Fiscal space for the immunisation program in Zambia- an efficiency analysis approach.

Objective: The immunisation programme in Zambia remains one of the most effective public health programmes. Its financial sustainability is, however, uncertain. Using administrative data on immunisation coverage rate, vaccine utilisation, the number of health facilities and human resources, expenditure on health promotion, and the provision of outreach services from 24 districts, we used Data Envelopment Analysis to determine the level of technical efficiency in the provision of immunisation services.

An evaluation of the cost of human papilloma virus (HPV) vaccine delivery in Zambia.

Background: Human papillomavirus (HPV) is a common sexually transmitted infection and the leading cause of cervical cancer. The HPV vaccine is a safe and effective way to prevent HPV infection. In Zambia, the vaccine is given during Child Health Week to girls aged 14 years who are in and out of school in two doses over two years.

Association between household food security and infant feeding practices among women with children aged 6-23 months in rural Zambia.

Infant and young child feeding (IYCF) practices directly affect the nutritional status of children under two years of age, ultimately impacting their survival. However, ensuring that newborns and young children are fed according to the WHO-recommended practice has proven to be a challenge in many developing nations, especially in households that face food insecurity. This study aims to determine the association between IYCF practices and household food security's availability and access dimensions in rural Zambia.

An Evaluation of the Cost of Human Papilloma Virus (HPV) Vaccine Delivery In Zambia.

Background: Human papillomavirus (HPV) is a common sexually transmitted infection and the leading cause of cervical cancer. The HPV vaccine is a safe and effective way to prevent HPV infection. In Zambia, the vaccine is given during Child Health to girls aged 14 years who are in and out of school in two doses over two years.

A cross-sectional study on factors associated with health care seeking for acute respiratory infection and fever in children under-five in Zambia.

Introduction: mortality in under-five children remains a significant challenge in developing countries, including Zambia, where pneumonia and malaria account for twenty percent of under-five deaths. Poor health care seeking is one of the contributors to the high mortality rates. This study examined the predictors of health care seeking for acute respiratory infection (ARI) and fever among under-five children in Zambia.

Monetary Incentives and Early Initiation of Antenatal Care: A Matched-Pair, Parallel Cluster-Randomized Trial in Zambia.

Monetary incentives are often used to increase the motivation and output of health service providers. However, the focus has generally been on frontline health service providers. Using a cluster randomized trial, we evaluate the effect of monetary incentives provided to community-based volunteers on early initiation of antenatal care (ANC) visits and deliveries in health facilities in communities in Zambia.

Healthcare Management of Human African Trypanosomiasis Cases in the Eastern, Muchinga and Lusaka Provinces of Zambia.

Human African trypanosomiasis (HAT) is a neglected tropical disease that has not received much attention in Zambia and most of the countries in which it occurs. In this study, we assessed the adequacy of the healthcare delivery system in diagnosis and management of rHAT cases, the environmental factors associated with transmission, the population at risk and the geographical location of rHAT cases. Structured questionnaires, focus group discussions and key informant interviews were conducted among the affected communities and health workers.

Essential newborn care practices in Zambia.

Neonatal mortality remains high in Zambia and is declining slower than infant and under five mortality. Improved adoption of essential newborn care (ENC) could help mitigate this situation. To determine the adoption of ENC practices in Zambia, cross-sectional data was used to assess ENC practices including baby kept warm, umbilical cord care and breastfeeding.

Effects of performance based financing on facility autonomy and accountability: Evidence from Zambia.

Several low and lower- middle income countries have been using Performance-Based Financing (PBF) to motivate health workers to increase the quantity and quality of health services. Studies have demonstrated that PBF can contribute to improved health service delivery and health outcomes, but there is limited evidence on the mechanisms through which PBF can necessitate changes in the health system. Using difference-in-difference and synthetic control analytical approaches, we investigated the effect of PBF on autonomy and accountability at service delivery level using data from a 3-arm cluster randomised trial in Zambia.

Revisiting the polygyny and intimate partner violence connection: The role of religion and wife's rank in Nigeria.

Objective: The study examines the association between polygyny and intimate partner violence (IPV) by focusing on the Muslim-vs.-Christian context of polygyny and on co-wives' rank.

Background: Although prior research points to a higher incidence of IPV in polygynous unions, the association between polygyny and IPV are not well understood.

Mathematical modelling for health systems research: a systematic review of system dynamics and agent-based models.

Background: Mathematical modelling has been a vital research tool for exploring complex systems, most recently to aid understanding of health system functioning and optimisation. System dynamics models (SDM) and agent-based models (ABM) are two popular complementary methods, used to simulate macro- and micro-level health system behaviour. This systematic review aims to collate, compare and summarise the application of both methods in this field and to identify common healthcare settings and problems that have been modelled using SDM and ABM.

Looking at the bigger picture: effect of performance-based contracting of district health services on equity of access to maternal health services in Zambia.

Zambia has been using output-based approaches for over two decades to finance whole or part of the public health system. Between 1996 and 2006, performance-based contracting (PBC) was implemented countrywide with the Central Board of Health (CBoH) as the provider of health services. This study reviews the association between PBC and equity of access to maternal health services in Zambia between 1996 and 2006.

Estimating the economic and social consequences for patients diagnosed with human African trypanosomiasis in Muchinga, Lusaka and Eastern Provinces of Zambia (2004-2014).

Background: Acute human African trypanosomiasis (rHAT) caused by Trypanosoma brucei rhodesiense is associated with high mortality and is fatal if left untreated. Only a few studies have examined the psychological, social and economic impacts of rHAT. In this study, mixed qualitative and quantitative research methods were used to evaluate the socio-economic impacts of rHAT in Mambwe, Rufunsa, Mpika and Chama Districts of Zambia.

Assessing care-givers' satisfaction with child immunisation services in Zambia: Evidence from a national survey.

Aim: The main aim of this study was to assess care-giver satisfaction with vaccination services in public health facilities in Zambia, and examine its determinants.

Methods: This study used data from a recent population-based household survey, conducted from May to August 2015. Respondent satisfaction with vaccination services received during the last visit was measured on a five point Likert scale ranging from 1 to 5.

An assessment of the effect of user fee policy reform on facility-based deliveries in rural Zambia.

Background: Improving maternal health outcomes by reducing barriers to accessing maternal health services is a key goal for most developing countries. This paper analyses the effect of user fee removal, which was announced for rural areas of Zambia in April 2006, on the use of public health facilities for childbirth.

Methods: Data from the 2007 Zambia Demographic and Health Survey, including birth histories for the five years preceding the survey, is linked to administrative data and geo-referenced health facility census data.

Utilization of focused antenatal care in Zambia: examining individual- and community-level factors using a multilevel analysis.

Objectives: We examine the individual- and community-level factors associated with the utilization of antenatal care, following the adoption of the focused antenatal care (FANC) approach in Zambia.

Methods: Using the 2007 Zambia Demographic and Health Survey, linked with administrative and health facility census data, we specify two multilevel logistic models to assess the factors associated with (1) the inadequate use of antenatal care (ANC) (defined as three or fewer visits) and (2) the non-use of ANC in the first trimester of pregnancy.

Results: Although all women in the selected sample had at least one ANC visit, 40% did not have the minimum number required (four), whereas more than 80% of the initial check-ups did not occur in the first trimester.