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Background: Limited research has been conducted on the forms, manifestations and effects of intersectional stigma among young HIV-positive men who have sex with men (MSM) and transgender women (TGW) in Zambia. In this study, we aimed to address this gap by elucidating the experiences of these in a small group of young, HIV + MSM and TGW in Zambia. Methods: We applied a mixed-methods design. Data were collected from January 2022 to May 2022. Qualitative data were collected using in-depth interviews while quantitative data were collected using a questionnaire. Qualitative transcripts were coded using thematic analysis while paper-based questionnaire data were entered into Kobo Connect. Descriptive statistics, using chi-squared tests were calculated using Excel. In this paper, we provide a descriptive profile of the sample and then focus on the qualitative findings on intersectional stigma, depression, and contemplation of suicide. Results: We recruited 56 participants from three sites: Lusaka, Chipata, and Solwezi districts. Participants' mean age was 23 years. The study found that 36% of all participants had moderate to significant symptoms of depression, 7% had major depression, 30% had moderate signs of anxiety, 11% had high signs of anxiety, 4% had very high signs of anxiety and 36% had contemplated suicide at least once. A greater proportion of TGW had moderate to significant symptoms of depression (40%) or major depression (10%) compared to MSM, at 33% and 6%, respectively (X2 = 0.65; p = 0.42). Similarly, more TGW (55%) had contemplated suicide than MSM peers (36%, X2=1.87; p = 0.17). In the qualitative data, four emergent themes about the forms, manifestations, and effects of intersectional stigma were (1) HIV, sexual orientation, and gender identity disclosure; (2) Dual identity; (3) Challenges of finding and maintaining sexual partners; (4) Coping and resilience. Overall, having to hide both one's sexuality and HIV status had a compounding effect and was described as living "a private lie." Conclusion: Effectively addressing stigmas and poor mental health outcomes among young HIV-positive MSM and TGW will require adopting a socio-ecological approach that focuses on structural interventions, more trauma-informed and identity-supportive care for young people with HIV, as well as strengthening of authentic community-informed public health efforts. [ABSTRACT FROM AUTHOR]

Purpose: While the literature has highlighted the impacts of COVID-19, there is limited evidence on the gendered determinants of the impact of COVID-19 among small-scale rural traders in developing and emerging economies. Design/methodology/approach: Cross-border fish traders who had operated before and during the COVID-19 pandemic were interviewed in a survey conducted in Zambia and Malawi. Logistic regressions among male and female traders were employed to assess the gendered predictors. Findings: Heterogeneous effects in geographical location, skills, and knowledge were reported among male cross-border traders. Effects of household structure and composition significantly influenced the impact of COVID-19 among female traders. Surprisingly, membership in trade associations was associated with the high impact of COVID-19. Research limitations/implications: Due to the COVID-19 pandemic and the migratory nature of cross-border fish traders, the population of cross-border fish traders at the time of the study was unknown and difficult to establish, cross-border fish traders (CBFT) at the landing sites and market areas were targeted for the survey without bias. Originality/value: This paper addresses a gap in the literature on understanding gendered predictors of the impacts of COVID-19 among small-scale cross-border traders. [ABSTRACT FROM AUTHOR]

Food security, a vital determinant of overall health and well-being, hinges on the simultaneous achievement of four dimensions: physical availability of food, economic and physical access to food, utilization of nutrients, and stability over time. This paper explores the complex and multi-faceted food security situations in Kenya and Zambia, emphasizing key factors such as agricultural production, government policies, and socio-economic conditions. [ABSTRACT FROM AUTHOR]

Aim: To review the international evidence base on interventions to support the mental health of family carers of children with brain injuries in low and middle income countries (LMIC). Methods: Searches were conducted with five electronic databases (Pubmed, Web of Science, Embase, PsycINFO, CINAHL) using search terms related to "family carers", "brain injury", "children" and "low and middle income countries". Studies were independently screened using predetermined eligibility criteria by two authors. Data were extracted from included studies using standardised data extraction and quality appraisal tools. These data were then subjected to narrative synthesis. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were used to govern the review process. Findings: One study met our inclusion criteria and described an acquired brain injury called nodding syndrome which occurs in Sub-Saharan Africa. The study was conducted in Ghana and provided group-based psychotherapy to carers and their children. As such we found no study which sought to solely support the mental health of family carers. Conclusions: There has been a lack of focus in the literature on the mental health of family carers of children with brain injuries in LMIC. Considering the vital importance of caregivers in supporting their children it is imperative that service providers and researchers devise programmes to better meet their needs. The mental health of family carers should be better supported to improve their overall wellbeing, which will in turn improve the wellbeing of their children. [ABSTRACT FROM AUTHOR]

COVID-19 laid bare many failings and shortcomings of state systems, institutions and structures which aim to protect citizens against harm. As observed from the outcomes of the pandemic in many parts of the Global South and Global North, the resilience of health, social protection, governance, economic, education, and social welfare systems has been significantly eroded or challenged, leaving large segments of the population open to heightened risk and vulnerability. This has been noted to have significantly eroded social capital, namely the trust, communication, and dialogue between citizens in the state as well as citizens with each other. Based on comparative research carried out on the return to schooling process in five countries, Lebanon, Nigeria, Colombia, Georgia, and Zambia, the paper highlights the important role and function that educational governance, decision-making, and control throughout the pandemic has played a key role in either maintaining or erode social capital, and ultimately the resilience of the entire education system. Much of this was based on how well state officials and local education officials both considered and communicated their actions to educators, students and their families. The importance of education as a site where both bridging and linking social capital is both strengthened, but also capitalized on is also discussed. Specifically, the paper highlights, using the example of COVID-19 education responses, how a state that is responsive and accountable to its citizenry in a time of crisis, stands the greatest chance of ensuring such periods do not lead to an erosion of social capital. [ABSTRACT FROM AUTHOR]

Context and Background: The specialised land court in Zambia is known as the Lands Tribunal, and it was created in 1996 through the 1995 Lands Act. The Tribunal was established with the objective of achieving speedy, low cost, flexible and efficient means of settling conflicts over land. Inspite of being existence for 27 years, little has been done on the progress and challenges of the Lands Tribunal in resolving conflicts over land in the country. Goal and Objectives: This paper aims at establishing the progress made by the Lands Tribunal in resolving conflicts over land and investigating the challenges faced by the Lands Tribunal in resolving conflicts over land. Methodology: The study incorporated the use of both primary and secondary data collected between January and October 2023. Secondary data were obtained through documents which include peer-reviewed journal articles, theses, books, media, Zambian land laws, and technical reports. Secondary data was supplemented by primary data obtained from three purposively selected institutions: Lands Tribunal, Law Association of Zambia, and Zambia Land Alliance (Kitwe office). The data collection method used with the key informants was in-depth face-to-face interviews. Office management at each institution chose the key informant based on their expertise and experience on the subject. Results: In order to strengthen the Tribunal's operations, the Lands Tribunal Act of 2010 was enacted, enhancing the Tribunal's operations by granting it more authority and responsibilities (that is, expanding jurisdiction). Research findings showed that between 2014 and 2023, the Lands Tribunal handled 3318 cases. According to research findings, if the Tribunal was operating efficiently and effectively, it could have handled more than 3,318 cases between 2014 and 2022 considering the numerous problems facing the general courts which adversely affect the general public to resolve their land conflicts. However, the Tribunal could not handle more cases because of various challenges which include inadequate funding, Inadequate staff, poor conditions of service for members of the Tribunal, inadequate transport, delay in the delivery of judgments, low public awareness of the Lands Tribunal, centralised operations of the Lands Tribunal, and forum shopping [ABSTRACT FROM AUTHOR]

Background: Over the years, low-and middle-income countries have adopted several policy initiatives to strengthen community health systems as means to attain Universal Health Coverage (UHC). In this regard, Zambia passed a Community Health Strategy in 2017 that was later halted in 2019. This paper explores the processes that led to the halting and re-issuing of this strategy with the view of drawing lessons to inform the development of such strategies in Zambia and other similar settings. Methods: We employed a qualitative case study comprising 20 semi-structured interviews with key stakeholders who had participated in either the development, halting, or re-issuing of the two strategies, respectively. These stakeholders represented the Ministry of Health, cooperating partners and other non-government organizations. Inductive thematic analysis approach was used for analysis. Results: The major reasons for halting and re-issuing the community health strategy included the need to realign it with the national development framework such as the 7th National Development Plan, lack of policy ownership, political influence, and the need to streamline the coordination of community health interventions. The policy process inadequately addressed the key tenets of community health systems such as complexity, adaptation, resilience and engagement of community actors resulting in shortcomings in the policy content. Furthermore, the short implementation period, lack of dedicated staff, and inadequate engagement of stakeholders from other sectors threatened the sustainability of the re-issued strategy. Conclusion: This study underscores the complexity of community health systems and highlights the challenges these complexities pose to health policymaking efforts. Countries that embark on health policymaking for community health systems must reflect on issues such as persistent fragmentation, which threaten the policy development process. It is crucial to ensure that these complexities are considered within similar policy engagement processes. [ABSTRACT FROM AUTHOR]

Introduction: Despite substantial investment in improving healthcare among adolescents in low- and middle-income countries, barriers to access and utilization of services persist, especially to sexual and reproductive health (SRH) services. In response to adolescents' health service needs due to their vulnerability, interventions aimed at improving access and utilization of sexual and reproductive health services have been implemented in specific regions of Zambia. To highlight progress in the access and the overall delivery of services in Zambia, in the wake of a system-level funding mechanism, this paper aims to understand the accessibility, availability, acceptability and quality (AAAQ) of health services provided to young people. Materials and methods: In a qualitative case study, 48 discussions-32 individual interviews with stakeholders and 16 focus group discussions, consisting of 128 male and female adolescents were conducted in six districts from Eastern, Southern and Muchinga provinces of Zambia. Interviews were audio-recorded, recordings transcribed verbatim, and transcripts were analysed using deductive thematic analysis, using the AAAQ framework and Atun's framework on integration, as a guide to reporting the findings. Results: We found that adolescents knew of and had access to common commodities and services-male condoms, health education and HIV counselling and testing. However, availability was affected by access-related barriers such as frequent stock-outs and insufficiently trained healthcare providers. In addition, accessibility was more restricted during the COVID-19 pandemic lockdown and compounded by the low acceptability of SRH service among adolescents across all contexts. This led to the use of alternatives such as herbal medicine and maintained common myths and misconceptions. The overall quality was marred by the lack of dedicated spaces for adolescent health services and the lack of information, education and communication (IEC) materials in some spaces. Conclusion: While it was noted that some services were available for adolescents in all the study sites, numerous barriers inhibited access to these services and had an impact on the quality-of-service provision. With the added restriction to SRH service asses for young people, due to the low acceptability of adolescent SRH service use, the overall integration of adolescent SRH interventions into routine service provision was low and can be improved by targeting contextual barriers and maintaining best practices. [ABSTRACT FROM AUTHOR]

Background: Attractive Targeted Sugar Baits (ATSBs) offer a complementary vector control strategy to interventions targeting blood feeding or larval control by attacking the sugar feeding behaviour of adult mosquitoes using an attract-and-kill approach. Western Zambia was the first location to receive and deploy ATSB Sarabi version 1.2 stations in a Phase III cluster randomized controlled trial. This paper describes ATSB station installation, monitoring, removal, and disposal, quantifies ATSB station coverage, and reports major reasons for ATSB station replacement. Methods: ATSB stations were deployed during two annual transmission seasons, through scheduled installation and removal campaigns. During deployment, monitoring was conducted per protocol to maintain high coverage of the ATSB stations in good condition. Routine monitoring visits during the trial captured details on ATSB station damage necessitating replacement following pre-defined replacement criteria. Annual cross-sectional household surveys measured ATSB station coverage during peak malaria transmission. Results: A total of 67,945 ATSB stations were installed in Year 1 (41,695 initially installed+ 26,250 installed during monitoring) and 69,494 ATSB stations were installed in Year 2 (41,982 initially installed+ 27,512 installed during monitoring) across 35 intervention clusters to maintain high coverage of two ATSB stations in good condition per eligible household structure. The primary reasons for ATSB station replacement due to damage were holes/tears and presence of mold. Cross-sectional household surveys documented high coverage of ATSB stations across Year 1 and Year 2 with 93.1% of eligible structures having ≥ 2 ATSB stations in any condition. Discussion: ATSB station deployment and monitoring efforts were conducted in the context of a controlled cRCT to assess potential product efficacy. Damage to ATSB stations during deployment required replacement of a subset of stations. High coverage of eligible structures was maintained over the two-year study despite replacement requirements. Additional research is needed to better understand the impact of damage on ATSB station effectiveness under programmatic conditions, including thresholds of threats to physical integrity and biological deterioration on product efficacy. Conclusions: Optimizing ATSB stations to address causes of damage and conducting implementation research to inform optimal delivery and cost-effective deployment will be important to facilitate scale-up of ATSB interventions. [ABSTRACT FROM AUTHOR]

Introduction: Community-based health workers (CBHWs) possess great potential to be the missing link between the community and the formal health system for improving adolescents' access to sexual and reproductive health and rights (SRHR) information and services. Yet, their role in addressing adolescents' SRHR within the context of the community-based health system has received very little attention. This paper analyses how CBHWs experience and perceive their role in addressing adolescents' SRHR needs in rural Zambia, including the possible barriers, dilemmas, and opportunities that emerge as CBHWs work with adolescents. Methods: Between July and September 2019, we conducted 14 in-depth interviews with 14 community-based health workers recruited across 14 different communities in the central province of Zambia. The interviews were focused on eliciting their experiences and perceptions of providing sexual and reproductive health services to adolescents. Charmaz's grounded theory approach was used for the analysis. Results: We present the core category "being both a grandmother and a CBHW", which builds upon four categories: being educators about sexual and reproductive health; being service providers and a link to SRHR services; being advocates for adolescents' SRHR; and reporting sexual violence. These categories show that CBHWs adopt a dual role of being part of the community (as a grandmother) and part of the health system (as a professional CBHW), in order to create/maximise opportunities and navigate challenges. Conclusion: Community-based health workers could be key actors providing context-specific comprehensive SRHR information and services that could span all the boundaries in the community-based health system. When addressing adolescents SRHR, playing dual roles of being both a grandmother and a professional CBHW were sometimes complimentary and at other times conflicting. Additional research is required to understand how to improve the role of CBHWs in addressing adolescents and young people's sexual and reproductive health. [ABSTRACT FROM AUTHOR]

Mining-induced sinkholes are a common feature in underground mines. Sinkholes usually disrupt mining operations and associated infrastructure when they occur. This paper presents a case study of the lubambe copper mine, where nine (9) sinkholes have been reported on the eastern and southern limbs. The development of sinkholes has resulted in increased mining costs due to the closure of the 182 ml decline on the eastern limb and the 175 ml truck route on the southern limb. This study establishes the influence that poor ground formation, rock stability, geological structures, and inappropriate mining practices have on the formation of surface sinkholes. Assessment of ground condition was done by core logging, and borehole analysis was conducted using GEM4d-basrock software to classify the rock mass quality based on RQD, RMR, Q-System and GIS. Assessment of the mining operational environment was focused on the effects of varying stope designs and sequencing on ground stability. Results of the study indicate that the formation of surface-induced sinkholes is attributed to historical mining in weak rock formation and weathered rock coupled with subsequent failure of unsupported stopes with stope height between 8 and 25 metres and less stand-up time of 7 days. [ABSTRACT FROM AUTHOR]

Goal and Objectives: This paper examined the relations between informal documentations and land tenure security on change in land use/cover. Using Chamuka land registration, the paper focuses on caused of land use/cover change and how informal documents-based land dealings leads to tenure security and a more productive land use. Methodology: The study used various methods, including 345 households' interviews, group discussions and satellite images of 2010, 2015 and 2020, to understand how land ownership in Chamuka chiefdom effect on land use. Results: The study results shows that the introduction of Land Advisory Boards (LABs), Customary Certificate of Land Occupancy (CCLO) and the land register has scored several successes (i.e., increase in land rights, ownership, low cost of land registration, tenure security and reduction in land-related conflicts. Other improvements include the practice of conservation farming, i.e. agroforestry, fire management resulting to improved crop and livestock farming. Despite these positive results, the satellite images showed decline in vegetation and forest cover due to expansion of agricultural area, buildup and decrease in water bodies. This study provides new insights into how the evolution of the traditional land tenure system, as an integral part of resource governance, its effect on land use/cover. Next to suggesting is how to strengthen informal documents, and efficiency of local land management institutions in order to reduce loss of vegetation and deforestation. [ABSTRACT FROM AUTHOR]

This paper asks whether value chain integration increases smallholder resilience during shocks. Using a qualitative research study design and the test case of the 'sugar‐belt' in Zambia, the paper draws on interviews with participants from different stakeholder groups, including household case studies and group discussions. Results show sugarcane value chain integration enhances smallholder livelihood resilience during pandemics through its coordination arrangement, but more could be done. Indirect involvement in, and joint procurement processes of inputs between smallholders and the management company, existing ready and stable access to markets and access to Fairtrade relief funds that point to direct livelihood support proved crucial for strengthening smallholder livelihood resilience during the pandemic. There were COVID‐19‐related adjustments by the management company, which further increased smallholder support. However, in as much as coordination arrangements seemed to have worked well during COVID‐19, smallholder livelihoods remained narrow and risky, raising the need for diversification that could strengthen sustainable resilience. This paper sheds light on how value chains could be organised to enhance pandemic recovery and build livelihood resilience. It helps us to reflect on the '(in)effectiveness' of value chain institutions and the role and importance of smallholder coordination arrangements during pandemics. Ultimately, the result is a contribution to livelihood resilience thinking in value chains—one we hope is appropriate to our conjuncture. [ABSTRACT FROM AUTHOR]

A prioritisation study was conducted to address the lack of adequate information about potential pests likely to be introduced in Zambia and become invasive. The study was conducted by subject matter experts from relevant institutions in and outside Zambia. Although this study focused on major pest categories, this paper only addresses bacteria and Protista. A list of 306 bacterial and 10 Protista species adjudged to affect plants was generated using CABI's Horizon Scanning Tool. The 316 (total) pest species were refined to focus on pests that affect value chains important to Zambia's economy. This resulted in a final list of 133 bacteria and eight Protista. Four additional bacteria species considered of phytosanitary interest were added and all 137 bacteria and eight Protista species were subjected to a rapid risk assessment using agreed guidelines. Vectors reported to transmit any of the pathogenic organisms were also subjected to a risk assessment. A proportion of 53% (n = 77 of 145) comprising 73 bacteria and four Protista species were reported as present in Africa. Of these, 42 (57%, n = 73) bacterial species and two (n=4) Protista species were reported in neighbouring countries. Considering a cut-off of 54, the highest scor- ing pests were 40 bacteria (highest score of 140) and three Protista (highest score of 125). Three actions were suggested for high-scoring pests, a detection surveillance, a pest-initiated pest risk analysis (PRA) or a detection surveillance followed by pest-initiated PRA. A "no action" was suggested where the risk was very low although, for some pathogenic organisms, a "no action" was followed by periodic monitoring. This information will contribute towards proactive prevention and management of biological invasions. [ABSTRACT FROM AUTHOR]

Background: Parental stress often arises when parenting demands exceed the expected and actual resources available for parents to succeed in the parenting role. Parental stress is an important contributor to parent-child relationships. This, in turn, affects opportunities to engage their children in stimulating activities which could improve their development outcomes. However, limited evidence exists from sub-Saharan Africa (SSA) on the association between parental stress, caregiving practices, and child developmental outcomes. Methods: The findings reported in this paper were derived from data collected through previous longitudinal work on nurturing care evaluation studies in Kisumu and Nairobi Counties in Kenya, and Chisamba District in Zambia. A total of 341 caregivers and their children who participated in the three rounds of data collection were included in this study. The children's mean age was 9.3 (SD = 8.2) months pre-intervention, 25.5 (SD = 8.6) months in mid-intervention, and 36 (SD = 10.0) months post-intervention. The Ages and Stages Questionnaire (ASQ), Parental Stress Scale (PSS), and caregiving tools were used to assess children's developmental outcomes, parental stress, and stimulation practices, respectively. A Random Intercept Cross-Lagged Panel model (RI-CLPM) was used to determine the association between caregivers' parenting stress, child stimulation practices, and child developmental outcomes. Results: The findings showed that caregiver stimulation practices were positively associated with developmental outcomes. Findings on the associations between parental stress and caregivers' stimulation practices and children's developmental outcomes were not universally supported. Conclusion: The findings show that improved caregiver stimulation practices are likely to improve children's developmental outcomes. The policy implications of the findings from this study focus on improving parenting practices by addressing the predictors of parental stress. This includes subsidising childcare services to reduce costs. Trial registration: Pan African Clinical Trials Registry (https://pactr.samrc.ac.za/) database (ID number: PACTR20180774832663 Date: 26/July/2018. [ABSTRACT FROM AUTHOR]

Background: Nicotine replacement therapy (NRT) and short messaging service (SMS)-based tobacco cessation interventions have demonstrated effectiveness in reducing tobacco use in many populations, but evidence is needed on which tailored treatments are most efficacious in meeting the complex medical and psychosocial factors confronting people living with HIV (PLWH) in sub-Saharan Africa (SSA). This paper describes the protocol of a study to test the efficacy of both NRT and a tailored SMS-based tobacco use cessation intervention among PLWH in Uganda and Zambia. Methods: In a randomized controlled trial, 800 adult PLWH who use tobacco will be recruited by health care professionals at HIV treatment centers where they are receiving care. Participants will be randomized to one of the four study arms: (1) standard of care [SOC; brief clinician advice to quit combined with HIV education and information aimed at encouraging HIV treatment adherence (with no mention of tobacco) delivered via text messages]; (2) SOC + 12 weeks of NRT; (3) SOC + 6 weeks of SMS text messages to support quitting tobacco use (SMS); or (4) SOC + NRT + SMS. Participants will receive a cell phone and solar panel with power bank for charging the phone. The main outcome is cessation of tobacco use by study participants verified by urinary cotinine (< 15 ng/mL) at 6 months post-enrollment. As a secondary tobacco use outcome, we will measure 7-day point-prevalence abstinence (7 consecutive days of no tobacco use) measured by self-report and biochemically-verified at 4 weeks, 8 weeks, and 3 months post enrollment. Discussion: Our study will provide insight into the efficacy, feasibility and applicability of delivering tobacco cessation interventions through health care professionals combined with tailored tobacco cessation SMS text messaging in two countries with different tobacco use patterns, policy environments, and health care resources and provide needed information to providers and policymakers looking for cost-effective tobacco cessation interventions. The previously tested SMS-platform to be used in our study is uniquely positioned to be scaled in low- and middle-income countries worldwide, in which case evidence of even modest success in reducing the prevalence of tobacco consumption among PLWH could confer enormous health and economic benefits. Trial registration: ClinicalTrials.gov Identifier NCT05487807. Registered August 4, 2022, https://clinicaltrials.gov/ct2/show/record/NCT05487807 [ABSTRACT FROM AUTHOR]

Modern rail/road transportation systems are critical to global travel and commercial transportation. The improvement of transport systems that are needed for efficient cargo movements possesses further challenges. For instance, diesel-powered trucks and goods trains are widely used in long-haul unimodal transportation of heavy cargo in most landlocked and developing countries, a situation that leads to concerns of greenhouse gases (GHGs) such as carbon dioxide coming from diesel fuel combustion. In this context, it is critical to understand aspects such as the use of some parameters, variables and constraints in the formulation of mathematical models, optimization techniques and algorithms that directly contribute to sustainable transportation solutions. In seeking sustainable solutions to the bulk cargo long-haul transportation problems in Zambia, we conduct a systematic review of various transportation modes and related mathematical models, and optimization approaches. In this paper, we provide an updated survey of various transport models for bulk cargo and their associated optimized combinations. We identify key research challenges and notable issues to be considered for further studies in transport system optimization, especially when dealing with long-haul unimodal or single-mode heavy cargo movement in countries that are yet to implement intermodal and multimodal systems. [ABSTRACT FROM AUTHOR]

COVID-19 has had serious consequences for world food security; lockdowns and social distancing have led to changes in global food value chains, primarily affecting the poorest of the planet. The aim of this research is to analyse the relationship between food insecurity and the structural risk factors for adverse impacts of COVID-19. To that end, 12 contingency tables are constructed to identify the association between the pillars of the food insecurity index and the INFORM COVID-19 Risk Index. We use the Gamma coefficient as a measure of association. In addition, this paper proposes a synthetic index produced by applying the TOPSIS method, using the pillars of the two aforementioned indices (criteria) to establish a ranking of 112 countries (alternatives) ordered from highest to lowest risk faced in the key year of the pandemic, 2020. The results show that the two problems are connected, indicating to international organizations that countries with worse food insecurity will suffer more serious consequences from extreme situations such as the one experienced during the pandemic. The ranking established directs international organizations' attention to countries such as Haiti, Zambia and Burundi, highlighting their greater need for an injection of financial aid than other emerging economies. Conversely, Switzerland is the country with the lowest combined risk. [ABSTRACT FROM AUTHOR]

As a land-locked country in Southern Africa, Zambia is rich in natural resources suitable for fish production. However, aquaculture is still in its infancy with enormous potential as most of Zambia's fish now comes from capture fisheries. The aim of this study was to review the recent progress, status, challenges, and opportunities in Zambia's aquaculture industry while drawing some lessons from China's aquaculture experience, focusing on policy instruments, external support, quality seeds, and the investment environment for possible adaptation. To achieve this, we reviewed the existing literature about aquaculture in Zambia. This paper starts by reviewing the overall fishery sector's developments based on the analysis of relevant statistics over decades before narrowing down to the aquaculture sub-sector. The review shows that aquaculture production has continued to expand significantly and will soon play a leading role in food and nutrition security in Zambia. However, the industry still faces major challenges relating to investments, science and technology, fish seed and feed, and an underdeveloped value chain besides the increasing demand for fish products. Nevertheless, great potential still exists to further develop the aquaculture sub-sector and meet the ever-growing demand for fish products caused mainly by the rapid population increase. [ABSTRACT FROM AUTHOR]

Unpaved roads, usually found in rural and sparsely populated areas, are prone to dust, potholes, corrugations, rutting and loose gravel and deteriorate faster than paved roads. Thus, they require regular condition monitoring to keep them at the required level of service. However, the cost of condition assessment could be huge, considering how vast and far away they are from the cities. Currently, subjective visual surveys and manual methods for monitoring and assessing the condition of unpaved roads dominate, while data-driven objective methods are not commonly applied for maintenance planning and decision-making. The paper proposes a participatory data-driven approach for unpaved road condition monitoring based on the literature and an exploratory case study of road maintenance practices in Sweden and Zambia. Participatory data collection empowers regular unpaved road users to collect road condition data, for instance, by equipping their vehicles with the relevant data acquisition devices embedded with a global positioning system (GPS) as they drive on unpaved roads on a typical day. By integrating open data collection aligned with sustainable practices, regular unpaved road users (garbage collectors, postal service providers, and road owners) share the collected condition data with the road governing bodies and process it for Nowcasting and Forecasting the unpaved road condition, thus providing valuable information for condition monitoring of unpaved roads. Thus, road users can support long-term maintenance planning and decision-making, potentially improving unpaved road management and minimising the cost of collecting and evaluating unpaved road condition data. However, the participating road users require training in data acquisition, and the vehicles must be calibrated according to the sensor properties, vehicle vibration response and speed to ensure quality data collection. Based on the literature and the case study findings, participatory data collection for unpaved roads can provide an efficient and effective alternative for collecting road condition data, accomplishing broad coverage. [ABSTRACT FROM AUTHOR]

This paper historicises the diplomatic and economic relations of Southern Rhodesia and Zambia between 1963 and 1973. While there has been comprehensive scholarship delineating the relations between, for instance, Zimbabwe and South Africa over the years, neighbouring Zambia has hitherto been given little attention by historians. Where the relations of Zimbabwe and Zambia have been examined, this has been in the context of political and military connections between Zambia’s United National Independence Party-led government and the Zimbabwean liberation movements the Zimbabwe African National Union and the Zimbabwe African People’s Union. In terms of Zambia–Rhodesia economic and diplomatic interactions, much has been written on how Zambia fared against the backdrop of Rhodesia’s Unilateral Declaration of Independence and the sanctions that followed, from the point of view of Zambia. We shift the focus because there is very little scholarship on the Rhodesian point of view, particularly its relations with Zambia in the period covered by this article. Using archival sources, newspapers and secondary literature, we contend that until the closure of the Rhodesia–Zambia border, the connection between the two countries was characterised by a cautious partnership marked by both covert and overt hostility, which escalated to an outright breakdown of border relations in 1973. Essentially, economic diplomacy became a critical tool deployed by Rhodesia towards Zambia to survive times of financial challenges precipitated by sanctions imposed by Britain and the United Nations, as well as the context of wars of liberation waged in Rhodesia since 1966. [ABSTRACT FROM AUTHOR]

Crop abandonment is when farmers decide not to harvest their previously planted crop. There is limited but emerging literature on crop abandonment or failure predominantly examining weather and crop failure rates. Consistent with these existing scant studies, it is not immediately clear to what extent historical relationships can be extrapolated in the long run under climate change. This paper seeks to improve our understanding of determinants of crop abandonment decisions in Zambia for maize production at subnational level. We find that crop abandonment (harvesting) is positively (negatively) related to fertiliser use, rainfall and temperature and negatively (positively) related to cost of living, price of maize, index-based insurance cover, town and random shocks. Therefore, fertiliser, rainfall and temperature increase the likelihood of crop abandonment in Zambia whereas increasing cost of living, maize price, insurance participation, town specific and random shock reduce it. [ABSTRACT FROM AUTHOR]

Rationale: Workplace attitudes among nurses with back pain disability are usually unsupportive as nurses tend to rely on passive approaches like pain medications and taking sick leave to manage the impact of their back pain experiences. Aims and Objectives: To lessen the burden of back pain disability, this paper aimed to collate information from publicly accessible health resources such as posters, pamphlets, and electronic resources and cross‐culturally validate this information for nurses in Zambia. Methods: Focus group discussions were used to produce the validation data for this study's qualitative research design. For cross‐cultural validation, deductive analysis was carried out using Herdman's framework for Conceptual Equivalence, Item Equivalence, and Semantic Equivalence. Results and Conclusion: The 14 messages on back pain given to the participants were reviewed to enhance clarity, applicability, and acceptability. Messages with similar meanings were merged, reducing the total number to 7. The revisions made to the 14 back pain messages aimed to improve understanding, acceptability, and relevance within the contexts and circumstances in which nurses' practice. This is important because the messages adapted for use in low‐ and middle‐income countries like Zambia are equivalent and applicable to those originally developed in high‐income countries. [ABSTRACT FROM AUTHOR]

Knowledge is an essential determinant and component of the international development cooperation agenda and projects. Therefore, it is vital to understand and reflect on how knowledge in international development cooperation is created, what knowledge counts, and how it influences the planning, implementation, and outcomes of international development cooperation projects. In this paper, we critically examine the knowledge system of the development cooperation of the Czech Republic, an emerging donor country, by applying system theory and utilizing system properties as an analytical tool. To this end, we carried out a multi-phase qualitative research with actors from the Czech Republic and Zambia. Subsequently, we analysed the knowledge system properties and identified those often overlooked by development actors, such as taboos, mistrust, and development burden, revealing how knowledge flows can be obstructed by these characteristics. In addition, we compiled a set of suitable interventions to tackle the overlooked system properties and foster knowledge cross-fertilisation. These interventions include, among others, active engagement of traditional leaders, active work with narratives of success, and introducing action-reflection-reaction cycle into the development practice. Furthermore, the proposed interventions clearly emphasize the need for more collaborative and transdisciplinary processes. Finally, we discuss that it is essential to uncover deep layers of the international development cooperation knowledge system to shift and leverage it towards more inclusive and just outcomes. [ABSTRACT FROM AUTHOR]

Background: Access to safe abortion care is highly unequal and fundamentally rooted in socioeconomic inequalities which are amplified by restrictive social norms and legal systems. We analyse these inequalities along the reproductive health continuum amongst adolescent girls in Zambia. Methodology: This paper draws from 20 focus group discussions conducted in 2021 with community members (young/adult) in five urban, peri urban, and rural sites in Zambia. Data was analysed using thematic analysis. Results: Adolescent pregnancy in the community was reported to be very common across the communities with girls from poorer families being disproportionately affected. Parents were reported to be complicit in facilitating their daughter's sexual-economic exchanges which emerged as a key driver of pregnancies. Young age and unmarried status meant adolescent girls could face triple stigma: stigma around accessing contraception to prevent a pregnancy, stigma in experiencing an unintended pregnancy and stigma around terminating an unintended pregnancy. There were clear socioeconomic differences in adolescent girl's exposure to community and health provider censure and/or acceptance of their pregnancy, and in their ability to conceal an abortion. Having the means to pay for health care allows some adolescents to seek terminations earlier and to access private health facilities while poorer adolescent girls face greater exposure to community censure through their embeddedness within the community. Abortions in this group attracts greater visibility through complications arising from their constrained choice for safe abortion methods. Stigmatising attitudes of community members also undermined adolescents' reproductive agency and mental health. For adolescents who choose to keep an unintended pregnancy, reintegration into school was highly challenging despite a national policy in place, with marriage being viewed as the only future option for poorer teenage mothers. Conclusion: The embeddedness of adolescent pregnancies within community structures of economic insecurity and gendered and age-related power relations highlight the importance of introducing community level approaches to tackle unintended pregnancies and unsafe abortion. Understanding teenage pregnancy as a community issue creates opportunities for community level support to young girls especially when they return to school. [ABSTRACT FROM AUTHOR]

Zambia is a low‐income country on the African continent which is facing a high rate of health inequalities. Although the government has made efforts to reform the organization of healthcare to reduce inequalities, the practical implementation of disability policies remains challenging. Specifically, people with intellectual disabilities (ID) face barriers to accessing healthcare services in Zambia, due to geographic or socioeconomic factors, stigma, and limited specialized health professionals. This perspective paper provides an overview of the current policy and organization on the healthcare provision for people with ID. It presents the key challenges people with ID face in Zambia to access quality healthcare services. Additionally, we provide examples of good practices with a community approach. We discuss policy implementation of disability rights, including access to healthcare, the impact of raising knowledge and awareness about people with ID, and how gathering contextual information through research can help to reduce inequalities. Community and culturally sensitive approaches to improve access to healthcare for people with ID in Zambia are crucial. We call for close collaboration between the fields of research and practice to combine expertise and strengthen the impact and possibilities of scaling good practices within Zambia. [ABSTRACT FROM AUTHOR]

Little is known about psychosocial or 'internal' behaviours that can perpetuate chronic poverty and how to alleviate them in development programmes. This paper presents a conceptual and evaluation framework examining the relationship between a person's psychosocial behaviours, empowerment and economic wellbeing. The framework shows empowerment is enabled or limited by internal behaviours – including one's identity, aspiration, hope and confidence. We tested the framework on a behaviour change intervention among 1508 extremely poor smallholder farmers in Zambia. The intervention was a six‐session curriculum for promoting positive mindsets using faith‐based messages. We used concurrent mixed methods to examine changes and differences in levels of empowerment for individuals exposed to the intervention and those not. We found significant correlations between participation in the intervention and improvements in participants' internal attitudes and overall empowerment. The framework and mixed methods evaluation offer insights into how to design programmes to address internal constraints to empowerment. [ABSTRACT FROM AUTHOR]

Zambia experienced its third electoral turnover in the 2021 election. While the ruling Patriotic Front (PF) lost votes across the territory, the electoral collapse in urban Zambia was particularly remarkable. This paper argues that economic performance voting can explain urban party switching in Zambia. The argument is supported by a unique panel survey of Zambian voters in the period 2019–2022. We show that urban voters were more likely to desert the PF, even when we control for ethnicity. We also show that they were more likely to evaluate the economy poorly and more likely to change their electoral preferences in view of such poor economic evaluation. Our results stress that African elections should not be understood as static expressions of stable political cleavages but may function as real opportunities for political accountability. However, the extent to which voters are willing to re-evaluate their vote choice varies across space. [ABSTRACT FROM AUTHOR]

This study employs an explorative case study methodology, which utilises interviews, historical analysis and observations to identify and analyse the local powers and politics that influence large-scale mining development in developing societies. It uses the Trident Mine Project in Kalumbila in rural North-Western Zambia as a case study. The Trident Project comprises an existing copper mining/processing operation at Sentinel Mine and a nickel mining development project at Enterprise Mine. It is owned by Kalumbila Minerals Ltd, a subsidiary of the Canadian-listed metal and mining company First Quantum Minerals Ltd. Situated on land previously managed under customary tenure, the Trident Project presents a useful case study to explore the tensions and contradictions that arose in this large-scale mining development. The findings reveal how several local actors influence large-scale mining and the nature and direction of the mining-induced socio-economic benefits. This implies that the state is not limited to a duality (civil and customary powers) of the type identified by Mahmood Mamdani. Instead, the paper explores several public and 'private' power poles that often function as a fractured state. [ABSTRACT FROM AUTHOR]

High human immunodeficiency virus (HIV)–prevalence countries in Southern and Eastern Africa continue to receive substantial external assistance (EA) for HIV programming, yet countries are at risk of transitioning out of HIV aid without achieving epidemic control. We sought to address two questions: (1) to what extent has HIV EA in the region been programmed and delivered in a way that supports long-term sustainability and (2) how should development agencies change operational approaches to support long-term, sustainable HIV control? We conducted 20 semi-structured key informant interviews with global and country-level respondents coupled with an analysis of Global Fund budget data for Malawi, Uganda, and Zambia (from 2017 until the present). We assessed EA practice along six dimensions of sustainability, namely financial, epidemiological, programmatic, rights-based, structural and political sustainability. Our respondents described HIV systems' vulnerability to donor departure, as well as how development partner priorities and practices have created challenges to promoting long-term HIV control. The challenges exacerbated by EA patterns include an emphasis on treatment over prevention, limiting effects on new infection rates; resistance to service integration driven in part by 'winners' under current EA patterns and challenges in ensuring coverage for marginalized populations; persistent structural barriers to effectively serving key populations and limited capacity among organizations best positioned to respond to community needs; and the need for advocacy given the erosion of political commitment by the long-term and substantive nature of HIV EA. Our recommendations include developing a robust investment case for primary prevention, providing operational support for integration processes, investing in local organizations and addressing issues of political will. While strategies must be locally crafted, our paper provides initial suggestions for how EA partners could change operational approaches to support long-term HIV control and the achievement of universal health coverage. [ABSTRACT FROM AUTHOR]

This paper examines the short-term impact of the Coronavirus pandemic on firms in a developing country i.e. Zambia. This is motivated by the characteristics of the Labour market in developing countries where informality dominates, and female workers form a larger proportion of the informal workforce. The Zambian version of the World Bank Enterprise Survey conducted just before the pandemic (September 2019 to March 2020) and during the pandemic (June 6 to 17 July 2020) is used to explore the experience of firms in terms of changes in the number of employees and firm survival. Results suggest that informal workers are more likely to lose their jobs while firms that are at least partly owned/managed by females are also less likely to survive. It is argued that policy actions that protect informal workers are salient especially since future pandemics cannot be ruled out. [ABSTRACT FROM AUTHOR]

Pharmaceutical sector corruption undermines patient access to medicines by diverting public funds for private gain and exacerbating health inequities. This paper presents an analysis of UN Convention Against Corruption (UNCAC) compliance in seven countries and examines how full UNCAC adoption may reduce corruption risks within four key pharmaceutical decision-making points: product approval, formulary selection, procurement, and dispensing. Countries were selected based on their participation in the Medicines Transparency Alliance and the WHO Good Governance for Medicines Programme. Each country’s domestic anti-corruption laws and policies were catalogued and analysed to evaluate their implementation of select UNCAC Articles relevant to the pharmaceutical sector. Countries displayed high compliance with UNCAC provisions on procurement and the recognition of most public sector corruption offences. However, several countries do not penalise private sector bribery or provide statutory protection to whistleblowers or witnesses in corruption proceedings, suggesting that private sector pharmaceutical dispensing may be a decision-making point particularly vulnerable to corruption. Fully implementing the UNCAC is a meaningful first step that countries can take reduce pharmaceutical sector corruption. However, without broader commitment to cultures of transparency and institutional integrity, corruption legislation alone is likely insufficient to ensure long-term, sustainable pharmaceutical sector good governance. [ABSTRACT FROM AUTHOR]

The late Tom Lodge's magisterial Red Road to Freedom will surely become the standard text on communism in South Africa, definitively re-assessing the sociological development and historiographically-contested political arc of the Communist Party of South Africa (CPSA). The book, nevertheless, is squarely focused on the South African public realm, eliding the important private experiences of individual CPSA members and significant transnational interchanges with the broader Southern and Central African region. Early CPSA leaders were often strikingly restrictive about the kinds of relationships available to members; had a complicated, often hostile, relationship with immigrant workers; and were opposed to organising across colonial borders. For marginalised groups, these examples prompt difficult questions about what 'freedom' meant to communists and where the early CPSA's Red Road was ultimately headed to. [ABSTRACT FROM AUTHOR]

Design charts provide one of the preliminary ways used to determine slope stability by aiding the complex limit equilibrium analysis through provision of supporting data towards achieving a solution. The previously developed charts for slide-head toppling were mostly developed based on the toppling rather than the sliding of the blocks on the slope. Furthermore, the previously developed charts were based on the assumption that the base and inter-block friction are equal ( ϕ p = ϕ d ). However, this may not usually be the case since there exists a possibility for the failure plane to counter-tilt within the slope owing to geological disparities (discontinuity characteristics). It is therefore possible for the frictional resistances to vary within the rockmass. This paper presents 2D and 3D charts based on the sliding equation to aid in the limit equilibrium analysis for slide-head toppling based on the variation of friction concerning the basal plane and the inter-block resistance ( ϕ p ≠ ϕ d ). A case study in Zambia has been presented for the prescribed situation to illustrate application of the developed charts. The results of the case study indicate that the charts can be applied on both the initial and counter-tilted weak planes. Furthermore, positive values for zeta (ζ ) have been observed for weak plane ( ψ p ) angles that are less than the base friction and vice-versa for values of ψ p greater than base friction. Apart from aiding in the determination of slide-head toppling, the developed charts also illustrate the relationship that exists between base friction and inter-block friction. [ABSTRACT FROM AUTHOR]

With limited inclusion of Black traveler experiences in tourism scholarship and given that gender and racialization occur across geographies, this article explores the ways in which positionality and embodiment influence a Black diasporic woman researcher's experience in the cross-cultural context of Livingstone, Zambia. It further explores key player and researcher-participant relationships within the research context, where an autoethnographic approach and the creative analytic practice (CAP) of poetry are used as reflexive practices and to demonstrate the impact of researcher social identities (e.g. race, gender, nationality) on the research process. Aligning with the creative (re)turn in geography scholarship, the use of CAP demonstrates how similar methodologies can provide a more well-rounded view of participant voices, specifically that of Black people informing the production of knowledge. More importantly, the Blackness of diasporic researchers is valued, especially when coupled with mindful intentionality in the approach and assumptions of the research process. [ABSTRACT FROM AUTHOR]

Rural livelihood diversification can improve food security at the household level. However, a large majority of the research has focused on male-headed households, thus overlooking experiences of female-headed households that constitute a significant portion of households in low-income and middle-income countries. This paper explores how on-farm livelihood diversification affects female-headed households' food security experiences. Using interviews and focus group discussions, the paper finds that on-farm diversification improves female-headed households' food security. The paper also finds that on-farm diversification was more effective in improving the food security experiences of female-headed households compared with off-farm diversification. Further, the additional income from diversification creates additional benefits, including empowering women and allowing them to further diversify their livelihoods. • Female-headed households are neglected in rural livelihood diversification research. • On-farm diversification can improve female-headed households' food security. • On-farm diversification can improve women's empowerment. • On-farm activities support off-farm diversification in female-headed households. [ABSTRACT FROM AUTHOR]

• Territory extends onto and out from the body as a site of spatial subjugation and resistance. • In colonial space bodies become public sites on which the construction and contestation of the settler state take place. • Counter-colonial bodies engage in alternative practices of territorialization in ways that trouble colonial regimes. • Race and gender emerge in the context of people's efforts to move out of relations of spatial violence. • The body is a lively and contested site of both colonial appropriation and anticolonial struggle. The spatial architecture of settler colonialism in Africa has been subject to ample research, in geography and beyond. This paper offers an alternative reading of colonial settler territory at the scale of the body, showing how myriad colonial boundaries were displaced onto people's bodies, and naturalized, negated and negotiated through bodily practice, performance and movement. Using Northern Rhodesia/Zambia as a case, my argument is organized around three sites of colonial spatial power: the 'proper village', the tribal 'homeland' and the colonial township. The analysis builds on historical literatures, archival research and ethnographic work to show how the construction of each of these spaces (territories) was contingent upon the making of African bodies as objects and subjects of colonial imaginary. Bodies – chiefs' bodies, 'ghost-like' bodies, dirty bodies, unmanly bodies, malnourished bodies, reproductive bodies – became important bearers of symbolic value, subjected to racial and sexual regimes and power relations, all of which became sites of territorial inscription through which the construction and contestations of the colonial state and its territorial boundaries took place. The analysis makes visible the political work performed by these bodies, how their movement engendered administrative anxiety and became critical sites around which race, gender and territory were constructed and contested in intimate relation to each other. Through this conceptualization, the paper moves forward debates in geography on territory, showing how territory is not external to the body, not simply bodily experienced, but extend onto and out from the body as a critical site of subjugation and anticolonial resistance. [ABSTRACT FROM AUTHOR]

This paper uses the lenses of space and subjectivity to analyse the local impacts of large-scale metals mining on three extractive frontiers across the global South. Using insights around the role of the materiality of resource extraction in politics, the spatiality of power and subjectivity and the global nature of extractive industries, this paper draws on research across Ghana, Peru and Zambia to understand how patterns of action and impact, repeated across continents, reconfigure space and subjectivity. First, the paper outlines thinking on subjectivity, drawing on Foucault and Althusser and work on contemporary capitalism, colonialism, nature-society relations and frontiers. Second, three key areas where the presence and activities of extractive companies reshape spaces of subjectivity across extractive frontiers are explored: (1) material transformations, (2) dynamics of inclusion and exclusion and, (3) governance interventions which directly reshape the form and functioning of the state and local politics. The weighty presence of large-scale mining reconfigures the 'reality' and sense of place in the world of those living on extractive frontiers, profoundly altering subjectivity and shaping extractive subjects. The paper argues for the possibilities opened into understanding local processes and outcomes across globally connected extractive frontiers by examining space and subjectivities, highlighting insights into the complex, scalar and intersectional forms of power at work around mining operations. [ABSTRACT FROM AUTHOR]

The adoption of Sustainable Land Management (SLM) practices among smallholder farmers remains low, particularly among women farmers. Understanding the relationship between assets, gender, and SLM adoption and how their interaction impinges on household food self-sufficiency and livelihoods is essential for developing gender-responsive SLM programmes that effectively promote sustainable livelihoods and address household food insecurity. This study examines the effects of asset type on SLM practices adoption, women farmers, and their implications on household incomes and food self-sufficiency. Data was collected through a cross-sectional survey of 761 households selected from 11 chiefdoms across six districts in Eastern Zambia. Analysis involved Structural Equation System framework and Propensity Score Matching techniques to examine relationships between SLM adoption, food self-sufficiency, and household incomes, considering various socio-economic factors. Results showed marital status and household size as significant demographics, with education positively correlating with household income and SLM participation (p < 0.05). Gender disparities persisted, with maleheaded households having higher incomes. Labour allocation analysis revealed women's involvement in labour-intensive tasks, while smaller farms showed higher income probabilities, supporting sustainable agricultural intensification. Social capital significantly influenced SLM participation, and access to financial capital. Livestock assets, land size, and crop diversity predicted food security, while male decision-making influenced food security and income. Incomes were higher for women participating in SLM projects. This study underscores the importance of SLM practices in influencing household incomes and food security, especially for women. Addressing gender disparities and promoting women's empowerment in agriculture are crucial for achieving equitable and sustainable rural development. Policymakers can foster sustainable livelihoods in rural communities by prioritizing SLM and empowering women. [ABSTRACT FROM AUTHOR]

Background: This study aimed at describing the epidemiology of (neuro)cysticercosis as well as its clinical and radiological characteristics in a Taenia solium endemic district of Zambia. Methods: This was part of a cross-sectional community-based study conducted in Sinda district to evaluate an antibody-detecting T. solium point-of-care (TS POC) test for taeniosis and (neuro)cysticercosis. All TS POC cysticercosis positive (CC+) participants and a subset of the TS POC cysticercosis negative (CC-) received a clinical evaluation and cerebral computed tomography (CT) examination for neurocysticercosis (NCC) diagnosis and staging. Results: Of the 1249 participants with a valid TS POC test result, 177 (14%) were TS POC CC+. Cysticercosis sero-prevalence was estimated to be 20.1% (95% confidence intervals [CI] 14.6–27.0%). In total, 233 participants received a CT examination (151 TS POC CC+ , 82 TS POC CC-). Typical NCC lesions were present in 35/151 (23%) TS POC CC+ , and in 10/82 (12%) TS POC CC- participants. NCC prevalence was 13.5% (95% CI 8.4–21.1%) in the study population and 38.0% (95% CI 5.2–87.4%) among people reporting epileptic seizures. Participants with NCC were more likely to experience epileptic seizures (OR = 3.98, 95% CI 1.34–11.78, p = 0.01) than those without NCC, although only 7/45 (16%) people with NCC ever experienced epileptic seizures. The number of lesions did not differ by TS POC CC status (median: 3 [IQR 1–6] versus 2.5 [IQR 1–5.3], p = 0.64). Eight (23%) of the 35 TS POC CC+ participants with NCC had active stage lesions; in contrast none of the TS POC CC- participants was diagnosed with active NCC. Conclusion: NCC is common in communities in the Eastern province of Zambia, but a large proportion of people remain asymptomatic. [ABSTRACT FROM AUTHOR]

The predicament of digital authoritarianism is particularly grievous for Africa because democratic institutions have been gradually eroded in several countries throughout the region. Illiberal regimes, in particular, exploit digital technologies to undermine such fragile democracies as Ethiopia, Tanzania, Uganda, and Zambia. Moreover, surveillance technology is expanding throughout the region as national and local governments seek to increase their capacity to monitor and control their populations—a trend that has been aggravated with the COVID-19 pandemic. This article assesses the risks posed by smart cities to democratic institutions and processes by identifying the main models of smart city development and how they conceive of the state and citizens' relationship, then assessing how smart cities can potentially foster and consolidate digital authoritarianism, with a particular focus on the technology that a regime can exploit to pursue illiberal goals. I provide cases to illustrate how smart city systems promote digital authoritarianism and conclude by discussing proposals to mitigate the technological risks and promote democratic smart cities. [ABSTRACT FROM AUTHOR]

This study investigated the interplay between exchange rate volatility, inflation rates, and real interest rates on Zambia's economic growth from 1992 to 2022, utilizing annualized time series data. The study was necessitated by the limited published literature and relatively varying findings on the variables' relationships in resource-dependent countries, such as Zambia. Diagnostic tests, including stationarity and co-integration analyses, were employed to determine integration orders and potential long-run relationships. The linear and nonlinear autoregressive distributed lag models were employed to assess short- and long-run dynamics of the variables on economic growth. The results established a positive short-run relationship between inflation rates and Gross Domestic Product (GDP) growth in the linear autoregressive distributive lag model, while an inverse relationship was observed in the nonlinear autoregressive distributive lag model, suggesting that negative shocks in inflation rates had a highly significant positive impact on economic growth. Furthermore, interest rates exhibited a positive relationship with economic growth, further suggesting that positive shocks had a greater significant direct effect on economic growth in comparison to negative shocks in the short and long run, respectively. Finally, exchange rates in both models exhibited an inverse relationship with economic growth irrespective of positive or negative shocks in the long run, highlighting the adverse effect of exchange rate volatility on economic growth prospects in developing countries, such as Zambia. The speed of adjustment to convergence following any disruptions was determined to be 75.18% (ARDL) and 89.19% (NARDL), highlighting relatively fast speeds of adjustments from any short-run disruptions. Notably, some of the policy recommendations included regular assessments of exchange rate volatility influences on import prices, domestic inflation, and production costs in key sectors. Additionally, the implementation of currency hedging options and forwards as well as bulking of foreign exchange reserves will ensure the stability of exchange rates against other major currencies in various economic conditions. [ABSTRACT FROM AUTHOR]

This paper presents a conceptual model which explains the challenges of providing high quality sustainable, teacher professional development at scale. It provides a framework to support holistic thinking at a systemic level, applicable across different systems. It draws on sociocultural theories of learning and encourages the user to think about the knowledge and skills required by actors at different levels of the system and the structures required to support their learning. It brings together the needs of teachers, school leaders and Education Officers (at the County, District or Provincial level). The empirical evidence for this model comes from a seven-year programme of activity supporting school-based professional development in Zambia. Evaluation findings highlight the importance of the role of mid-level professionals (District and Provincial Officers) in ensuring the sustainability of gains made through development projects. This is important because the professional development needs of those supporting teachers are often neglected.

Aquaculture plays a critical role in Zambia's food and nutrition security. However, aquaculture is highly vulnerable to the effects of a changing climate which can lead to economic losses, and food and nutrition insecurity. In this study, we investigated the perceived effects of climate change on aquaculture production in Zambia, vulnerability factors, and adaptation strategies. We used semi-structured and structured questionnaires to collect data from aquaculture producers in all provinces across the country. Results revealed high (over 80%) awareness of climate change, primarily attributed to literacy levels and access to media. Producers perceived occurrence of climate-related changes such as rising temperature, altered rainfall patterns, cyclones frequency, and disease outbreaks, impacting production costs. Generally, the results indicate a high to medium perception of rising temperature and increased frequency of flooding and droughts across the country. Although rising temperature did not appear to affect aquaculture production cost, the frequency of droughts, floods, cyclones, and disease outbreaks showed a significant association with production costs. Identified vulnerability factors include reliance on a limited range of fish species, absence of insurance coverage, and low adoption of adaptation practices. Vulnerability levels vary across regions, with provinces in agroecological zone I (Eastern, Lusaka, Southern, and Western) showing higher vulnerability. Despite this, many producers aren't implementing adaptation measures due to financial limitations, species diversity constraints, and insufficient knowledge of alternative economic pursuits. Main adaptation strategies involve livelihood diversification and adjustments in fish cultivation periods and infrastructure. To foster aquaculture sustainability amid climate change, critical interventions such as farminsurance, research diversification in aquaculture species, and enhancing producer resilience are necessary. [ABSTRACT FROM AUTHOR]

Background: Despite attempts to increase Universal Health Coverage, availability, accessibility, acceptability, and quality-related challenges remain barriers to receiving essential services by women who need them. We aimed to explore the experiences and perceptions of women receiving post-abortal care services in Zambia, within a human-rights framework. Methods: A qualitative case study was conducted between August and September 2021 in Lusaka and Copperbelt provinces of Zambia. Fifteen (15) women seeking post-abortion care services were' interviewed using audio recorders; transcribed data was analyzed using thematic analysis. We report women's experiences and perceptions of the healthcare system, their experiences of abortion, and healthcare-seeking behaviour. We used the availability, accessibility, acceptability, and quality (AAAQ) framework to understand how women claimed their right to healthcare as they sought and utilized post-abortion care services. Results: Women who experienced spontaneous abortions delayed seeking health care by viewing symptoms as 'normal pregnancy symptoms' and not dangerous. Women also delayed seeking care because they feared the negative attitudes from their communities and the health care providers towards abortion in general, despite it being legal in Zambia. Some services were considered costly, impeding their right to access quality care. Conclusions: Women delayed seeking care compounded by fear of negative attitudes from the community and healthcare providers. To ensure the provision and utilization of quality all abortion-related healthcare services, there is a need to increase awareness of the availability and legality of safe abortion services, the importance of seeking healthcare early for any abortion-related discomfort, and the provision and availability of free services at all levels of care should be emphasized. Plain language summary: Unsafe abortions continue to be an avoidable public health concern both globally and locally. In Zambia, a fifth of maternal deaths are related to unsafe abortions. Unsafe abortions have been defined as any induced termination of pregnancy outside the health facility, performed by untrained health personnel. Several strides have been made including the provision of comprehensive abortion care in all facilities, and the training of health personnel to provide these services at different levels of healthcare. Despite the increased availability of comprehensive abortion care through liberalized abortion laws and regulations and the training of health personnel to provide these services at different levels of healthcare, the need for quality post-abortion care specifically persists. As such, we carried out in-depth interviews to explore the experiences of women who present at healthcare facilities in Lusaka and the Copperbelt provinces in Zambia seeking post-abortion services. It was found that delay in seeking care at a health facility was due to fear that the service is illegal; alongside judgment from health care providers and society for seeking such a service that is generally perceived as evil. The assumption that the cost of receiving such services is high and a general lack of awareness about the service being provided free was also expressed. The study highlighted the need for community awareness of the legal framework on abortions to ensure women access services at any time necessary without fear of being judged, which will consequently reduce the number of abortion-related disabilities and deaths. [ABSTRACT FROM AUTHOR]

Background: In the high disease burden and resource-constrained contexts of sub-Saharan Africa (SSA), health workers experience a range of psychosocial stressors that leave them vulnerable to developing burnout, which can reduce service quality and negatively impact their own health and wellbeing. As universal testing and treatment (UTT) for HIV scales up across SSA, we sought to understand the implications of this human resource-intensive approach to HIV prevention to inform decision-making about health workforce staffing and support needs. Methods: Using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), we assessed the prevalence of three domains of burnout—emotional exhaustion, depersonalization, and personal accomplishment—among three cadres of health workers delivering health services in areas receiving a UTT intervention in Zambia and South Africa. These cadres included health facility workers (n = 478), community health workers (n = 159), and a study-specific cadre of community HIV care providers (n = 529). We used linear regression to assess risk factors associated with emotional exhaustion, the only domain with sufficient variation in our sample. Results: The MBI-HSS was completed by 1499/2153 eligible participants (69.6% response rate). Less than 1% of health workers met Maslach's definition for burnout. All groups of health workers reported lower levels of emotional exhaustion than found in previous studies of this type (mean score scores ranged from 10.7 to 15.4 out of 54 across health cadres). Higher emotional exhaustion was associated with higher educational attainment (βadj = 2.24, 95% CI 0.76 to 3.72), greater years providing HIV services (βadj = 0.20, 95% CI 0.03 to 0.36), and testing negative for HIV at last HIV test (βadj = − 3.88 − 95% CI 5.69 to − 2.07). Working as a CHW was significantly associated with lower emotional exhaustion (βadj = − 2.52, 95% CI − 4.69 to − 0.35). Among all health workers, irrespective of HIV status, witnessing stigmatizing behaviors towards people living with HIV among their co-workers was associated with significantly increased emotional exhaustion (βadj = 3.38, 95% CI 1.99 to 4.76). Conclusions: The low level of burnout detected among health workers is reassuring. However, it remains important to assess how UTT may affect levels of emotional exhaustion among health workers over time, particularly in the context of emerging global pandemics, as burnout may impact the quality of HIV services they provide and their own mental health and wellbeing. Interventions to reduce HIV stigma in health facilities may protect against emotional exhaustion among health workers, as well as interventions to increase mindfulness and resilience among health workers at risk of burnout. Trial registration ClinicalTrials.gov number: NCT01900977. [ABSTRACT FROM AUTHOR]

Introduction: A number of seroprevalence studies in Zambia document the extent of spread of acute SARS-CoV-2 infection, yet knowledge gaps still exist on symptoms and conditions that continue or develop after acute COVID-19 (long COVID). This is an important gap given the estimated prevalence of long COVID in other African countries. We assessed factors associated with long COVID at the initial visit to a post-acute COVID-19 (PAC-19) clinic and longitudinally among a cohort of patients with ≥2 review visits. Methods: We implemented a cross-sectional and longitudinal analysis of PAC-19 clinic patients from Aug-2020 to Jan-2023. The study outcome was long COVID; defined as the presence of new, relapsing, or persistent COVID-19 symptoms that interfere with the ability to function at home or work. Explanatory variables were demographic and clinical characteristics of patients which included sex, age group, presence of new onset medical conditions, presence of pre-existing comorbidities, vaccination status and acute COVID-19 episode details. We fitted logistic and mixed effects regression models to assess for associated factors and considered statistical significance at p<0.05. Results: Out of a total 1,359 PAC-19 clinic patients in the cross-sectional analysis, 548 (40.3%) patients with ≥2 PAC-19 clinic visits were in the longitudinal analysis. Patients' median age was 53 (interquartile range [IQR]: 41–63) years, 919 (67.6%) were hospitalized for acute COVID-19, and of whom 686 (74.6%) had severe acute COVID-19. Overall, 377 (27.7%) PAC-19 clinic patients had long COVID. Patients with hospital length of stay ≥15 days (adjusted odds ratio [aOR]: 5.37; 95% confidence interval [95% CI]: 2.99–10.0), severe acute COVID-19 (aOR: 3.22; 95% CI: 1.68–6.73), and comorbidities (aOR:1.50; 95% CI: 1.02–2.21) had significantly higher chance of long COVID. Longitudinally, long COVID prevalence significantly (p<0.001) declined from 75.4% at the initial PAC-19 visit to 26.0% by the final visit. The median follow-up time was 7 (IQR: 4–12) weeks. Conclusion: Factors associated with long COVID in Zambia were consistent both cross-sectionally at the initial visit to PAC-19 clinics and longitudinally across subsequent review visits. This highlights the importance of ongoing monitoring and tailored interventions for patients with comorbidities and severe COVID-19 to mitigate the long-term impacts of COVID-19. [ABSTRACT FROM AUTHOR]

Introduction: Optimizing uptake of pre‐exposure prophylaxis (PrEP) for individuals at risk of HIV acquisition has been challenging despite clear scientific evidence and normative guidelines, particularly for key populations (KPs) such as men who have sex with men (MSM), female sex workers (FSWs), transgender (TG) people and persons who inject drugs (PWID). Applying an iterative Programme Science cycle, building on the effective programme coverage framework, we describe the approach used by the Centre for Infectious Disease Research in Zambia (CIDRZ) to scale up PrEP delivery and address inequities in PrEP access for KP in Lusaka, Zambia. Methods: In 2019, CIDRZ partnered with 10 local KP civil society organizations (CSOs) and the Ministry of Health (MOH) to offer HIV services within KP‐designated community safe spaces. KP CSO partners led KP mobilization, managed safe spaces and delivered peer support; MOH organized clinicians and clinical commodities; and CIDRZ provided technical oversight. In December 2021, we introduced a community‐based intervention focused on PrEP delivery in venues where KP socialize. We collected routine programme data from September 2019 to June 2023 using programme‐specific tools and the national electronic health record. We estimated the before‐after effects of our intervention on PrEP uptake, continuation and equity for KP using descriptive statistics and interrupted time series regression, and used mixed‐effects regression to estimate marginal probabilities of PrEP continuity. Results: Most (25,658) of the 38,307 (67.0%) Key Population Investment Fund beneficiaries were reached with HIV prevention services at community‐based venues. In total, 23,527 (61.4%) received HIV testing services, with 15,508 (65.9%) testing HIV negative and found PrEP eligible, and 15,241 (98.3%) initiating PrEP. Across all programme quarters and KP types, PrEP uptake was >90%. After introducing venue‐based PrEP delivery, PrEP uptake (98.7% after vs. 96.5% before, p < 0.001) and the number of initiations (p = 0.014) increased significantly. The proportion of KP with ≥1 PrEP continuation visit within 6 months of initiation was unchanged post‐intervention (46.7%, 95% confidence interval [CI]: 45.7%, 47.6%) versus pre‐intervention (47.2%, 95% CI: 45.4%, 49.1%). Conclusions: Applying Programme Science principles, we demonstrate how decentralizing HIV prevention services to KP venues and safe spaces in partnership with KP CSOs enabled successful community‐based PrEP delivery beyond the reach of traditional facility‐based services. [ABSTRACT FROM AUTHOR]

Multistakeholder platforms (MSPs) are increasingly applied in environmental governance as institutions to collectively negotiate challenges, opportunities, and policy options in contested landscapes. However, their contributions and effectiveness depend on how stakeholders perceive and frame the role of MSPs in addressing social and environmental challenges. Despite this dependence, stakeholder perceptions of MSPs are currently under-researched. Hence this empirical study carried out in Zambia's Kalomo District asks: how do stakeholder groups perceive the role of MSPs in addressing landscape challenges, given the context of the dual land tenure system, and what does this imply for the implementation of integrated landscape approaches? This study uses Q-methodology to analyze the perceptions of purposefully selected stakeholders from state institutions, civil society organizations, land users, and others familiar with existing MSPs at the district and village levels. The findings reveal three narratives. The first one presents MSPs as institutions that foster dialogue. The second narrative foregrounds the role of the government and private sector, despite acknowledging the diversity of stakeholders in MSPs. In this narrative, MSPs should focus on supporting market-driven solutions to resolve landscape challenges. The third narrative recognizes power imbalances and considers MSPs as institutions to identify policy gaps and needs. The first two narratives are positioned in Dryzek's discourse classification as environmental problem-solving, while the third inclines toward green radicalism. Despite this divergence, there was consensus that MSPs have the potential to harmonize policies in a dual governance system and encourage dialogue between stakeholders to reconcile landscape challenges. [ABSTRACT FROM AUTHOR]