The Ministry of Health has reported a steady decline in the number of COVID-19 infections from over 1,700 cases per week to about 278 per week in the last two months, needing a more sensitive surveillance system and response.
Out of the country's 116 districts, 96 districts had confirmed COVID-19. Districts in Lusaka, Copperbelt and Southern provinces continue reporting the highest number of cases.
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 national laboratory testing capacity has improved, but is still centralized, with most provinces not having supplies in stock to sustain testing on the available platforms. Only three of the ten provinces have all round testing capacity. Diagnostic and laboratory capacities are still inadequate and unsustainable. There are also challenges with supply chain management of diagnostics including testing strategies to guide decentralization of testing capacities using the Rapid Diagnostic Test (RDT).
The country continues experiencing low levels of compliance of the populations to recommended preventive measures including social distancing, masking and hand hygiene. Social and religious places are opening beyond recommended hours while social events have resumed.
The field teams responsible for surveillance, case investigation and contact tracing are inadequate and have inadequate resources for effective response such lack of transport for routine field work.
Inadequate triangulation of epidemiological data from various sources including sero-surveys, lab-surveys, and hospital-based data to better understand and interpret the epidemiological patterns of infectivity, caseload, and case fatality; as well as study and analyze the predictability of the second wave with early warning and further strengthening of the preparedness.
Inadequate regular in-depth gap analysis of critical diagnostics and life-saving essential health commodities including sustained and smooth provisions of medical oxygen therapy services at hospital to further improve the case management for COVID-19.
Need for building back better with health system resilience for sustaining the continuity of essential health services and continued monitoring of the consequences of COVID-19 on health systems.
The utilization of health facilities for routine services has declined due to fear of contracting SARS-CoV-2 in health facilities. There is a need for a robust unitary system to monitor performance of the health system.
The country is health commodities insecure due to strained funding of routine health services, with reliance on partners to support commodity security.
Health sector partners continued providing technical support, policy advocacy, and resources mobilization support to COVID-19 response in field operations countrywide.
Sector partners delivered personal protective equipment (PPEs) to the Ministry of Health including, 11,720 N-95 masks, 557,950 surgical asks, 65,352 gowns/coveralls, 26,600 face shields and 1,682,760 pairs of gloves. An additional procurement request for PPEs, laboratory and case management supplies worth $1,650,500 is under process.
Sector partners supported MOH with diagnostic items, including Ag-based laboratory reagents to support, 92,000 tests (Cobas 6880, Gene-Xpert Xpress, TagPath and Aptima Hologic). So far, 32,848 tests of Cobas 6880® SARS-CoV-2 and 5,000 tests of Gene-Xpert® Xpress SARS-CoV-2 have been delivered. Another 5,000 tests of Gene-Xpert® Xpress; 4,032 tests of Cobas 6880; 20,000 tests of Aptima; and 5,000 tests of TaqPathCOVID-19 CE-IVD RT-PCR are in the pipeline to be delivered by end of this month. Procurement order for another 20,000 tests of Aptima SARS-CoV-2 has been raised.
Sector partners delivered oxygen equipment, including 310 units of oxygen concentrators procured and delivered to the MSL (Medical Store Limited), 260 units of oxygen cylinders and 150 units of Low-pressure Oxygen Gauze.
The sector supported the rehabilitation and recommissioning of Oxygen Plants in University Teaching Hospitals (UTHs) Lusaka (Children Hospital). The rehabilitation work has begun for Mansa General Hospital in Luapula and Lewanika General Hospital in Mongu (Western Province) that will improve and ensure smooth availability of medical oxygen therapy to support the life-saving treatment of patients with respiratory diseases, including those with COVID-19.
The sector supported preparations and funding for roll-out of the revised third edition Integrated Disease Surveillance and Response (IDSR) strategy that emphasizes reporting of priority diseases, conditions and events from all levels which will increase the sensitivity of monitoring trends of diseases, conditions and events including COVID-19.
Monitoring routine service delivery through DHIS-2 (District Health Information System 2) being strengthened.
Sector partners continued to support at the technical level and provision of critical safety, laboratory and patient management supplies, vaccines and essential medicines, policy advocacy and resources mobilization.
Support to continuation of essential health services, traditional vaccines (BCG, bOPV, Td and MR) for entire country’s three-month requirement were procured and delivered. Another nine-month nationwide requirement of all four vaccines (BCG, bOPV, Td and MR) are in the pipeline. The shipments of these vaccines are being managed as per the Zambia 2020 vaccines forecast.
Sector partners procured 2,815 UN Inter-agency Emergency Health Kit (IEHK-2017) for basic curative treatment and essential maternal, newborn and child health (RMNCH) services. A partial shipment 66 kits delivered to Medical Stores Limited (MSL) and another shipment of 349 kits are expected to arrive in mid-November while 229 kits in first week of December. A total of 19 itemized RMNCH essential drugs procured and delivered to MSL and under distribution to the health facilities.
Sector partner continued supporting MoH disease control programs to implement plans for sustaining essential health services
Sector partners supported the assessment and improvement of the delivery system for oxygen and other life-sustaining critical care supplies and equipment.
Sector partners also supported the MoH Community Health department and MoGE to equip and engage teachers and prefects in schools with basic knowledge and skill in the COVID-19 prevention and response. A total of 600 (six hundred) teachers and prefects were trained as School Safety Officers who trained and monitor 14,862 pupils in Lusaka and Copperbelt.
Inadequate laboratory supplies to match the laboratory testing needs.
Low compliance of the community to recommended public health measures is still evident.
Coordination among the Incident Management System (IMS) logistics Team of ZNPHI, the Clinical Care and Diagnostic Services (CCDS) of MoH and the Medical Stores Limited (MSL) on the distribution planning and last-mile delivery of COVID-19 supplies.
Regular updates on the current epidemiological trend with recent data as well as triangulation of local data from various sources to better understand and interpret the epidemiological patterns and the predictability of a second wave.
The sub-national level decentralized laboratory services capacity on COVID-19 in line with MoH testing strategies and directives of conducting daily tests.
Reluctance of community to continue use of health facilities for routine health care .
Inadequate stocks of PPE in health facilities offering routine services .
Inadequate adherence to IPC recommendations by health workers offering routine services
Lack of a comprehensive service delivery monitoring framework.