use of pull mechanisms: Results-based incentives for private companies to develop and expand agricultural innovations that promote food security and benefit smallholder farmers.
 
Abt, the external evaluator for the AgResults initiative, is in charge of generating lessons learned on the use of pull mechanism to achieve agriculture development objectives. Abt is assessing the effectiveness of six AgResults pilot projects as well as the initiative as a whole, which is funded by Australia, Canada, the U.K., the U.S., and the Bill & Melinda Gates Foundation.
 
The Zambia Biofortified Maize Pilot is designed to spur the development of a market for bio-fortified provitamin A (PVA) maize by providing incentives to commercial millers and seed companies. The Abt-led evaluation is assessing the effect of the pilot on market development, smallholder production of PVA maize, and consumption of PVA maize in urban and rural areas alike. The AgResults evaluation team includes staff from across Abt plus outside experts, and has collected data from 11 Zambian districts since 2014.
 
Learn more about AgResults.