Relevance of selected Social Science Degree programs on skills development and graduate employability in Zambia

A pragmatic approach was used to explore the extent to which four selected social science degree programs were relevant for the skill needs of the job market in Zambia. Both qualitative and quantitative data were collected from 162 participants using interviews and questionnaires. The SPSS version 24 and Atlas. Ti Version 8 were used to analyse and interpret data within the framework of the Capability Approach. The findings reveal that the relevance of each of the four social science degree programs depend on how key stakeholders in higher education and the labour market perceive them and that graduate employability was affected by factors such as the need and importance of social sciences to the labour market; employer and student perceptions of employability skills in the degree programs; demand for the programs; graduate work readiness, and the availability of graduate job prospects. It could be concluded that although all four social science degree programs were important, their relevance to the needs of Zambia’s labour market varied from program to program

Effectiveness of Internships as Pedagogical Practices in Promoting Employability Skills Amongst Graduating Students in Selected Social Science Degree Programmes in Zambia

To explore their role in enhancing graduate employability, the study investigated the effectiveness of student internships as pedagogical practices in promoting employability skills amongst graduating students in four Social Science Degree programmes of selected universities in Zambia. Qualitative and quantitative data were collected from 162 participants through the questionnaires and interview guides using a mixed-methods approach. The participants included different actors in the labour industry as critical informants; graduating students taking Social Science Degree Programmes; Lecturers, and Employers. The quantitative and qualitative data were analysed using the SPSS version 24 and Atlas. Ti. Version 8, respectively. This study employed the Human Capability Approach and Human Capital theories. Findings indicated that although internship practices were considered an essential component in the social science degree programmes for skills development, their effectiveness in promoting employability skills amongst graduating students varied from one programme to the other. The findings have implications on how universities and the labour industry could work together to design and implement internship experiences for students in social science degree programmes that are more effective in promoting the acquisition of employability skills in Zambia

Partnering with traditional Chiefs to expand access to cervical cancer prevention services in rural Zambia

Objective: To evaluate how the influence of traditional Chiefs can be leveraged to promote access to cervical cancer prevention services in rural Zambia. Methods: A retrospective review of outcome data was conducted for all screening outreach events that occurred in Zambian Chiefdoms between October 4, 2015, and October 3, 2016. Members of the health promotion team of the Cervical Cancer Prevention Program in Zambia visited local Chiefs to inform them of the importance of cervical cancer prevention. The local Chiefs then summoned adults living within their Chiefdoms to assemble for cervical cancer prevention health talks. Screen-and-treat services were implemented within each of the Chiefdoms over a 1-week period. Results: VIA-enhanced digital imaging of the cervix (digital cervicography) was offered to 8399 women in ten Chiefdoms as part of a village-based screening (VBS) program. In all, 419 (4.9%) women had positive screening test results. Of these women, 276 (65.8%) were treated immediately with thermocoagulation and 143 (34.1%) were referred to provincial government hospitals to undergo either the loop electrosurgical excision procedure/large loop excision of the transformation zone (n=109, 26.0%) or punch biopsy (n=34, 8.1%). Conclusion: The influence of traditional Chiefs was leveraged to facilitate access to cervical cancer prevention services in rural Zambia

Differences in cervical cancer screening knowledge and practices by HIV status and geographic location: Implication for program implementation in Zambia

The knowledge and perceptions of cervical cancer among HIV negative and positive women, aged 25-49 years, from rural and urban locations in Zambia was systematically accessed in this study to determine any differences. Data were coded and analyzed using NVivo software. Compared to HIV negative women, HIV positive women had more accurate information about cervical cancer. They were more likely to cite male circumcision as the best approach to cervical cancer prevention. HPV infection was more commonly mentioned as a risk factor among HIV positive women. However, HIV positive women displayed little knowledge about HPV being the major cause of cervical cancer. Among HIV positive women, lack of time was the major screening barrier cited while HIV negative women mentioned being symptomatic as a determinant for early detection. Compared to rural residents, urban residents cited a wider range of cervical cancer information sources, including media and workplace although all of the participants who stated that they had no knowledge of cervical cancer were urban residents. Overall, knowledge and perceptions of cervical cancer among study participants was high, although differences exist between subgroups. Sharing accurate and standardized information on cervical cancer would improve participation in cervical cancer screening services

Challenges, opportunities, and priorities for advancing breast cancer control in Zambia: A consultative meeting on breast cancer control

In 2016, the Zambian government made cancer control a national priority and released a National Cancer Control Strategic Plan for 2016 to 2021, which focuses on malignancies of the breast, cervix, and prostate, and retinoblastoma. The plan calls for a collective reduction in the cancer burden by 50%. In support of this vision, Susan G. Komen sponsored a consultative meeting in Lusaka, Zambia, in September 2017 to bring together the country’s main breast cancer stakeholders and identify opportunities to improve breast cancer control. The recommendations generated during the discussions are presented. There was general agreement that the first step toward breast cancer mortality reduction should consist of implementation of early detection service platforms focused on women who are symptomatic. Participants also agreed that the management of all components of the national breast cancer control program should be integrated and led by the Ministry of Health. As much as possible, early detection and treatment services presently offered by the Cervical Cancer Prevention Program of Zambia and Cancer Diseases Hospital should be leveraged. Efforts are under way through multiple stakeholders to implement the following recommendations: development of national guidelines for the early diagnosis of breast cancer, training of breast surgeons, implementation of early detection and surgical treatment service platforms at the district-hospital level, and epidemiologic research, including the improvement of electronic recording mechanisms

Antimicrobial susceptibility patterns and their correlate for urinary tract infection pathogens at Kitwe Central Hospital, Zambia.

Antimicrobial susceptibility patterns amongest the most common bacterial causes of UTIs amongest patients presenting at Kitwe Central Hospital (KCH), Zambia.Inadequate data on antimicrobial susceptibility patterns in the Africa region and indeed in Zambia have led to ineffective empirical treatment before the culture and sensitivity results are made available. The purpose of this study was to determine the antimicrobial susceptibility patterns amongest the most common bacterial causes of UTIs amongest patients presenting at Kitwe Central Hospital (KCH), Zambia. A 5-year record review of data captured in the laboratory urine register from 2008 to 2013 was conducted. Demographic data, culture and antimicrobial susceptibility data were entered in Epi Info version 7 and analysed using SPSS version 17.0. Associations were determined using the Chi-squared test at the 5% significance level. A total of 1854 records were extracted from the laboratory register. The highest frequency of UTI (43.9%) was in the 15–29 years age group. The overall sensitivity patterns indicated that E.coli was mostly sensitive to ciprofloxacin (69.8%), Klebsiella species to ciprofloxacin (68.2%), Proteus species to cefotaxime (66.7%) and Staphylococcus saprophyticus to nitrofuratoin (63.7%). Sensitivity for E. coli to nalidixic acid was higher for males (58.6%) than females (39.5%). Sensitivity for E. coli to cefotaxime and norfloxacin varied with age (Chi-squared for trend=10.32, p=0.001). Our results have shown that UTI pathogens isolated at KCH were less than 70% sensitive to the recommended and used antibiotic. Studies to establish highly sensitive antibiotics to UTI pathogens are needed to effectively treat patients.Office of Global AIDS/US Department of Stat

Minimizing Delays in the Breast Cancer Pathway by Integrating Breast Specialty Care Services at the Primary Health Care Level in Zambia

PURPOSE In Zambia, more than two-thirds of female patients with breast cancer present with late-stage disease, leading to high mortality rates. Most of the underlying causes are associated with delays in symptom recognition and diagnosis. By implementing breast care specialty services at the primary health care level, we hypothesized that some of the delays could be minimized. METHODS In March 2018, we established a breast care specialty clinic for women with symptomatic disease within 1 of the 5 district hospitals in Lusaka. The clinic offers breast self-awareness education, clinical breast examination, breast ultrasound, ultrasound-guided breast biopsy, surgery, referral for chemoradiation, follow-up care, and electronic medical records. RESULTS Between March 2018 and April 2019, of 1,790 symptomatic women who presented to the clinic, 176 (10%) had clinical and/or ultrasound indications for histologic evaluation. Biopsy specimens were obtained using ultrasound-guided core-needle procedures, all of which were performed on the same day as the initial visit. Of the 176 women who underwent biopsy, 112 (64%) had pathologic findings compatible with a primary breast cancer, and of these, 42 (37%) were early-stage (stage I/II) disease. Surgery for early-stage cancers was performed at the district hospital within 2 weeks of the time of definitive pathologic diagnosis. Patients with advanced disease were referred to the national cancer center for multimodality therapy, within a similar time frame. CONCLUSION Breast care specialty services for symptomatic women were established in a district-level hospital in a resource-constrained setting in Africa. As a result, the following time intervals were minimized: initial presentation and performance of clinical diagnostics; receipt of a definitive pathologic diagnosis and initiation of surgery; receipt of a definitive pathologic diagnosis and referral

Myths and misconceptions about cervical cancer among Zambian women: rapid assessment by peer educators.

OBJECTIVE: To make a rapid assessment of the common myths and misconceptions surrounding the causes of cervical cancer and lack of screening among unscreened low-income Zambian women. METHODS: We initiated a door-to-door community-based initiative, led by peer educators, to inform unscreened women about the existence of a new see-and-treat cervical cancer prevention program. During home visits peer educators posed the following two questions to women: 1. What do you think causes cervical cancer? 2. Why haven't you been screened for cervical cancer? The most frequent types of responses gathered in this exercise were analyzed thematically. RESULTS: Peer educators contacted over 1100 unscreened women over a period of two months. Their median age was 33 years, a large majority (58%) were not educated beyond primary school, over two-thirds (71%) did not have monthly incomes over 500,000 Zambian Kwacha (US$100) per month, and just over half (51%) were married and cohabiting with their spouses. Approximately 75% of the women engaged in discussions had heard of cervical cancer and had heard of the new cervical cancer prevention program in the local clinic. The responses of unscreened low-income Zambian women to questions posed by peer educators in urban Lusaka reflect the variety of prevalent 'folk' myths and misconceptions surrounding cervical cancer and its prevention methods. CONCLUSION: The information in our rapid assessment can serve as a basis for developing future educational and intervention campaigns for improving uptake of cervical cancer prevention services in Zambia. It also speaks to the necessity of ensuring that programs addressing women's reproductive health take into account societal inputs at the time they are being developed and implemented. Taking a community-based participatory approach to program development and implementation will help ensure sustainability and impact

Patient Preferences and Willingness to Pay for Cervical Cancer Prevention in Zambia: Protocol for a Multi-Cohort Discrete Choice Experiment

Background: Although most countries in southern Africa have cervical cancer screening programs, these programs generally fail to reach a significant majority of women because they are often implemented as pilot or research projects, and this limits their scope and ability to scale up screening. Some countries have planned larger-scale programs, but these have either never been implemented or have not been successfully scaled up. Most of the global burden of cervical cancer is experienced in countries with limited resources, and mortality from cervical cancer is the most common cause of cancer-related deaths among women in Sub-Saharan Africa. Objective: The purpose of this study is to learn about preferences for cervical cancer screening in Zambia, to identify barriers and facilitators for screening uptake, and to evaluate willingness to pay for screening services to support the scaling up of cervical cancer screening programs. Methods: We will conduct a discrete choice experiment by interviewing women and men and asking them to choose among constructed scenarios with varying combinations of attributes relevant to cervical cancer screening. To inform the discrete choice experiment, we will conduct focus groups and interviews about general knowledge and attitudes about cervical screening, perception about the availability of screening, stigma associated with cancer and HIV, and payment for health care services. For the discrete choice experiment, we will have a maximum design of 120 choice sets divided into 15 sets of 8 tasks each with a sample size of 320-400 respondents. We will use a hierarchical Bayesian estimation procedure to assess attributes at the following two levels: group and individual levels. Results: The model will generate preferences for attributes to assess the most important features and allow for the assessment of differences among cohorts. We will conduct policy simulations reflecting potential changes in the attributes of the screening facilities and calculate the projected changes in preference for choosing to undergo cervical cancer screening. The findings from the discrete choice experiment will be supplemented with interviews, focus groups, and patient surveys to ensure a comprehensive and context-based interpretation of the results. Conclusions: Because willingness to pay for cervical cancer screening has not been previously assessed, this will be a unique and important contribution to the literature. This study will take into account the high HIV prevalence in Sub-Saharan Africa and prevailing gender attitudes to identify an optimal package of interventions to reduce cervical cancer incidence. This simulation of women’s decisions (and men’s support) to undergo screening will lay the foundation for understanding the stated preferences and willingness to pay to help design future screening programs

Advancing Cervical Cancer Prevention Initiatives in Resource-Constrained Settings: Insights from the Cervical Cancer Prevention Program in Zambia

Groesbeck Parham and colleagues describe their Cervical Cancer Prevention Program in Zambia, which has provided services to over 58,000 women over the past five years, and share lessons learned from the program's implementation and integration with existing HIV/AIDS programs