Our Impact in 2021
On Call Africa is a learning organisation that aims to share all learning from our programmes to influence policy and practice more widely. We also aim to share openly the work that we are doing, and why, so that others can replicate or adapt our approaches and try these in different contexts. We use this space to share recent publications and reports so that others can learn from what has and hasn’t been successful in our programmes and projects. Below you will find recent reports that have been produced internally and externally for this purpose.
Providing health services - COVID-19 response
Between January and March 2021 we supported the Ministry of Health to respond to rising cases of COVID-19, which led to hospitals becoming overwhelmed. We placed 10 volunteer doctors in three district hospitals and two urban clinics to ensure continuation of services, and continued training and support for medical students. We also provided an ambulance service for the District Health Offices in Kazungula and Zimba.
- 315 placement days completed by volunteer doctors, with 717 patient consultations and extensive training delivered
- 40 medical students provided with on clinic mentoring. Medical students reported 40% increase in confidence in sitting their upcoming exams
- 48 teaching sessions delivered to 423 students and staff
For more information on how we supported the health system throughout the pandemic you can read our blog, here.
Co-producing Model Rural Health System With Ministry of Health
The Community Health Unit has a national strategic objective of developing, testing, and sharing learning from a model rural health system in Zambia. Working in partnership with the Community Health Unit, Zimba District Health Office, health facility staff, CBVs, communities and volunteer doctors, we have taken the following key steps towards achieving this goal:
- Developed a simple assessment tool using existing Zambian standards, to assess a health facility, and identify areas for improvement for it to meet national standards
- Used this assessment tool to assess the functionality of two rural health posts in Zimba District and worked with stakeholders to co-produce quality improvement maps
- Began delivery of elements such as Community Lead Total Sanitation, antibiotic stewardship, capacity of staff, and improved water through District Health Office, health workers and CBVs
We are delighted that MoH have endorsed both our assessment tool, and quality improvement roadmaps and have adopted the pilot sites as model health systems that they intend to share learning from.
In Kanyanga Health Post we identified antibiotic over prescribing as a significant challenge with almost all patients visiting the clinic being prescribed antibiotics. On Call Africa volunteers trained health facility staff and CBVs, and provided patient education leading to a 22.8% reduction in antibiotic prescription rates. This helps to reduce medicine stock outs and has wider implications for antibiotic microbial resistance.
WASH in Healthcare Facilities
In 2021 we entered into a formal partnership with WaterAid to support government led improvements to water, sanitation, hygiene, accessibility and waste management in 27 rural healthcare facilities in Western Province over a three-year period. In 2021 we also improved access to water at two rural healthcare facilities in Southern Province:
- Contributed towards the development of standardised national designs for WASH in healthcare facilities to align with new national standards
- Designed interventions at 7 healthcare facilities in Western Province
- Improved water provision at 1 healthcare facility in Southern Province through installation of solar pump, tank and tank stand
- Provided a bore hole, solar pump tank, and tank stand at 1 new rural health facility that had no access to water previously
- Supported the delivery of key hygiene behaviour change campaigns to communities served by 7 healthcare facilities in Western Province
Community Based Volunteer Development Programme
Following on from our work in 2020 to develop national COVID-19 guidelines for Community Based Volunteers (CBVs), and the continuation of services protocols for TB, we continued to strengthen our relationship with the Ministry of Health in Zambia through the Community Health Unit. We are part of the Community Health Unit Technical Working Group, and continue to contribute to key policy and programme development for CBVs. In March 2021 we hosted a strategic planning session for the Community Health Unit, and have continued to support developments to enhance CBV programmes in Zambia. Some of the work we contributed to in 2021 includes:
- Engaged Education, Health Promotion and International Development masters students from UCL Institute of Education to conduct research with On Call Africa CBVs on how CBVs could better support deaf and blind community members and to understand what incentives they would value. Research was shared with MoH and partners
- Contributed towards work to develop standardised incentives for CBVs
- Supported MoH to begin the design of a standardised training package for CBVs
- Supported the design of a digital health programme for CBVs to enhance service delivery and improve reporting and supervision
In 2021 On Call Africa worked with health workers, teachers and CBVs to pilot health promotion activities that utilised play and explored the role of play in enhancing delivery and retention of key health messages. Sessions were delivered to 80 children in schools in Kanyanga with positive feedback. On Call Africa also engaged Education, Health Promotion and International Development masters students from UCL Institute of Education to work with On Call Africa CBVs to explore culturally sensitive health promotion activities and the role of play. This pilot and these pieces of research will help to inform our approach to health promotion in the future.
We also worked with Zimba DHO and council to co-produce and deliver a new Community Led Total Sanitation (CLTS) programme for two catchment areas. Together we delivered training delivered to 72 community champions and teachers resulting in 215 pit latrines being brought up to Ministry of Health standards within just three months.