Final Report: Enhanced Humanitarian Response in Choma, Kalomo and Monze Districts in the Southern Province of Zambia

The water and sanitation activities benefited 7,859 people (2579 people, more than planned target) who use safe water in greater quantities and reduce the incidence of disease including awareness about better protection from gender-based violence. Of these people, 5654 people benefited from cash assistance to meet some basic needs. Some beneficiaries invested the money in purchasing agricultural inputs, small livestock and upgrading shelter to increase crop yields and improve food and nutrition security as well as decent shelter. In total, 14,574 people were reached and accessed information thereby contributing to disease prevention and improved hygiene practices. CARE assigned 3 staff and supported 4 DMMU enumerators who participated in conducting the vulnerability assessment and producing the 2023 national contingency plan. The plan informs the design of government and NGO interventions in response to disasters. Read More...

The Cost of Delivering COVID-19 Vaccines in Zambia

While Zambia aims to deliver COVID-19 vaccines to 70% of its people by June 30, 2022, the road to getting there is uncertain. The Zambian Ministry of Health reports that, as of February 21, 2022, 21.6% of people were fully
vaccinated. Vaccine doses available in the country are slowly rising, with 6.2 million doses arrived as of February 11, but less than half of those doses have made it into people’s arms. By February 23, only 2.77 million doses had gotten to people. By December 31, 2021, only 7.2% of people had gotten a vaccine, compared to a goal of 40%. Without significant investments in last mile delivery, especially for people at highest risk, Zambia risks missing its next COVID-19 vaccine targets.
CARE estimates that in Zambia, vaccine delivery costs a minimum of $17.18 per fully vaccinated person, or $7.30 per dose delivered. That is 7.2 times more than current global estimates. Even with its robust childhood vaccination system—93% of Zambian children got their first measles vaccine in 2019—Zambia has not been able to get enough COVID-19 vaccines to the last mile. Read More...

SANI (Southern Africa Nutrition Initiative)

The Southern Africa Nutrition Initiative (SANI) is a $29,487,135 CAD project to address undernutrition in women of reproductive age (15-49) and children under 5 years in Malawi, Mozambique and Zambia. A partnership between CARE, Cuso International, Interagency Coalition on AIDS and Development (ICAD) and McGill University and the Governments and communities of implementing countries, SANI aimed to improve the nutritional status of women of reproductive age (15-49 years) and children under-5 years old. SANI was designed to align with national health and nutrition strategic priorities of Malawi, Mozambique and Zambia, and has been implemented in close collaboration with the Ministries responsible for Health, Agriculture, and Gender in each country, as well as national and district-level nutrition coordination committees (NCC and DNCC). Between June 2016 and March 2021, SANI contributed directly to the improved health of 234,000 women, children and men directly and over 498,000 individuals indirectly.
This final report covers the implementation period of the original SANI contribution agreement and project implementation plan finalized in February 2017.
Key project achievements:
Outcome 1100 aimed to improve nutrition practices and services for women of reproductive age, boys, and girls under 5 by strengthening the delivery of community-based nutrition services at the intersection between community health and the health system. Growth Monitoring and Promotion (GMP) and Community Management of Acute Malnutrition (CMAM) programs built this link, working on the continuum of prevention of malnutrition and early detection and treatment of moderate and severe acute malnutrition. Training and support on Maternal, Infant, and Young Child Nutrition (MIYCN), CMAM, and GMP was provided to health service workers and community health workers, and Care groups were established to support families to learn about and apply gender-sensitive MIYCN practices. Interactive teaching was also done at scale through participatory education theatre and cooking demonstrations using local nutritious foods. Social Analysis and Action (SAA) dialogues encouraged families involved in the program to identify, discuss, and challenge traditional social norms and practices that affect women’s health, nutrition, and empowerment.
Endline data revealed the following increases in nutrition-specific indicators from baseline:
- All three countries had considerable increases in rates of exclusive breastfeeding of children up to 5 months, increasing by 15-percentage points in Zambia (from 70% to 85%), 25- percentage points in Malawi (from 61% to 86%) and 17-percentage points in Mozambique (from 65% to 82%)
- Minimum Acceptable Diet (MAD) for children 6 to 23 months increased by 24-percentage points for boys and girls in Malawi (from 7% to 31%) and in Zambia by 7-percentage points for boys (from 24% to 31%) and by 13-percentage points for girls (from 17% to 30%)
- Knowledge of men and women on MIYCN practices improved by 6-percentage points for men (from 79% to 85%) and 4 percentage points for women in Malawi (from 90% to 94%), by 12- percentage points among women (from 59% to 71%) in Mozambique, and by 11-percentage points for women (from 81% to 92%) and 14-percentage points for men (from 72% to 86%) in Zambia. Read More...


Pandemics and outbreaks have differential impacts on women, men, girls and boys. From risk of exposure and biological susceptibility to infection to the social and economic implications, individuals’ experiences are likely to vary according to their biological and gender characteristics and their interaction with other social determinants (UNWomen, 2020). Because of this, global and national strategic plans for COVID-19 preparedness and response must be grounded in strong gender analysis and must ensure meaningful participation of affected groups, including women and girls, in decision-making and implementation.

The Rapid Gender Analysis (RGA) was conducted in the four districts of Lusaka, Kalomo, Mpika, and Katete. A mixed method approach was employed to gather data from men, women, boys and girls on the impact of Covid-19 on Gender Based Violence (GBV), health, nutrition and water, sanitation and hygiene. Read More...

CARE Rapid Gender Analysis for COVID 19 East, Central and Southern Africa

The impacts – direct and indirect – of public health emergencies fall disproportionally on the most vulnerable and marginalized groups in society. Interconnected social, economic, and political factors pose complex challenges for the ECSA region’s ability to respond to COVID-19. The region already faces significant health challenges that would exacerbate the severity of COVID-19, such as high levels of malnutrition, malaria, anemia, HIV/AIDS, and tuberculosis. Access to healthcare in the region is the lowest in the world, thus there is limited capacity to absorb the pandemic1. Gender-based inequality is extensive in the region. Women are at a higher risk for exposure to infection due to the fact that they are often the primary caregivers in the family and constitute 70% of frontline healthcare responders.2 Most women already face limited access to sexual and reproductive health and rights (SRHR) services, and the region struggles with high levels of maternal mortality. For example, mother mortality rates recorded in South Sudan were 1150 per 100 000 live births3. COVID-19 will only increase women’s safety risks and care burdens as health services become stretched and resources shift to COVID-19 responses.
Women and girls are at increased risk of violence during the COVID-19 period. Current rates of violence against women and girls combined with the prevalence of harmful traditional practices leads to increased vulnerability. Income loss and limited mobility, compounded with existing gender role expectations, may contribute to increases in intimate partner violence and other forms of gender-based violence. Read More...

FANSER End of Project Evaluation: Knowledge, Attitudes & Practices Survey

This report presents the findings of an evaluation of the Food and Nutrition Security and Enhanced Resilience (FANSER) project implemented by CARE International in three wards in Katete District of the Eastern province of Zambia. The main objectives of the study were: to describe the nutrition situation among the FANSER target groups in Katete District i.e. assess the IDDS-W, IDDS-C; to assess the nutrition-related behaviours i.e. examine knowledge, attitudes, behaviours and practices related to agriculture, health, nutrition, hygiene and health practices of mothers (15-49 years old) and children (<2 years); and women empowerment; and to document evidence, lessons learned and good practices to inform future nutrition programming. The assessment utilized a mixed methods approach to collect data on project interventions in order to assess the impact of the project.
Using the global Scaling Up Nutrition (SUN) platform, CARE International in Zambia with funding from GIZ under the “One World No Hunger” Initiative of the German Government, implemented various nutrition interventions to building capacity of staff and community volunteers to promote the production, preparation and consumption of diverse foods in Katete District particularly in Chimtende, Vulamkoko and Chimwa wards. This came from the realization that rural areas are more prone and vulnerable to malnutrition and deficiency diseases. The main goal of the project was to ensure that the food and nutrition security and dietary diversity of women of reproductive age and children under the age of two, in Katete district is improved. Read More...


This End of Project Evaluation Report on the Community Driven Models for Equitable Services (COMEQs) solid waste project in four peri-urban settlements of Lusaka District (Chipata, Ng’ombe, Chaisa and Kanyama) starts by looking at the background and context of solid waste management and goes on to define concepts of waste, solid waste and solid waste management. It is very clear from several reports that Zambia’s current solid waste management system does not provide a clear roadmap on the management of solid waste as evidenced by piles of garbage lying uncollected in many major cities including Lusaka.
This End of Project Evaluation Report on the Community Driven Models for Equitable Services (COMEQS) solid waste project, was commissioned by CARE International Zambia, CARE UK, COMEQS Project Team and the key project stakeholders. The overall goal of the summative end of project evaluation is to inform stakeholders the progress and change that the project has made in the communities of the targeted peri urban settlements of Lusaka. (60 pages) Read More...

Southern African Nutrition Initiative (SANI): Baseline Household Evaluation — Zambia

CARE is currently implementing the South Africa Nutrition Initiative (SANI) project in Malawi, Mozambique and Zambia. The goal of SANI is to improve the nutritional status of women of reproductive age and boys and girls under 5 years. This baseline study was conducted to obtain baseline values for the key SANI intervention areas in Mpika and Shiwang’andu Districts of Zambia. Eleven (11) key PMF indicators were able to be measured in order to set-up baseline values and establish achievable life of project targets for SANI in Zambia. (64 pages) Read More...

Baseline Evaluation of Zambia’s First 1,000 Days Nutrition Programme

This report provides the baseline results of the impact evaluation of Zambia’s First 1,000 Most Critical Days Programme (MCDP). The evaluation of the MCDP will be a two year mixed methods non-experimental design that includes three components: a rapid qualitative assessment (RQA), a process evaluation, and an impact evaluation. The purpose of the evaluation is to learn if and how the programme impacts the lives of pregnant women, and children under 2 years old for an array of outcomes including young child nutrition; health, water and sanitation practices; and the use of health related services. Department for International Development (DfID) Zambia contracted the American Institutes for Research (AIR) and its partners Palm Associates and the University of North Carolina at Chapel Hill (UNC) to conduct the evaluation of the MCDP. (34 pages) Read More...

Evaluation of Zambia’s First 1,000 Days Nutrition Programme

National Food and Nutrition Council (NFNC) and several donors—including the United Kingdom’s Department for International Development (DFID), Irish Aid, and the Swedish International Development Cooperation Agency (SIDA) —designed a bundled, multisector programme called the First 1,000 Most Critical Days Programme (MCDP). The MCDP will run for three years (from late 2014 through 2016) in 14 districts across Zambia, and it includes targeted interventions such as micronutrient supplementation; promotion of best practices in breastfeeding and complementary feeding; promotion of diverse diets for pregnant and lactating women; zinc treatment for diarrhoea; promotion of safe water, hygiene, and sanitation; growth monitoring; deworming; and management of acute malnutrition. The impact evaluation of the MCDP consists of four components, the first of which is the rapid qualitative assessment (RQA). The RQA is intended to facilitate formative research and is designed to provide tailored, programme-relevant information to MCDP implementers in order to guide refinements to the programme. It was developed around one central research question: “What is the nature and experience of poverty and undernutrition, including access to food, dietary and feeding practices, and behaviour for households with young children in rural Zambia?” To answer this question, the RQA employed three primary methods of data collection: focused ethnographic studies (FESs); focus group discussions (FGDs); and social mapping (SM). (84 pages) Read More...

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