[Human and institutional resources development : (611-0206) project paper, Zambia.]

Title from cover of original work.

Efficient management of health centres human resources in Zambia

This study uses Data Envelopment Analysis (DEA) to estimate the degree of technical, allocative and cost efficiency in individual public and private health centres in Zambia; and to identify the relative inefficiencies in the use of various inputs among individual health centers. About 83% of the 40 health centres were technically inefficient; and 88% of them were both allocatively and cost inefficient. The privately owned health centers were found to be more efficient than public facilities. © 2006 Springer Science+Business Media, Inc.

Primary production, financial constraints and economic instability:Zambia since independence.

A systematic analysis is presented of the economic consequences of the abnormally high concentration of Zambia's exports on a commodity whose price is exceptionally unstable. Zambian macro-economic variables in the post-independence years are extensively documented, showing acute instability and decline, particularly after the energy price revolution and the collapse of copper prices. The relevance of stabilization policies designed to correct short-term disequilibrium is questioned. It is, therefore, a pathological case study of externally induced economic instability, complementing other studies in this area which use cross-country analysis of a few selected variables. After a survey of theory and issues pertaining to development, finance and stabilization, the emergence of domestic and foreign financial constraints on the Zambian economy is described. The world copper industry is surveyed and an examination of commodity and world trade prices concludes that copper showed the highest degree of price instability. Specific aspects of Zambia's economy identified for detailed analysis include: its unprofitable mining industry, external payments disequilibrium, a constrained government budget, potentially inflationary monetary growth, and external indebtedness. International comparisons are used extensively, but major copper exporters are subjected to closer scrutiny. An appraisal of policy options concludes the study.

Estimating the efficiency of healthcare facilities providing HIV/AIDS treatment in Zambia:a data envelopment approach

Zambia and many other countries in Sub-Saharan Africa face a key challenge of sustaining high levels of coverage of AIDS treatment under prospects of dwindling global resources for HIV/AIDS treatment. Policy debate in HIV/AIDS is increasingly paying more focus to efficiency in the use of available resources. In this chapter, we apply Data Envelopment Analysis (DEA) to estimate short term technical efficiency of 34 HIV/AIDS treatment facilities in Zambia. The data consists of input variables such as human resources, medical equipment, building space, drugs, medical supplies, and other materials used in providing HIV/AIDS treatment. Two main outputs namely, numbers of ART-years (Anti-Retroviral Therapy-years) and pre-ART-years are included in the model. Results show the mean technical efficiency score to be 83%, with great variability in efficiency scores across the facilities. Scale inefficiency is also shown to be significant. About half of the facilities were on the efficiency frontier. We also construct bootstrap confidence intervals around the efficiency scores.

The Pratt Pouch Provides a Three-Fold Access Increase to Antiretroviral Medication for Births outside Health Facilities in Southern Zambia.

INTRODUCTION: Modern day antiretroviral therapy allows HIV+ pregnant women to lower the likelihood of viral transmission to their infants before, during, and after birth from 20-45% to less than 5%. In developing countries, where non-facility births may outnumber facility births, infant access to safe antiretroviral medication during the critical first three days after birth is often limited. A single-dose, polyethylene pouch ("Pratt Pouch") addresses this challenge by allowing the medication to be distributed to mothers during antenatal care. METHODS: The Pratt Pouch was introduced as part of a one year clinical feasibility study in two districts in Southern Province, Zambia. Participating nurses, community health workers, and pharmacists were trained before implementation. Success in achieving improved antiretroviral medication access was assessed via pre intervention and post intervention survey responses by HIV+ mothers. RESULTS: Access to medication for HIV-exposed infants born outside of a health facility increased from 35% (17/51) before the introduction of the pouch to 94% (15/16) after (p<0.05). A non-significant increase in homebirth rates from 33% (pre intervention cohort) to 50% (post intervention cohort) was observed (p>0.05). Results remained below the national average homebirth rate of 52%. Users reported minimal spillage and a high level of satisfaction with the Pratt Pouch. CONCLUSION: The Pratt Pouch enhances access to infant antiretroviral medication in a rural, non-facility birth setting. Wide scale implementation could have a substantial global impact on HIV transmission rates from mother to child.

‘Black Settlers’: Hybridity, Neoliberalism and Ecosystemic Change Among Tonga Farmers of Southern Zambia, 1964-2008

This dissertation examines a process of indigenous accumulation among Tonga farmers in Zambia’s Southern Province. In the 1970s multiple authors concluded that capitalist farmers had emerged among Tonga agro-pastoralists, predominantly within private titled holdings. Relying on archival research, newspapers, secondary sources and extensive oral testimony this thesis fills a 35-year gap on the topic, providing insights into the social and environmental impacts of neoliberal policy among African peasants and capitalist farmers. In contrast to dominant narratives of the post-independence period, this study argues that Zambia did experience a developmental process post-independence, which saw significant achievements made in the agricultural sector, including the doubling of national cattle stocks. The data reveals a painful process of disarticulation beginning in the late 1980s. Following neoliberal adjustment, we observe significant heterogeneity in production systems, some regional specialization, and processes of migration. Most importantly, the thesis uncovers processes of overwhelming ecosystemic change that contributed to livestock epidemics of severe scale and scope. Amazingly, this went largely undocumented because of the simultaneous crisis of the state, which left the national statistics office and other state bodies incapable of functioning from the late 1980s into the 2000s. In response, the Zambian state has introduced a number of neodevelopmental initiatives in the sector, yet the lack of animal traction remained up to 2008 and agricultural production declined, while more capitalized farmers (largely white, and/or with foreign direct investment) have become more significant players in the country. This thesis provides compelling evidence to challenge dominant economic thinking of the Washington institutions as well as many of the common Marxian formulations.

A social and gender analysis of Northern Province, Zambia: Qualitative evidence that supports the use of a gender transformative approach

A qualitative social and gender analysis was carried out in June 2015 in Luwingu and Mbala Districts in Northern Province, Zambia. The research explored the norms and power relations at various institutional levels that constrain certain social groups from benefiting from programmatic investments aimed at improving livelihoods, health status, and food and nutrition security within the Irish Aid Local Development Programme (IALDP). This technical paper provides a summary of the research findings, lessons learned and suggests options for action the IALDP could consider to help bring about gender transformative change in the lives and livelihoods of poor and vulnerable people.

A manual for improving fish production in Northern Zambia through integrated farming systems

This manual was written as part of the Integrated Research in Development for Improved Livelihoods Programme in Northern Province, Zambia (IRDLP) and is primarily intended for extension agents to use with smallholder farmers engaged in semi-intensive fish farming in Northern Zambia. The IRDLP is an Irish Aid-funded project implemented by WorldFish, Harvest Plus and the Center for International Forestry Research (CIFOR). The goal of the IRDLP is to help improve the livelihoods, health status, and food and nutrition security of resource-poor households in the Mbala and Luwingu districts in Northern Zambia, especially women and vulnerable groups. This is achieved through generating and providing evidence-based information, scientific technologies and livelihood solutions to trigger community and farmer innovations for positive change. This manual provides information on how smallholder fish farmers can improve fish production in Northern Zambia, particularly in the Luwingu and Mbala districts, through integrated farming practices.

Hardpan and maize root distribution under conservation and conventional tillage in Agro-Ecological Zone IIA, Zambia

Hardpans (plough/hoe pans) are commonly believed to restrict plant root growth and crop yields under conventional small-scale agriculture in sub-Saharan Africa. This study questions the notion of widespread hardpans in Zambia and their remedy under conservation tillage. Soil penetration resistance was measured in 8x12 grids, covering 80 cm wide and 60 cm deep profiles in 32 soil pits. Large and fine maize roots were counted in 8x6 grids. Soil samples from mid-rows were analysed for pH, exchangeable H+, exchangeable Al3+, cation exchange capacity, total N and extractable P (Bray 1) at six depths from 0-10 to 50-60 cm. Cultivation-induced hardpans were not detected. Soils under conservation tillage were more compact at 5 cm depth than soils under conventional tillage. No differences in root distributions between conservation and conventional tillage were found. Maize ( Zea mays L. ) roots were largely confined to a relatively small soil volume of about 30 cm x 30 cm x 30 cm. Root growth appeared to be restricted by a combination of low concentrations of N and P. Soil acidity and Al saturation appeared to play a minor role in root distribution. L-shaped taproots in soils under manual tillage reported earlier were not necessarily due to hardpans, but may rather be caused by temporarily dry, impenetrable subsoils early in the rain season. There is no scientific basis for the recommendation given to farmers by agricultural extension workers to “break the hardpan” in fields under manual or animal tillage in the study areas.

Examining underlying determinants of fertility rates in Zambia: Evidence from the 2007 Zambia Demographic and Health Survey

Limited data exits on factors influencing fertility in Zambia. This study examined underlying determinants of fertility patterns and levels in Zambia. Data extracted from the 2007 Zambia Demographic and Health Survey was analysed using bivariate and multivariate logistic regression. Of 7146 women aged 15-49 years, age group 25-29 years experienced the highest prevalence of births (28.5%). Married women accounted for 27% of all births. Women with low education recorded more births (27%) than those with higher education (9.5%) (P<0.001). Fertility was higher among the poorest (28%) compared to the richest (12%) (P<0.001). Though not statistically significant, urban areas recorded more births (25%) than rural areas (15%). Education and wealth significantly influence fertility Zambia. Fertility management strategies should consider these factors and their fertility reducing effects. Improving education and wealth status of women can contribute to fertility reduction, particularly rural women. Lower fertility, with reduced mortality and migration, would provide less pressure on distribution of the limited economic resources of the country.

Current rural valuation practice : a survey of valuers and agribusiness managers on farm management and sustainable rural land use

Over the past 20 years the nature of rural valuation practice has required most rural valuers to undertake studies in both agriculture (farm management) and valuation, especially if carrying out valuation work for financial institutions. The additional farm financial and management information obtained by rural valuers exceeds that level of information required to value commercial, retail and industrial by the capitalisation of net rent/profit valuation method and is very similar to the level of information required for the valuation of commercial and retail property by the Discounted Cash Flow valuation method. On this basis the valuers specialising in rural valuation practice have the necessary skills and information to value rural properties by an income valuation method, which can focus on the long term environmental and economic sustainability of the property being valued. This paper will review the results of an extensive survey carried out by rural property valuers in Australia, in relation to the impact of farm management on rural property values and sustainable rural land use. A particular focus of the research relates to the increased awareness of the problems of rural land degradation in Australia and the subsequent impact such problems have on the productivity of rural land. These problems of sustainable land use have resulted in the need to develop an approach to rural valuation practice that allows the valuer to factor the past management practices on the subject rural property into the actual valuation figure. An analysis of the past farm management and the inclusion of this data into the valuation methodology provides a much more reliable indication of farm sustainable economic value than the existing direct comparison valuation methodology.