Zambia Integrated Health Project EMMP, V 1.0

The project will work closely with USAID, the Government of the Republic of Zambia (GRZ), and other stakeholders to provide both direct service delivery and technical assistance to increase local capacities at all levels across three components. The project will focus on increasing coverage of comprehensive and client-centered HIV, TB/HIV, FP/RH, and MNCH prevention, diagnosis, care, and treatment services in communities and health facilities to reach and maintain 95-95-95 in focus districts. Additionally, the project will increase utilization of community and facility-based quality, person-centered, integrated HIV, TB/HIV, FP and MNCH services, and increase capacities of the Provincial and District Health Offices (P/DHOs) to gradually transition differentiated service delivery (DSD) of quality integrated health services and sustain services beyond activity implementation. The project will be implemented in all districts in Copperbelt and Central Provinces and in select districts of North-Western Province in Zambia. Central Province covers a total area of 94,394 square kilometers and has a population of 2.25 million people, with an estimated HIV prevalence of 11.7%. Copperbelt Province has a population of 2.76 million people and an estimated HIV prevalence of 11.9%. North-Western Province has a population of 1.27 million people and an estimated HIV prevalence of 6.8%. The project may include construction activities that will likely involve refurbishment of existing structures, which entails environmental risk. Mitigation activities will conform to IEE standards to minimize waste, strengthen community- or facility-based clinical capacities to manage waste, routine monitoring of waste handling and disposal practices within supported clinical activities, and alert USAID to any deficiencies detected and the responsive corrective action plan at a given facility or community coverage area. The project will prepare an Environmental Mitigation and Monitoring Report (EMMR) for Contracting Officer’s Representative (COR) review and, upon approval, submission to the USAID Environmental Compliance Database. This report will summarize the effectiveness of mitigation measures, issues encountered, resolutions, and lessons learned. The EMMP has been developed by USAID Zambia Integrated Health (ZIH) and will be updated annually in conjunction with the Annual Work Plan. Implementation monitoring for this EMMP, and associated budget will be done by the Activity’s Contracting Officer’s Representative (COR). This EMMP is a living document which will be reviewed against the IEE and updated/tailored as needed over the life of USAID Zambia Integrated Health implementation. The EMMP includes a table that outlines the identified environmental aspects or impacts, mitigation measures, monitoring indicators, monitoring and reporting frequency, responsible parties, and field monitoring issues and resolutions for each activity. The table includes information on Activity 1.1: Increase access to quality, high-impact prevention services at HIV, TB/HIV, FP/RH, and MNCH service delivery, which includes mitigation measures such as minimizing waste, strengthening community- or facility-based clinical capacities to manage waste, and routine monitoring of waste handling and disposal practices. The project will work to minimize the potential environmental and climate risks associated with the project activities, including disease transmission from the use, storage, transportation, and disposal of blood or blood products, and the generation and disposal of medical waste. The project will also work to address the potential environmental and climate risks associated with assistance to the GRZ with commodity and other logistics, and management of expired medicines and commodities or outdated equipment through inappropriate monitoring and disposal practices.