Magister Public Health - MPH / Background: The irrational use of medicines, and increasingly antimicrobials, remains a key health problem in many developing countries including Zambia. Inappropriate, ineffective and inefficient use of medicines is common in health facilities at all levels. There are many factors influencing irrational prescribing and dispensing of antimicrobials including patients, prescribers, dispensers, the supply system (including industry influences), government regulations and medicines information and misinformation. Study aim: The aim of the study was to assess the rational use and availability of antimicrobials at primary level health facilities under the Lusaka district community health office, Zambia. Study design: The study was a cross-sectional descriptive study, with prospective and retrospective components. A standardized research methodology, including tools and indicators, adapted from the World Health Organization, was employed. Study population and sampling: The study population included all the 30 government primary level health facilities (health centres) in Lusaka District, from which 20 primary health facilities were sampled using a combination of purposive and random sampling. Using the WHO standard indicators of rational drug use, this study assessed 800 patient encounters, 520 medicines inventory records, and other baseline data, from 20 health facilities at three different levels under the Lusaka district community health office, Zambia. Data collection: The data collection tools were numbered and labeled. Tool 1: Prescribing Indicator Form was used to collect prescribing data; Tool 2: Patient Care (Pharmacy) Form was used to record dispensing data; Tool 3: Antimicrobial Availability Form for recording data for the availability of the key indicator antimicrobials and their substitutes; Tool 4: Facility Indicator Consolidation Reporting Form was used for consolidating the data collected for each health facility under study; and Tool 5: Facility Medicines Use Indicator Consolidation Form was used for the consolidation of the drug use data for the entire study. Third year Pharmacy Technology students were trained for the data collection process. The patients were first observed from outside the prescriber's room and the dispensing area for consultation and dispensing times respectively, and then they were interviewed to collect the prescribing and dispensing data. The tools were pre-tested. Data analysis: After data checking and consolidation, quantitative data were categorized into continuous numerical variables. Calculations were done manually and using computerized analysis (Epi Info package) and presented as simple frequency and means. Ethics: Ethical clearance for the study was obtained from University of the Western Cape Senate Research Committee. Permission was obtained from the Lusaka Provincial and District health offices, being the authorities that are overseeing the health facilities included in the study. Furthermore, permission was obtained from the health centre in-charges. Consent was obtained from healthcare providers and patients. Key results and discussion: The study found that at the primary level facilities there were more Clinical Officers (55%) than Medical Doctors (25%) and Registered Nurses (20%) in charge of prescribing. The main dispensers were Pharmacy Technologists (85%); there were no Pharmacists available in any of the facilities. A third [259 (32.4 %)] of all the 800 patients in the study were children below 12 years of age. Across the clinics, a mean of 2.94 medicines were prescribed per prescription, with an extremely low rate of prescribing drugs by generic name (36.7%). The proportion of prescriptions including an antibiotic was 36.2 % and 3.4 % included an injectable drug. Linking the antimicrobials and injections to patient diagnoses indicated that many were probably irrational, prescribing decisions. Amoxicillin and metronidazole were by far the most commonly prescribed antimicrobials at 32.0 % and 17.2 % of total antimicrobials, respectively. The essential drugs list was available in 80.0% of facilities and a high percentage of medicines were prescribed from the essential medicines list (81.2%). The overall mean percentage of medicines packages correctly labeled was considerably low at 44.8 %. The average consultation time was short at 4.0 (range 1-8.4) minutes, whereas the dispensing times were equally short and averaged at 116.6 (range 15-360) seconds, with the range of 15 to 360 seconds. The average percentage of first line antimicrobials available at health facilities was 79 %; and the average percentage of second line, substitute, antimicrobials available was 15 %. Conclusion: In line with studies from other settings, this medicines use study found considerable overuse and irrational use of antimicrobials in the primary health care clinics in Lusaka District. Irrational medicine prescribing was common and poor dispensing practices were also seen, resulting in poor use of and adherence to medicines and, consequently, poor therapeutic outcomes. Recommendations: Several recommendations have been formulated. They include: Reinforcing the Drug Therapeutic Committees (DTCs) at the national and the local facility level to help manage medicines use; clarification of prescribers and dispensers roles and responsibilities; development, enforcement or adaption of standard operating procedures (SOPS) for prescribing and dispensing; and improvement of prescribing and dispensing practices through introduction of appropriate education, supervision and audit.

Adolescent fertility is a problem that is urgent in developing countries due to rapid population growth rates. To gain a better understanding of adolescent fertility within developing countries a study was undertaken to examine adolescent sexual behavior among teens within a developing country, Zambia. A self-administered questionnaire was given to secondary school going teenage women in Zambia. The sample population consisted of 503 women between the ages of 12 and 19. The survey was analyzed using both regression and univariate analysis of the data. The findings revealed that a high percentage of the teens have initiated sexual activity; yet few (4.2%) have ever used modern contraceptive methods. Suggestions were made for family planning programs that would involve both parents and their children.

As managers with direct contact with workers on the floor, line managers are responsible for implementation of the performance appraisal system at Kansanshi Mining plc. Commonly, implementation of performance appraisal is affected by how line managers interact with their subordinates before, during and after an appraisal interview. Notably, no study has been conducted at Kansanshi mine to understand how line managers conduct performance appraisals since their introduction. This qualitative study aims to build an understanding of how line managers at Kansanshi conduct performance appraisal interviews and what enablers and barriers they face in this process. In pursuit of the research aim, line managers from all the ten departments of the mine were considered as eligible for the study. Using stratified random sampling, ten of the 30 line managers from all ten departments across the mine site were selected. A total of fifteen semi-structured, in-depth, face-to-face interviews were conducted with ten line managers to gather data. These individual interviews were conducted on the mine site in the interviewees' offices as well as other convenient places such as the Kansanshi main boardroom. On average, each interview took between 45 to 60 minutes. All these interviews were audio recorded, transcribed and thereafter analyzed using open coding and constant comparison technique to induce themes. Findings of the study show a variety of barriers and enablers of line managers in their conduct of performance appraisal interviews at Kansanshi mine in Zambia. All ten line managers unanimously highlighted that (a) lack of clear job descriptions and set of individual targets as well as (b) lack of adequate refresher training on how to conduct performance appraisals affected how they conducted performance appraisals. Eight of the ten line managers highlighted that (c) perceived subjectivity of the system while seven of the ten highlighted that (d) predominant production focus and priority were barriers to them in how they conducted performance appraisals. On the other hand, ten line managers highlighted that (a) top management commitment to the implementation of a performance appraisal system, seven highlighted that (b) employees' hope for rewards and five line managers highlighted that (c) spring for career development and progression were perceived as enablers in their implementation of performance appraisals. This research is of value as it highlights how the conduct of performance is not only impacted by organizational support and other complementary organizational systems but also how the barriers to the conduct of performance appraisals affect both the appraisee and the appraiser.

This study has investigated the biblical and historical relevancy of doing theology of pastoral ministry in rural Zambia .After a meticulous examination of essential distinctives of pastoral ministry, the study brought to the fore the fact that the role of the faith community among other things is to engage the community in a practical and relevant way by creating an enabling environment that promote dialogue. Social communication and cohesion are important imperatives especially in the context of rural Zambia where life thrives on informal social support networks which are the lifelines of rural Zambia thus the need to empower rural pastors with relevant skills and training to sustain a healthy hermeneutical dialogue. The study further examined the validity of three-fold theological perspectives namely: biblical, historical and cultural. The investigation revealed that these are important pastoral imperatives that should not be seen as an end but a means in a theological process. Therefore, this study calls for a re-examination of how the pastoral ministry engages in Rural Zambia in light of scripture and the social economics. The researcher has argued that most pastors, who engage in ministry within the Zambian rural context, do not fully understand the fact that for pastoral ministry to be effective it has to engage the community holistically. Many models appropriated in the Zambian rural context focuses on the salvation of the person “soul” with no due concern for the communities “social salvation”. With all the complications and implications that go with application of genuine pastoral ministry practice, this study has formulated and proposed a model that would be effective to rural Zambia. More research still need to be done to address adequately all the impediments identified through this study. Copyright / Dissertation (MA(Theol))--University of Pretoria, 2010. / Practical Theology / unrestricted

Smallholder farmers' efficiency has been measured by different scholars using different approaches. Both parametric and non-parametric approaches have been applied; each presenting unique results in some ways. The parametric approach uses econometric approaches to make assumptions about the error terms in the data generation process and also impose functional forms on the production functions. The nonparametric approaches neither impose any functional form nor make assumptions about the error terms. The bottom line of both approaches is to determine efficiency in production. In this study a parametric stochastic frontier approach is used to assess technical, allocative and economic efficiency from a sample of smallholder maize producers of Chongwe District, Zambia. This approach was chosen based on the fact that production among this group of farmers varies a great deal, and so the stochastic frontier attributes part of the variations to the random errors (which reflects measurement errors and statistical noise) and farm specific efficiency. Using a Cobb-Douglas frontier production function which exhibits self dual characteristics, technical efficiency scores for the sample of the smallholder maize producers are derived. With the parameter estimates(âi) obtained from the Cobb-Douglas stochastic production frontier, input prices (âi) and taking advantage of the self dual characteristics of the Cobb-Douglas, a cost function is derived. This forms the basis for calculating the farmers' allocative and economic efficiency. Results obtained from the study showed considerable technical, allocative and economic inefficiencies among smallholder maize producers. Technical Efficiency (TE) estimates range from 40.6 percent to 96.53 percent with a mean efficiency of 78.19 percent, while Allocative Efficiency (AE) estimates range from 33.57 to 92.14 percent with a mean of 61.81. The mean Economic Efficiency (EE) is 47.88 percent, with a minimum being 30 percent and a maximum of 79.26 percent. The results therefore indicate that inefficiency in maize production in Chongwe District is dominated by allocative and economic inefficiency. Additionally, in the two stage regression households characteristics: age; sex; education level; occupation; years in farming; land ownership; household size; access to extension and access to credit services; are regressed against technical efficiency scores using a logit function. Results obtained shows that land ownership, access to credit services, access to extension services, land ownership and education level of up to post primary (secondary and tertiary) have a positive influence on the households' technical efficiency. On the other hand, age of the household head; female headed household and lack of education (though not statistically significant at any confidence level) have a negative influence on this group of maize producers. In a similar two stage regression, access to extension services, membership to producer organisation, access to credit and disaster experienced on the farm such as floods, drought and hail, are regressed against AE. The result shows that access to extension services, access to credit services, membership to cooperatives and natural calamities affect AE. Results therefore show that there is a great deal of both allocative and economic inefficiency among smallholder maize farmers than there is technical inefficiency. To address these inefficiencies observed there is need to design policies that will ensure that environmental (e.g. poor land practices which lead to nutrient depletion from the soils), economic (e.g. high transport cost due to poor road infrastructure) and institutional issues (access to credit) are addressed. In other words, Government should help create credit facilities to provide affordable loans to this group of farmers. Additionally, there is need to improve extension systems to help educate farmers about better farming practices and other innovative technologies to further improve their efficiency in production. Issues of land ownership among this group of farmers needs to be addressed as this will not only raise confidence but will also ensure that their cost of production is reduced since there will be no need for payment of rental charges, and that farmers will adhere to good farming practices knowing they own title to land. Copyright / Dissertation (MSc)--University of Pretoria, 2012. / Agricultural Economics, Extension and Rural Development / unrestricted

The focus of this study is to critically analyse the legislative framework for private and public private zonemodels in Zambia. The analysisis against the background of Zambia’scommitment to promote private sector development and the initiative to use the investmentpolicy tool of special economic zones (SEZs). The analysis is based on the salient provisions of Zambia’s Development Agency Act and Public Private Partnerships Act which regulate SEZs and public private partnerships respectively.. The main question sought to be addressed is the efficacy of the legislative framework for private and public private model zones, taking into account accommodation of private sector participation and nature of the investment and business environment. In addressing this question this study will analyse the salient provisions of the aforementioned laws showing how private sector actors are accommodated in the development and operation of the zones.The provisions under the aforementioned laws are to an extent analysed in conjunction with some of Zambia’s international trade and investment obligations such as the World Trade organisation Trade Related Investment Measures. An examination of how the incentives in SEZs are used is also provided as well as some lessons from Ghana, Mauritius and identified international best practices The main findings of the study include the following:  In so far as admission of investors to develop and operate SEZs is concerned the legislative framework does not generally discriminate between local and foreign investors and that admission through PPPs accommodates various kinds of well-known PPPs, even allowing prospective investors to kick start projects through submission of unsolicited proposals;  The need for Zambia’s SEZ policy to continuously evolve and diversify by undergoing relevant changes and improvements so that it remains relevant and adapts to the evolving nature of market availability and needs of SEZs whilst leveraging on Zambia’s comparative advantages;  The interplay between SEZs and Zambia’s international obligations present challenges and opportunities and thus revealing cause for the better appreciation of opportunities and complexities of SEZ policies and consequence of Zambia’s membership in more than one regional arrangement Need to periodically review the incentive structure so that Zambia does not inadvertently loss revenue through incentives that do not necessarily prove useful to investors or yield the intended benefits for the country. Based on the foregoing findings, among others,this study concludes that factors relating to the establishment of SEZs in Zambia incorporate private sector participation through the lifecycle of SEZs, that is to say from the time the investment is sought to be made to when it is becomes operationalmaking significant stride towards achieving openness to private sector participation through private and public private zone models. Against the foregoing findings and conclusion this study recommends,interalia, forcontinuous and timely observation and assessment of the shifts in use of SEZ policies vis-à-vis changes in the macroeconomic conditions in whichthe SEZ policy is to be implemented and investor market availability. The rationale of the recommendation is so that any necessary review of the Zambian SEZ policy and pursuit of enhanced private sector development is done from an informed position. / Dissertation (LLM)--University of Pretoria, 2014. / gm2015 / Centre for Human Rights / LLM / Unrestricted

This dissertation presents a study on Grade 10 learners’ understanding of key Mathematics concepts in selected secondary schools in Chibombo District of Zambia. The performance of learners in Mathematics countrywide has not been gratifying. This study therefore sought to investigate the Grade 10 learners’ understanding of key Mathematics concepts. This poor performance in Mathematics by learners in many schools at grade 12 final examination in Chibombo District prompted the researcher to conduct this study. The target population was 250 Grade 10 learners in five secondary schools in Chibombo District. The data were collected by means of questionnaire and focus group discussions. A concurrent triangulation design was adopted for the study in which the researcher simultaneously gathered both quantitative and qualitative data merged it using both quantitative and qualitative data analysis. The study revealed that Grade 10 learners’ understanding of the key Mathematics concepts of zero, equal, function, and variable is unsatisfactory. However, it is surprising how these learners can reach secondary school level with such a weak understanding of mathematical concepts, which are ubiquitous in the subject. It is anticipated that the findings of this study will provide curriculum developers with new insights into this problem so that they come up with a curriculum that focuses on learners’ understanding of basic concepts that serve as building blocks to next levels. The Ministry of General Education should rigorously monitor this process and provide both technical and financial support required. Finally, based on the findings of this study, the researcher gave some recommendations for improving learners’ understanding of mathematical concepts in schools. / Mathematics Education / M. Ed. (Mathematics Education)

Thesis (M.A.) / INTRODUCTION: Cervical cancer exists as the second most common cancer among women world wide, and in numerous countries is the leading type of female cancer. Specifically, Zambia has one of the highest mortality rates and cervical cancer incidence rates. The goal of this study is to analyze the published literature on preventative techniques for cervical cancer in resource-deprived areas of sub-Saharan Africa by focusing on the correlation between the Human Papilloma Virus (HPV), Acquired Immunodeficiency Syndrome (AIDS), and cervical cancer; the accuracy and feasibility of “screen and treat” clinics; and socio-economic and geographical barriers. RESULTS: Correlations exists between the prevalence of HIV, HPV, and cervical cancer in sub-Saharan Africa, and a clear association exists between HPV and cervical cancer. The deliverance of HPV vaccines as well as educational programs has helped to improve this medical problem. Main screening methods for cervical cancer include the Pap smear, naked eye visual inspection of the cervix after the application of either diluted acetic acid (VIA), Lugol’s iodine (VILI), or with a magnifying device (VIAM), colposcopy, and tests for HPV markers. Studies indicate that the VILI screening test has the highest level of sensitivity with the LEEP method also of importance. The procedure is relatively low cost and is easy to implement when excising lesions. Major risk factors and determinants of cervical cancer can help to explain the underlying barriers of access to care. Women’s misconceptions regarding cervical cancer, gender inequality in African nations, socio-economic status, and foreign aid all play major roles the cervical cancer screening process. A lack of proper education, especially among women in sub-Sahara Africa, has led to misconceptions about the causes of cervical cancer. Studies have found that some women associated cervical cancer with prostitution, a Satanic curse, and other bad behavior. Gender inequality also plays a significant role since the Zambia government had reported that a husband would have absolute rights over children and reproductive rights over his wife once he had made payments for a bride. Geographical barriers also exist as the terrain in Zambia is swamp-like and heavy flooding throughout the year is common. After flooding occurs, communities become physically separated. Furthermore, there are correlations between high incidence rates of cervical cancer and high poverty as it has been shown that the largest number of people living on less than $1.25 dollars per day is that of sub-Saharan Africa. DISCUSSION: Studies have indicated that virtually all of cases of cervical cancer are caused by HPV, implying that HPV testing and detection would largely prevent the progression of lesions. Ultimately, this would reduce the high incidence rate of cervical cancer in Zambia and in other Sub-Saharan African countries. In areas where cytology programs are either non-existent or not efficient, HPV testing approaches should be evaluated and implemented, and they should be based off of the HIV/AIDS infrastructure that has already been established. In regards to the screening approaches, VIAM and VIA are the only two tests that are also practical, affordable, and available. Affordability is the major concern when implementing screening programs in sub-Saharan Africa; for this reason, either VIAM and VIA would arguably be the best options as long as they were effective. VIA would be considered the most appropriate method in terms of screening procedures as the method has the advantage of giving immediate results that can be applied to large populations. Lastly, the lack of proper education, including sex education, has in part led to drastic misconceptions about the causes of cervical cancer. Women hold negative beliefs about cervical cancer since they associate it with being unclean and view it as a reflection of bad behavior. Geographical barriers also play a role; the physical inaccessibility of the clinic discourages women to come to the clinic for screenings. Home visits by physicians and/or the utilization of community health workers may help to eliminate this particular barrier of access. This strategy would be especially beneficial to residents of rural areas since they are more likely to live farther away from institutionalized clinics and screen and treat facilities and are also more likely to be in a state of extreme poverty.

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"While public participation in constitution-making is recognised under international law, its extent is not elaborated. This has resulted in governments pursuing constitution-making processes that, despite involving public participation, do not involve meaningful public participation. As shall be illustrated in this study, this is the dilemma faced in Zambia. Zambia has experienced constitutional instability since independence. It has had four constitutions since then, and is currently in the process of making its fifth. This will represent an average of a new constitution every eight years: one of the highest rates of constitutional change in Commonwealth Africa. This is an unimpressive record in so far as it is generally accepted that a constitution defines and limits the exercise of governmental power, and regulates major political activities in a country. It cannot, therefore, be frequently subjected to change like any other ordinary piece of legislation. ... This study constitutes five chapters. Chapter one introduces the study. Chapter two analyses the origins and nature of government and constitution. Chapter three examines and analyses the constitutional development process in Zambia from the pre-colonial period to the current time. In chapter four, the making of the current constitution of South Africa is duscussed and analysed. Chapter five provides the conclusion and recommendations." -- Introduction. / Thesis (LLM (Human Rights and Democratisation in Africa)) -- University of Pretoria, 2006. / Prepared under the supervision of Prof. Edward Kofi Quashigah at the Faculty of Law, University of Ghana, Legon / http://www.chr.up.ac.za/academic_pro/llm1/dissertations.html / Centre for Human Rights / LLM