Zambia Child Survival Situation Analysis

The initiative aimed to increase the use of health products, services, and behaviors in the areas of child survival, family planning and reproductive health, STI/HIV/AIDS, and malaria. The primary objective of the initiative was to contribute to the Government of Zambia's efforts to reduce child mortality to 64 deaths per 1000 births by 2015. The initiative focused on three key areas: increasing the supply and diversity of health products and services, increasing the awareness of and demand for health products and services through communications campaigns, and increasing the use of zinc complementing oral rehydration therapy through the private sector. The initiative also explored the introduction of new child health products, including vitamin A sachets and community-based treatment of acute respiratory infection. The situational analysis included a review of the epidemiology of child morbidity and mortality in Zambia, a review of Child Survival related policies and the enabling environment, and interviews with key stakeholders involved in Child Survival. The analysis identified two major factors contributing to the high under-five mortality rate in Zambia: delayed seeking of care and poor case management and treatment outcomes of major childhood infections. The Government of Zambia's strategy for health is outlined in the 2006-2011 National Health Strategic Plan, which places a strong emphasis on promoting community-level access to high-quality and cost-effective health services. The plan aims to strengthen Child Health activities at the community level through the adoption of the community-based Management of Childhood Illnesses (c-IMCI) guidelines. The Ministry of Health has adopted the c-IMCI guidelines, which include six priority family health practices: breastfeeding, complementary feeding, provision of vitamin A, deworming, immunizations, and home management of sick children. However, the implementation of these guidelines is not yet at scale, and there is a need for further coordination and support to ensure their effective implementation. The National Community Health Worker Strategy aims to provide a comprehensive framework for the role of community health workers (CHWs) in Zambia. The strategy includes plans to train "super" CHWs who will provide services from health posts, a level below the health facilities. The strategy also aims to address issues related to CHW remuneration and training. Nutrition is an essential component of Child Survival programming in Zambia. The National Nutrition Policy provides an overview of the nutritional status of various target groups, including children, in Zambia. The policy highlights the lack of coordination and comprehensive, forward-looking strategy around nutrition in the country. The regulatory environment for Child Survival related products is essential to moving forward in this area. The Pharmaceutical Regulatory Authority (PRA) has designated various Child Health products as either "prescription only" or "public sector" products, which determine the channels through which products can be provided. However, there are still some regulatory issues that need to be addressed, particularly with regards to the administration of antibiotics at the community level.