UNICEF Essential Medicines Covid-19

Overall Impact of the program: In line with the Theory of Change, the programme contributed to mitigate the disruption of lifesaving routine immunisation and RMNCAH service delivery resulting from the aggressive community transmission of COVID19. The programme continued to reinforce the Humanitarian Development Nexus with simultaneous contribution to Health Systems Strengthening and systems resilience through improved essential health commodities security, cold chain system and medical oxygen delivery system. The programme contributed to revival of maternal and newborn survival agenda particularly the critical need for Zambias health system to deliver high quality, universal, respectful services across the continuum of care. Through establishment and strengthening of essential newborn care units and kangaroo mother care units, the project contributed to protecting and supporting the mother-baby relationship. Additional 80 newborn lives were saved over a period of 6 months (July to December 2022) with an observed 10 per cent decline (22.5 to 11.7 per cent) in preterm mortality rate at one of the hospitals (Katete Mission Hospital) through provision of Kangaroo Mother Care (KMC) at KMC unit supported under the project. Key Outcome level gains made in the programme during the reporting period (1 June 2022 to 31 May 2023) Outcome 1: A total of 357,556 infants (Target: 375,000) and 48,923 pregnant women (Target: 58,000) received routine immunisation services (by accessing four traditional vaccines: BCG, bOPV, MR and Td) across the 10 provinces in the country, while 158,344 infants and 24,097 pregnant women received routine immunisation services across the four priority RMNCAH provinces (Eastern, Southern, Luapula and Muchinga). Outcome 2: Approximately 544,754 (Total cumulative target: 1 million) Zambian people (Adults: 350,613 Children under 5 years: 154,510 and Adolescents: 39,631) accessed basic curative care and RMNCAH services in the four priority RMNCAH provinces (Eastern, Southern, Luapula and Muchinga). Outcome 3: As previously reported in second progress report, this outcome target was fully met to protect 5,000 health care workers with the provision of PPEs. Outcome 4: A total of 3,675 newborns received essential newborn care (Target: 4,000). This included 1,528 newborns who received neonatal resuscitation and 2,147 newborns who received thermal care services in seven hospitals with strengthened Neonatal Intensive Care Unit (NICU) and KMC units. Key output level results contributing to the above gains include the following Output 1: 1.1 During the reporting period, all health facilities across the country were supplied with traditional vaccines for the delivery of quality immunisation services for additional six months for BCG (Bacille CalmetteGuérin) and bOPV (Bivalent Oral Polio Vaccine), and additional one month for Td (Tetanus Diphtheria) and MR (Measles and Rubella). 1.2 Procurement was completed for a total of 531,000 doses of BCG and 1,411,600 doses of bOPV and delivered to MoH in September 2022. This contributed to prepositioning of additional six months requirement for the entire country for BCG and bOPV. 1.3 Procurement was completed for 182,700 doses of Td and 235,000 doses of MR and delivered to MoH in September 2022, adding one months supply. Output 2: 2.1 All 48 hospitals in the four priority RMNCAH provinces were equipped with essential medicines for curative treatment and RMNCAH services with delivery of one unit each of the Interagency Emergency Health Kit (IEHK) Supplementary Medicine kit and the Interagency Emergency Health Kit (IEHK) renewable medical kit in September 2022 that covered the needs of 10,000 people for three months in each hospital. 2.1 All 983 PHC facilities were equipped with one unit of basic IEHK that covered the needs of 1,000 people for three months in each health centre. As previously reported, of these 983 IEHK kits, 170 were airlifted and delivered to Zambia Medicines and Medical Supplies Agency (ZAMMSA) on 26 May 2022. The remaining 813 basic kits to cover three months requirement of the remaining 813 PHC facilities of the four RMMCAH provinces arrived during current reporting period and were delivered to ZAMMSA in September 2022, (Subsequently delivered to each health centre by ZAMMSA). 2.2 A total of 145 primary care workers and community health workers were trained on integrated RMNCAH services with over 300 outreach sessions supported across 10 hardtoreach and prioritised districts. Output 3: 3.1 Last mile delivery was completed for 267,100 masks and 105,500 face shields during the reporting period covering the needs of 5,000 health care workers across 1,031 health facilities and enabling continuation of delivery of essential health services to the population in the four RMNCAH provinces. 3.2 Zambias 14 modular Essential Newborn Care course, in line with World Health Organization (WHO) updated ENC package, was drafted and finalised during the reporting period. The development and adaptation of the qualityof care standards for maternal and newborn care and for small and sick newborn care at health facilities was completed following stakeholder consultations and validation meetings scheduled during reporting period. The packages were released during World Prematurity Day commemoration event on 17 November 2023. The Ambassador attended the commemoration ceremony. 3.3 Newborn Intensive Care Units (NICUs) and Kangaroo Mother Care units were upgraded across seven hospitals to provide essential and emergency newborn care with provision of equipment and supplies. 3.4 Sixty doctors, nurses and midwives were trained on essential and emergency newborn care at University Teaching Hospital, Women and Newborn Unit through an onsite reverse mentorship programme. Follow up mentorships visit was undertaken by national mentors to all seven Centres of Excellence. Output 4: 4.1 Zambias first ever fiveyear (20222026) National Medical Oxygen Strategic Plan was finalised and formally launched on 11 May 2023. 4.2 The construction of medical oxygen production plant was initiated at Kitwe Teaching Hospital following groundbreaking ceremony that was held on 11 May 2023. The Head of Development Cooperation attended the groundbreaking

The goal of the proposed programme is to mitigate the consequences of Covid-19 on the health system with provision of essential health commodities to ensure the continuation of essential health services delivery in 4 provinces of Zambia. The programme is intended to promote resilience of the health system as a mitigation for Covid-19 impact by ensuring essential health commodity security especially focused on vaccines, essential medicines and supplies for reproductive, maternal, newborn, child and adolescent health services. The partnership with UNICEF has been significant in achieving the planned results as per its 1st interim progress report submitted in June 2021. Significant contributions of the partnership were reported in mitigating the impact of COVID-19 in Zambias health systems, especially with regards to sustaining the continuity of life-saving essential health services and building the resilience of the health system. Both Sida and UNICEF therefore, proposed and agreed to further expand the partnership to sustain Essential Health Commodities security. The aim of the program is to access 1 million people with curative treatment, including COVID-19 and Reproductive, Maternal, Newborn, Child, and Adolescent (RMNCAH) services, in 983 Primary Health Care (PHC) facilities and 48 hospitals in 4 provinces for 9 months (increased from 6 months); 5,000 health workers in 983 PHC facilities and 48 hospitals equipped with Personal Protective Equipment (PPEs) for 4 months to ensure continuation of essential health services; An estimated 4,000 new-born received quality essential new-born care services in 7 hospitals 1) University Teaching Hospital (UTHs) Childrens Hospital, Lusaka, 2) UTHs Women and Newborn Unit, Lusaka, 3) Mansa, 4) Chinsali, 5) Choma, 6) Chipata and 7) Katete (ER-4). More specifically, the key objectives are: - Procurement, pre-positioning, and in-country distribution of traditional vaccines for routine immunisation: BCG and bOPV for a total of six months requirement of the entire country. - Procurement of cold chain equipment to revitalise and strengthen the cold chain systems in four provinces. - Training of primary level health workers and CBVs in 10 high-risk districts of four provinces. - Operational support to PHC facilities and community outreach in 10 high-risk and/or hard-to-reach districts of four provinces. - Procurement, pre-positioning, and in-country distribution of the United Nations' Interagency Emergency Health Kit (IEHK)-2017 that comprised of all essential medicines and commodities for reproductive, maternal, neonatal, child and adolescent health services in four provinces for nine months. - Procurement of itemised essential drugs for Emergency Obstetric and New-born Care (EmONC) services for three months. - Procurement of Medical Oxygen services equipment (concentrators, cylinders, and flowmetres). - Rehabilitation of Oxygen plants at UTH children's Hospital, UTH adult Hospital, Lewanika General Hospital, and Mansa General Hospital to improve treatment of COVID-19, and other critical patients. - Training of hospital staff on the operations and maintenance of oxygen plants. - Last mile delivery and end-user monitoring of all three (basic, supplementary and renewable) types of IHEK-2017 kits, itemised EmONC drugs, and medical oxygen services supplies at health facility levels. - Procurement, pre-positioning, and in-country distribution of Personal Protective Equipment (PPEs) and Infection Prevention and Control (IPC) supplies. - Last mile delivery and end-user monitoring of PPEs and IPC supplies. - Last mile delivery and end-user monitoring of IEHKs, medical oxygen equipment, PPEs, and IPC supplies at health facility levels. - Procurement of medical equipment (neonatal resuscitators, neonatal warming systems) to strengthen the ENC services. - Establishment of a centre of excellence for Essential New-born Care (ENC) at UTH Children Lusaka. - Training of doctors and nurses at national and provincial level hospitals on ENC Services in four provinces.