The COVID-19 situation in Zambia is still on an upward trend, with 13,446 cumulative cases reported so far.
The country continues to experience challenges with mortality reporting, with inconsistent numbers of reported deaths relative to cases. About three quarters of the deaths are occurring in the communities which may be indicative of gaps in health seeking behavior and completeness of the surveillance system.
The profile of severe illness is still significant, with a high number of cases needing oxygen and life support. On the 27 August 2020, out of 80 COVID-19 cases were admitted to health facilities, 36 were on oxygen, eight in intensive care unit and one on ventilator support.
There is a need to increase the number of health worker trained in infection prevention and control (IPC) and to counteract the high number of health workers infected.
National laboratory testing capacity is still low and inconsistent with major daily changes in total tests performed. A total 346, 651, 599 and 1,400 samples were tested on 24, 25, 26 and 27 August respectively. The lab system still experiences inadequate laboratory supplies with half the testing sites not performing testing as the supplies used in the platforms are out of stock.
Need to increase the capacity and human resources of field teams responsible for surveillance, case investigation and contact tracing to improve the rate and quality of work.
In-depth gap analysis of critical diagnostics and life-saving essential health commodities including sustained and smooth provisions of oxygen therapy services at hospital to further improve the case management for COVID-19 .
The utilization of health facilities for routine services has declined thought to be due to fear of contracting SARS-CoV-2 in health facilities. There is a need to increase public confidence in seeking timely health care provision to avoid non COVID-19 related illness and deaths.
Health commodities and supplies are insecure due to strained funding of routine health services.
Sustain the continuity of essential health services and enhance monitoring of the consequences of COVID-19 on essential health services is critical of providing required support on time to effectively respond to broader health sector response through integrating into the routine HMIS with identifying and reporting on a number of critical core indicators regularly on certain interval.
Health sector partners continued providing technical support, policy advocacy, and resources mobilization support to COVID-19 response in field operations countrywide.
Partners provided six vehicles to the sub-districts in Lusaka district to facilitate transport of responders during field operations.
Supported operations in the two national call centers through hiring of additional call center personnel. The centers are instrumental in addressing concerns from the community, following contacts to cases of COVID-19 and risk communication.
Providing technical assistance during field operations in the areas of surveillance, contact tracing, monitoring IPC compliance in health facilities, academic institutions and public places.
Supported the preparations for dissemination of national COVID-19 SOPs and guidelines. These are newly developed and will provide guidance to all sectors at all levels during performance of COVID-19 response functions.
Supported the health sector to disseminate the SOPs and guidelines to all provinces and districts in the country.
Training of case management clinicians in three remaining provinces of Luapula, Western and North Western. The training will be the last face-to face training that will be followed by a shift in strategy to virtual trainings and supervision with mentorship of case managers.
Continued supporting stabilization of oxygen therapy supplies through the rehabilitation of Oxygen Plants in 3 hospitals including University Teaching Hospital (UTH) Lusaka (Children Hospital) that will improve and ensure smooth availability of oxygen therapy to support the life-saving treatment of patients with COVID-19 and other respiratory diseases. The rehabilitation of Oxygen Plants in University Teaching Hospital (UTH) Lusaka was completed and is now operational, while work will begin for Mansa General Hospital in Luapula and Lewanika General Hospital in Mongu. Sector partners organized a major visibility event officially handing over 259 oxygen concentrators, 1.3 million pairs of gloves and more than 500,000 surgical masks to the Minister of Health.
Supported the expansion of Levy Mwanawasa Hospital Bed Capacity from 300 to 800 through the connection of power supply by Zesco at a cost of US$225,865.85 .
Last mile distribution of essential health commodities to two districts in Western province with five more districts earmarked for distribution in September.
Orientation of 25 healthcare providers in Infection Prevention and Control in Western Province .
Delivery of dignity kits and hand-washing buckets in Luapula, Western and Northwestern provinces to cover maternity wings and GBV centers.
Monitoring SRHR activities for service delivery in response to COVID-19 pandemic in Lukulu District.
Development and dissemination of multimedia campaign messages on COVID-19 for young people in Western province. Four jingles and four posters were produced.
Training for COVID-91 Community-Based Distributors (CBDs) and Healthcare Providers in 16 districts of Western Province in provision of the Family Planning method mix in the context of COVID. The CBDs and HCPs were provided with IPC materials.
Reinforcing community awareness through community engagement activities across three refugee settlements (Mayukwayukwa, Mehebe and Mantapala) reaching over 90,000 refugees and host community members (45,900 female and 44,100 male).
Trained 20 health-care workers (11 male, 9 female), 45 community health workers (24 male, 21 female), 60 community protection workers (26 male, 34 female) and 60 community leaders in Mayukwayukwa Settlement on COVID-19.
Sector partners continued supporting the Government to procure and distribute supplies and commodities required for COVID-19 response in the areas of diagnostics, PPE and clinical management. During the reporting period: UNICEF procured and delivered 519,950 surgical masks, 1.3 million pairs of gloves, 266 sets of oxygen concentrators and 5,500 COVID-19 test kits (6880 Cobas and Gene-Xpert) to perform 10,000 tests. Donated 31 units of oxygen concentrator machines that have since been installed in isolation centers. Donated laboratory supplies that included 12,000 Viral Transport Media, 13,200 lab test kits and 83,520 PPEs.
Partners donated items to refugee settlements that included 20,000 medical masks, 9,000 surgical gloves for the use of some 70 health care workers in 12 health facilities across three settlements (Mayukwayukwa, Mehebe and Mantapala), eight megaphones (being donation from NCA) to reinforce community sensitization activities in above locations. Donated Essential Reproductive Health Commodities to the MOH including IUDs (12 months of stock), DMPA SC (2.5 months of stock), Combined Oral Contraceptives (6 months of stock), Noristerat (2.2 months of stock) worth $2.1 million.
Continuation of essential health services, traditional vaccines (BCG, bOPV, Td and MR) for the entire country’s three months’ requirement was procured and delivered. Procurement orders for another six months’ requirement has been placed.
Supported MOH disease control programs to implement plans for sustaining essential health services.
Challenges in mortality reporting with inadequate systematic review and investigation of all mortalities in the community which can inform the exposure and prevalence of COVID-19. High mortality rate outside health facilities remains a challenge.
Ineffective surveillance including delay in notifying COVID-positive cases as well as delayed contact identification/ quarantining/ testing as needed.
Irregular updates on the needs and gaps of critical COVID-19 supplies.
Inadequate laboratory supplies to match the laboratory testing needs.
Lack of a well-defined COVID-19 testing strategy emphasizing both on the supply chain management of testing kits, the establishment and strengthening of the laboratory set-up and systems with sub-national level decentralized laboratory services capacity on COVID-19 in line with MOH recent directives of conducting 1000 tests per day .
Low compliance of the community to recommended public health measures is still evident. There is need for intensified RCCE with enforcement of the measures by all sectors. RCCE will need to be decentralized and supported by multi-channel, multisectoral approach backed-up by strong policy advocacy and evidence-based locally contextualized community mobilization interventions to address the stigma and skepticism.
High rates of infection among health workers that is likely to affect staff morale and capacity for service delivery. Inadequate adherence to IPC recommendations by health workers .
Inadequate isolation capacity in some districts especially those furthest from provincial headquarters.
Community continued use of health facilities for routine health care .
Inadequate stocks of Personal Protective Equipment (PPE) in health facilities .
Lack of a comprehensive service delivery monitoring framework and a robust system to monitor .