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Factors associated with the increase in bottle feeding among children 0-5 months in Zambia.
Get PDFThesis of Master of Public Health.The study aimed at determining factors associated with the increase in bottle feeding among children 0-5 months in Zambia. The Data used in the study was drawn from a cross sectional study design collected through Demographic Health Survey and was analyzed using Stata version 15.0. To investigate the association between the dependent variable and the independent variables, a simple binary logistic regression analysis was carried out. Then multivariate logistic regression analysis was used based on a significance level of p-value < 0.05. Thus the adjusted odds ratios were obtained by entering at once all the independent variables that were found to be significant in the bivariate analyses. The study was guided by the following research questions. a) What is the magnitude of bottle feeding? b) What are the socio-economic factors associated with bottle feeding? The study revealed that, 3.3% of women bottle-fed their children while 96.7% did not. The study found that women with higher education had the highest percentage of bottle feeding at 21.48% followed by the richest women at 13.92% and 11.45% for women that delivered by caesarean section. It was found that richest women had higher odds of bottle feeding than the poorest women with (AOR = 7.92; 95% CI: 3.967, 15.806). It was revealed that women who delivered by C-section were1.51times more likely to bottle feed than those who did not deliver by C-section. On the other hand, Women from rural areas were 0.66 times less likely to be bottle feed compared to those in urban areas. Therefore, the study recommends: i. The establishment of friendly breastfeeding workplace policies for working mothers. ii. The enactment of laws to allow for six months paid maternity leave to enable employed mothers to exclusively breastfeed. iii. For strict adherence to ARV treatment for breast feeding parents living with HIV. iv. The need for future research on the effectiveness of interventions aimed at improving exclusive breast feeding
Determine factors to retention in care for HIV positive clients on art in Sioma district- western province, Zambia.
Get PDFThesis of Master of Public HealthIntroduction: Keeping clients in care is essential to achieving strong patient outcomes and prevent treatment failure or resistance. Globally, HIV/AIDS remains one of a major public health problems with an estimated 38.4 million people are living with HIV while 1.5 million people become newly infected with HIV annually. HIV/AIDS has continued to be a major public health challenge even for Zambia, with the highest HIV prevalence rate of 13.1% in sub-Saharan Africa. Although the government of Zambia has increased the availability of ARVs in all the health facilities in the country and ensured that all HIV positive clients are put and retained in ART by means of “Test and Treat” program, not all patients who are initiated on antiretroviral treatment remain in care; with some patients being lost at different points in the continuum of care. Hence, this study is aimed at determining several factors to retention in care for HIV positive clients and their outcome at 4 health facilities in Sioma District in Zambia. Methodology: This is a retrospective cohort study, from period February, 2020 to February 2023,
used a systematic quantitative method of collecting information or data by reviewing pre-existing data of a sample of an individuals as well as by administering research questionnaires to HIV defaulters. To determine the geographical, sociocultural, Health systems and medical condition factors that underlie retention and its outcome in selected primary health facilities in the district. Sample size was calculated using Kaplan Meier formula with confidence interval of 95%.
360 defaulters were studied on and data was analyzed using Kaplan Meier curves and Log rank tests in STATA to determine the survival outcome of all defaulters over time. Findings: The overall retention rate of the ART sites was found to be 89% for client initiated 3 years ago. With reduced mortality survival rate of 86% from 100% of the non-defaulters, while the morbidity survival rate was at 39% compared to over 95% for non-defaulter clients. The median duration of follow-up was 18 months (0-41). At 12 months, the Date of Death-free survival was 85.7% (95% CI: 53.9-96.2) and at 24 months, the Date of Death-free survival was 38.6% (95% CI: 13.4-63.6). The survival rate for HIV defaulters reduced over time, as the defaulter rate increased over time.
Most of the mortalities 67% (n=6) occurred within 12 months after stopping taking ARVs. This applies to the increase in the occurrence of Opportunistic Infections (OIs) over time after clients stopped taking ARVs. The majority developed OIs 93% (n=313) within 12 months, 100% of mortalities were associated with OIs. Geographical and sociocultural factors were the major contributors to poor retention in the district accounting for over 62%. 214 of all respondents stopped taking ARVs because of long distance (> 12 KMs) for drug pickups, while 6% (n=25) was due to floods and cut off reasons
Sustainability of faecal sludge management service models in peri-urban areas of Lusaka district post donor funding : a case study of Lusaka water supply and sanitation company.
Get PDFThesisLusaka has one of the fast-growing populations in Zambia with majority of these
people residing in peri-urban areas. The efforts by the Lusaka Water Supply Sanitation
Company (LWSC) to provide adequate and sustainable Faecal Sludge Management
(FSM) services has been hampered by a lack of systems and inadequate sustainable
financing. There are simply no self-financing mechanisms against a backlog for an
urgent desire to continuously provide good FSM services that not only reduces the risk
of disease outbreak but which are also financially sustainable long after donor funding
is exhausted. The planning and design of a sustainable FSM service model requires an
assessment of the current practices, the level of sustainability and adequate data on
which future service models could be made. The lack of sufficient information that
affects and impacts on the sustainability of FSM service models in Lusaka District
triggered the conception of this research. This study assessed the current sanitation
practices of the FSM service model in Peri-Urban Areas in order to bring out factors
that affect and impact its sustainability thereby aiding the design of a model that is
sustainable post-donor funding. Sanitation practices were assessed through a technical
approach using household surveys, field observations, semi-structured questionnaires
and Focus Group Discussions (FGDs). Determination of the technical, institutional
and social factors were assessed through semi-structured interviews, technical
assessment and field observations. There was a total of 150 households (HH) and
technical experts purposively sampled for this research. Analysis of the data was done
through a technical, institutional and social assessment. Firstly, the findings indicated
that in the current sanitation practice, only one type of emptying called formal manual
emptying and transportation were officially registered and dominant. Secondly, the
financial transfers available included an emptying fee charged on households
amounting to ZMW150 per 16 barrels representing 50 percent, a discharge fee paid to
the utility by the Private Service Providers (PSPs) and the last financial transfer is the
50 percent subsidy paid to the PSPs by LWSC, money which was funded through
donor. It was also found that the community was not adequately involved in the
initiation of the FSM service projects. This created a feeling of no ownership hence
triggering resistance to support the FSM project and subsequently affecting the
willingness to sustain the system and later on had an implication on the sustainability
of the FSM service model. Data analysis of the sustainability indicated an overall
sustainability index of the FSM service model to be 6.09 indicating that the model was
performing well in the 60.9 percent of its components and this was considered a
potentially sustainable FSM project. The financial analysis showed that there was a
general increase in the costs associated with managing the FSM service model of about
18 percent from 2018 to 2022 triggered mainly by the depreciated of the Zambian
Kwacha against the US dollar which recorded a value of ZMW9.50/USD in 2018 to
ZMW17.50/USD in 2022. These findings had a negative impact on the FSM service
model thereby impacting on the sustainability. Considering these findings, a new FSM
service model was designed which recommends increased demand responsiveness, the
introduction of discharge licence fee paid directly by PSPs to the government. This if
implemented would guarantee a safe environment and will trigger a reduction in
emptying fees in the long run and hence replacing the donor funding component which
will benefit both the PSPs, HHs and the utility company thereby achieving some level
of sustainability of FSM service model resulting in improved sanitation in Peri-urban
areas of Lusaka District.
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Key terms: Faecal Sludge, Demand Responsiveness, Sanitation, Sustainability, Peri Urban Ar
The role of names in the development of plot and theme in ndumba's chiwano kuphili yakayimbwe(1994) and Mukwato's Kwato's Kwatokuna Mukwenu (1959).
No full textThesis of Master of Arts in Literature.Names in African societies are not only mere identifiers of entities, but do carry connotative meanings in most cases. Coming from an oral tradition, significant events such as droughts, death, and famine are documented and preserved through naming. The art of naming has become prominent in literary works as characters and places are named to serve certain purposes among them being maintaining the status quo of the name-giver. This present research examines the role of names of characters and places in the development of theme and plot in Ndumba’s Chiwano Kuphili Yakayimbwe (1994) and Mukwato’s Kwatoku Na Mukwenu (1959). The names of characters are carefully chosen to explore the theme of the texts under scrutiny. It has been established that there is a direct relationship between a name of a character and the role he or she plays. The names of the characters are descriptive of what they are and do throughout the text as the story unfolds. The titles of the books are descriptive of what transpires in both texts and so are the place names
Optimization in the structural design of composite deck bridges.
Get PDFThesisThe study aimed at demonstrating the positive outcome of incorporating optimization
techniques in the design procedure for designing steel-concrete composite bridges was
conducted. Optimization algorithms have the capability of finding optimal or near optimal
solutions in complex problems. In order to accomplish this task, a software known as
COMPOPT, was developed in C# programming language to optimize composite bridge
designs based on a classical method of optimization known as ‘direct search’. The
software output was then compared to structural designs that would be obtained through
the typical ‘traditional’ design procedure. Traditional design procedure is a term in this
study that alludes to normal procedure of design that practicing structural engineers
follow in the design process, including use of design aids such as structural analysis and
design software like Prokon and Robot. In summary, the output structural designs from
the developed C# application were compared to typical structural designs from selected
practicing structural engineers in Zambia. The results showed that the design output from
COMPOPT performed better than the typical designs on several key parameters.
Keywords: Optimization Techniques; Direct search method; Steel-Concrete Composite
Bridges; Bridge Optimization; COMPOP
A framework for cyber security risk modeling and mitigation in smart grid communication and control systems.
Get PDFThesisThe objective of this research was to present a risk analysis methodology for
enhancing cyber security and defending the crucial parts of Zambia's electric
power grid. By building on the basic concerns of risk assessment and
management and using a Design Science Research Methodology (DSRM) as
a research methodology, this framework tried to advance the current risk
analysis debates on the electric power system. By conducting a review of the
literature and providing a stochastic risk-based framework, this thesis stresses
the need for a coordinated cybersecurity effort toward developing strategies
and actions conducive to defending the nation against attacks on the electric
power infrastructure.
We used PIPE (Platform-Independent Petri Net Editor) and Great Stochastic
Petri Nets (GSPN) to model and analyze the GSPN attack model of the
SCADA network. Additionally, it enables the user to animate the model
through direct user manipulations or the arbitrary firing of transitions. These
instruments' analysis environments include a variety of modules, including
steady-state, steady-space, and GSPN analyses. Fifty simulations of the
designed GSPN model of the DoS attack were performed using various starting
random firings of 100, 300, 500, 700, 1000, and 1200. The transition triggering
rates of the Defense Scenario’s firewall, password, and combined SPN models,
respectively. The results show that the net probability of being attacked with
only a password as an intrusion protection mechanism was 95.59 percent,
compared to 95.11 percent for the firewall model, and 78.902 percent for the
combined model. This indication demonstrates that given a firewall and a
password as a combined intrusion protection mechanism, the probability of
being hit by a cyber-attack is relatively high.
To enable proactive cybersecurity and threat intelligence sharing for the
digitalized power infrastructure, it can be said that there is a need for a general
cybersecurity framework. In contrast to previous efforts on AGC cyber physical security, we model AGC false data injection attacks (FDIA) and
explore the potential vulnerabilities that could result from ignoring them. First,
we showed that the AGC's behavior and, consequently, the control decision,
differ if the FDIA is taken into consideration. We demonstrated that the linear
AGC models that do not account for FDIA do not offer adequate protection
against cyber-physical attacks that work in the nonlinear region of the system.
Second, we suggested and put into practice a two-stage strategy based on
LSTM to identify and reduce the compromised signals to handle these threats.
Its better performance in attack detection with good statistical metrics is
confirmed by the examination of the detection model. The mitigation model
can also improve the system's behavior and dramatically lower the RMSE of
the attacked signals. The results obtained were later compared with findings
from other studies such as PRIME (PNNL cybeR physIcal systeMs tEstbed),
and edge-based multi-level anomaly detection framework for SCADA
networks named EDMAN
Psycho-social experiences of healthcare staff on management of COVID -19 patients at a selected public University teaching hospital in Lusaka, Zambia.
Get PDFThesis of Master of Science in Counseling.This study aimed at exploring the psycho-social experiences of healthcare staff on management of Covid-19 patients at a selected public university teaching hospital in Lusaka, Zambia. The study’s objectives were: establish the psycho-social experiences of healthcare staff involved in the management of Covid 19 patients at a study institution, explore how identified psycho-social experiences affect the wellbeing of health staff at the study institution and ascertain mitigation measures in place to improve the psycho-social wellbeing of health staff in the care of Covid-19
patients at the study institution. The study employed a case study research design. A case study was considered appropriate because it is used to gain concrete, contextual, in-depth knowledge about a specific real-world subject. The study’s population was drawn from selected public University Teaching Hospital in Lusaka, Zambia because of high numbers of COVID-19 cases in their facility. The sample size thus comprised of 28 respondents. Grouped as follows: Medical doctors 5, nurses 10, pharmacists 5, those dealing with oxygen supply 2 and other support staff seen like drivers 6. Data was collected using interview guides while analysis was through thematic analysis. The study revealed a number of psycho-social experiences in the management of COVID-19 pandemic, among these include: stress, fear, anxiety, handling unexpectedly high workloads, longer working hours, insufficient personal protective equipment (PPE), and being separated from family during quarantine. These aspects psychologically and socially negatively affected their well-being as they continued to care for COVID-19 patients at the study institution. The study recommended that, healthcare facility should always prepare staff for possible pandemics such as COVID-19, make sure facility had sufficient PPE and other medical equipment in readiness for situations like COVID-19 and have sufficient staff to reduce on high workload experienced during COVID-19 period. In order to motivate healthcare staff, management should provide sufficient information, regularly hold team meetings and ensure employees are psychologically and socially supported through positive reinforcement by providing counseling services not only to patients but staff as well during pandemic period or
demanding situations at the facility
An investigation of knowledge management and its influence on organisational performance: a case study of the Zambia revenue authority.
No full textThesisThis study examined the knowledge management practices and its influence on performance at the Zambia Revenue Authority Headquarters in Lusaka. A case study design based on the quantitative approach was used in conducting this study. The data was collected through structured questionnaires comprising of closed-ended questions. A total of 108 employees responded to the questionnaire. SPSS version 25 was used as the statistical software for data analysis. The study findings revealed that a slightly large proportion (58%) of the respondents reported that there is a KM strategy/or policy at the Authority. The study findings suggest that KM has been partially integrated in the operations of the Authority. The study found that the Authority has several KM strategies in place to support the process of managing knowledge within the institution. The most common type of KM strategies reported by the respondents included database management systems (81.5%), Website (s) on its activities (74%), shared databases (71.3%), electronic mails (70.4%), internet and intranet (66.7%). The study established several knowledge capture and acquisition sources commonly used to capture and acquire knowledge include formal discussions/brainstorming, meetings/discussions, appraisals/evaluations, and lessons learned from projects. The study found that knowledge is moderately shared among different functional units within the Authority. Most of the respondents (76.9%) broadly agreed that the Authority utilises various written devices such as newsletter and manuals, to store the knowledge they capture from employees. Overall, it was established that KM practices significantly influence organisational performance. The findings revealed a positive highly significant relationship between Knowledge Capture and Acquisition and Organisational Performance. A significant positive relationship was also found between Knowledge Storage practices and Organisational Performance and between knowledge Sharing practices and Organisational Performance. However, no significant relationship was found between Knowledge Utilisation practices and Organisational Performance. The study findings provide a basic understanding of knowledge management practices and their influence on performance at the Zambia Revenue Authority. The study recommends that tax organisations should adopt KM practices to enhance their organisational performance; and consequently, may improve their service delivery.
Keywords: Employees, knowledge management practices, knowledge management practices, knowledge sharing, performance, storage, strategy
Risk of human exposure to brucella pathogens through consumption of cultured milk in the southern province of Zambia.
Get PDFThesis of Master of Science in Food Safety and Risk AnalysisBrucella is bacteria that causes Brucellosis, one of the most common zoonotic diseases in the world. The disease affects mainly animals but, in some cases, humans who are considered incidental hosts. Brucellosis is transmitted to humans through inhalation of aerosols or contact with skin sores, by the intake of infected animal products such as undercooked meat as well as consumption of raw milk or unpasteurised milk and dairy products. This study aimed to estimate the risk of human exposure to Brucella pathogens through the consumption of cultured milk in the Southern Province of Zambia. The specific objectives were to determine the consumption patterns of cultured milk by the population in the three districts of the Southern province and to estimate the likelihood of being exposed to Brucella spp. through cultured milk.
A survey was conducted using a structured questionnaire to interview traditional farmers at the milk collection centres and in selected households. Survey data were analysed in the STATA Statistical package to obtain frequencies on consumption patterns of cultured milk. A risk model was developed to estimate the risk of being exposed to Brucella spp. by consuming contaminated cultured milk using the Monte Carlo simulation in ModelRisk®.
The study had 236 males and 87 females, representing 73.1% and 26.9%, respectively. The proportion of farmers that fermented milk using raw milk was 65.3%. Boiled milk was used by 13.3%, and 21.7% purchased milk already fermented, not knowing if it was. The most common milk fermentation period was one day (40.9%), followed by those who fermented for two days (29.1%). Most respondents (63.8%) fermented milk at room temperature, and the majority (52.9%) consumed half to one litre of sour milk per person per day, while 47.1% consumed less than half a litre. The frequency of consumption was two-three times per day (60.7%), followed by one-two times per day (35.6%) and more than once per week (3.7%).
The surveys showed that there were four probabilities to be exposed to Brucella and the numbers of people likely to be exposed with the results are as follows: first probability (cultured milk prepared from raw milk obtained from an infected): 0.019 (90% CI: 0.059-0.022), number to be exposed was 17 (90% CI: 4-24). The second probability (cultured milk prepared from boiled milk obtained from an infected cow): 0.0184 (90%C I: 0.01265-0.037), the numbers to be exposed: 21 (90% CI: 11-39, the third probability (cultured milk prepared from raw milk obtained from a seronegative cow): 0.166(90% CI: 0.00135-0.0154), the numbers to be exposed was 15 (90% CI: 1-16). The fourth probability (cultured milk prepared from boiled milk obtained from a seronegative cow): was 0.023 (90% CI: 0.0029-0.02609), and the number to be exposed was 24 (90% CI: 2-29).
Most people consumed about 0.5 to 1.0 litres of cultured milk per day, made from raw milk fermented for one day. The consumption of cultured milk in the three districts was high and frequent. Moreover, consuming cultured milk from an infected animal exposed the population to Brucellosis and posed a risk to public health. To reduce the risk of humans being exposed to Brucella spp., there is a need to raise awareness among the farmers, the sellers, the consumers and the government about Brucellosis and associated risk factors. Furthermore, studies are required to assess the risk with a larger population