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Informed by recent scholarship that underscores the centrality of death, corpses and funerals in contemporary African politics, this article explores the ways in which political actors in the ruling Movement for Multiparty Democracy (MMD) and the opposition Patriotic Front (PF) in Zambia appropriated the corpse and legacy of President Levy Mwanawasa to mobilise political support in 2008. The article insists that in order to secure support indispensable to winning the presidential by-election necessitated by his death, leaders in the MMD and PF deployed the president's corpse in their conflicting bids to retain power and to construct an alternative political order, respectively. In placing Mwanawasa's death, corpse and funeral and resultant rival discourses at the centre of its analysis, this article distances itself from secularist and modernist scholarship that disconnects death and mortuary ceremonies from contemporary African politics.

This paper quantifies the economic impact of regime changes and macroeconomic indicators on debt stress in Zambia using the Autoregressive Distributed Lag (ARDL) Bounds test. A 1% short run increase in gross domestic products (GDP) increases debt stress by 3.16% and in the subsequent year lowers it by 7.21%; in the long-run the 1% GDP increases lowers debt stress by 22%. In the long-run, a 1% rise in inflation and the lending rate negatively and positively impacted debt stress levels by -1.52% and 3.90%, respectively. Short-run shocks culminated regime change had short-run adverse impact on debt stress by 3.45% in one year and in the subsequent year by -10.35%, with the variables adjusting to long-run equilibrium at a speed of 71.5%. This is the first paper to quantify the empirical effect of macroeconomic indicators and change in Presidents on debt stress, especially in Africa were the problem of the debt trap is perpetuated. The results from the study implies that to deescalate the impact of debt stress on the economy, the electorate should vote in governments that will not fall short on growth driven macroeconomic policies, making it possible for economic sustainability to prevail; and paper seeks to promote good governance and good economic policies as a premise for sustained macroeconomic stability and development.

Abstract Bakground Salmonella spp. is a major cause of bacterial gastroenteritis worldwide borne from consuming contaminated food or water. The growing incidence of difficult-to-treat Salmonella infections has been heightened by increased AMR due to increased use of antibiotics posing acritical public health challenge. Methods This was a cross-sectional study involving 205 children with AGE at Levy Mwanawasa University Teaching Hospital in Lusaka Zambia, between September 2020 and February 2021. Stool samples were collected and subjected to standard microbiological testing, serotyping, antimicrobial susceptibility testing and molecular confirmation for Salmonella spp. In addition, a questionnaire was administered to participants’ guardians to determine the level of knowledge and practices towards Salmonella infections. Data analysis was performed using Microsoft Excel, GraphPad Prism and WHONET. Results Twenty Salmonella isolates were recovered from the processed stool samples (n = 205), giving a 9.76% prevalence. Out of 20 Salmonella isolates identified, only four were susceptible to all tested antibiotics. Seven isolates (35%) were classified as multidrug resistant. The highest resistance was observed to trimethoprim-sulfamethoxazole (42.9%). Identified risk factors included use of untreated drinking water and suboptimal feeding practices. Conclusions The presence of multidrug-resistant Salmonella among paediatric patients highlights the need for strengthened AMR surveillance, antimicrobial stewardship and targeted public health interventions.

This study measured socioeconomic-related unsafe abortion inequalities among women presenting for abortion care services in Lusaka and the Copperbelt provinces of Zambia and decompose its causes. We conducted a cross-sectional study between August and September 2021. Unsafe abortion inequalities were assessed using corrected concentration index and Erreygers-type decomposition analysis was conducted to assess causes of unsafe abortion inequalities. Out of 362 women, the magnitude of unsafe abortion was 77(21.3%, [95% CI: 17.8, 24.9]). The corrected concentration index was − 0.231 (95% CI: -0.309, -0.154), implying pro-poor inequality in unsafe abortion among women. Decomposition analysis showed that the major contributors of the unsafe abortion inequality were socioeconomic status (66.6%), marital status (6.3%), education (10.2%) and employment (3.7%). Additionally, history of unwanted pregnancy (5.1%), awareness of whether abortion is legal in Zambia (8.9%) and knowledge that hospitals offered free abortion services (11.3%). The findings suggest that the unsafe abortion is a problem in Zambia and substantial inequality mainly due to socioeconomic factors. Stakeholders and policymakers should consider socioeconomic strategies to reduce unsafe abortion inequality promoting advocacy to increased access to legal safe abortion and use of modern contraceptives so that no woman is left behind in the prevention of unsafe abortion.

Approximately 100 surgeons in Zambia serve a population of 16 million, a severe shortage in basic surgical care. Surgical education in Zambia and other low-middle income countries has not been well characterized. The aim of this study was to evaluate surgical training resources from a resident perspective. 6 of 8 COSECSA-accredited major medical centers were included. We developed a Surgical Education Capacity Tool to evaluate hospital characteristics including infrastructure, education, and research. The questionnaire was completed by administrators and trainees. 18 of 45 trainees were surveyed. Caseloads and faculty-to-trainee ratio varied by location. No sites had surgical skills, simulation, or research labs. Most had medical libraries, lecture halls, and internet. Outpatient clinics, bedside teaching, M&M conferences, and senior supervision were widely available. Despite some exposure, research mentorship, basic science, and grant application guidance were critically limited. Lack of access to proper infrastructure, research, and personnel all impact surgical training and education. The Surgical Education Capacity Tool offers insights into areas of potential improvement, and is applicable to other LMICs. •Number of trainees and caseloads varied widely by site.•Resource-intensive tools such as simulation or research labs were unavailable.•Clinical training was robust, with dedicated teachers and high patient volume.•Despite some research exposure, mentorship and funding were severely limited.

Background The specialization of medical students is essential for enhancing healthcare quality, and meeting the diverse needs of patients, with medical training programs significantly influencing their career trajectories and expertise development. This study aimed to investigate the future specialty preferences of medical students from various medical schools in Zambia. Materials and Methods The study included participants from seven medical schools who had completed at least their first clinical clerkship. Data collection involved distributing structured questionnaires containing Likert scale items and open‐ended questions via an online Google Sheets platform. Data collected included: demographics, name of medical school, year of study, specialty preferences, factors influencing specialty preferences, awareness about medical specialties, and career pathways. Results A study involving 127 medical students in clinical clerkships revealed a gender ratio of 1.1:1 male to female, with 73% aged between 20 and 25 years. Specialty preferences varied, with internal medicine (12%) and cardiovascular surgery (10%) being popular choices, and 62% changing their preferences during clerkships. Key factors influencing specialty choice were personal interest (74%), work‐life balance (41%), and career prospects (30%). Only 21% were very familiar with medical specialties, and 83% rated mentorship availability poorly and suggested organizing workshops to enhance awareness. Future plans included further specialization (54%), international humanitarian work (54%), and medical academics (27%). Conclusion Despite recognizing the importance of mentorship, students rated the availability of mentorship and informational resources as inadequate. The findings emphasize the need for enhanced mentorship programs, comprehensive career guidance, and targeted informational workshops to support informed specialty choices, contributing to a better‐prepared and more satisfied medical workforce.

Access to health insurance is vital for achieving Universal Health Coverage, yet barriers such as high costs, inadequate coverage, and systemic inefficiencies often impede access to necessary health care. This study evaluated access to the National Health Insurance Scheme-provided services among enrollees at the outpatient department (OPD) of Levy Mwanawasa University Teaching Hospital (LMUTH) in Lusaka, Zambia, chosen for its role as a pioneering NHIS-accredited facility and its significance as a major publicly funded referral hospital. Data were collected in May 2024 from 270 systematically sampled NHIS enrollees at the OPD of LMUTH using an interviewer-administered questionnaire. Descriptive analysis revealed a balanced gender distribution, with most respondents aged 35 and above, married, holding tertiary education, and earning a monthly Zambian Kwacha (ZMW) of 20,000 or less. The thematic analysis using NVivo uncovered positive and negative experiences with NHIS services, highlighting issues such as medical service availability, drug shortages, service delays, technological problems, communication challenges, equity in service delivery, and coverage gaps. The key policy implications for improving access to NHIS services include enhancing supply chains, digital infrastructure, coverage to rural areas, staff training, public awareness of the NHIS, and information technology systems.

Introduction. Globally, there is a growing concern over antimicrobial resistance (AMR) which is currently estimated to account for more than 700,000 deaths per year worldwide. AMR undermines the management of infectious diseases in general especially in pregnancy where significant bacteriuria continues to be a serious cause of maternal and perinatal morbidity and mortality. We therefore aimed to determine the prevalence of AMR and the associated factors among pregnant women with urinary tract infections (UTIs) attending antenatal clinic at a selected hospital in Lusaka, Zambia. Methods. This was a hospital-based, cross-sectional study conducted between November 2018 and May 2019. Interviewer-administered questionnaire was used to assess the sociodemographic characteristics and behavioural characteristics. Laboratory tests were also conducted. Descriptive statistics of study participants were used to describe the characteristics of the respondents. Chi-square was used to assess the association between categorical variables. The logistic regression analysis was carried out to generate the adjusted odds ratio with 95% confidence interval. Results. Overall (n = 203), the prevalence of UTI was 60% (95% CI: 53.3%–66.7%). The most isolated bacteria were E. coli (59%) and Klebsiella (21%). The prevalence of AMR was found to be 53% (95% CI: 46.1%–59.8%). The drugs highly resistant to antimicrobials were nalidixic acid (88.3%), ampicillin (77.8%), and norfloxacin (58.5%), while the least resistant drug was chloramphenicol (20%). There were no important significant predictors to AMR among pregnant women observed in this study. Conclusion. We found high burden of AMR closely linked to observe high prevalence of UTI suggested in this small population. This suggests a need to develop integrated surveillance systems that aim for early and regular screening of pregnant women for UTI as well as concurrent determination of antibiotic susceptibility patterns. This is important to prevent complications that may endanger maternal and fetal health outcomes. Furthermore, further research is needed to explore reasons for this high prevalence of AMR including examining possible attribution to the misuse of drugs so as to inform, enforce, or adjust the prescription-only policies and enforce antimicrobial stewardship programs.

The death of President Levy Mwanawasa in August 2008 plunged Zambian politics into a state of flux. This article argues that the way the main parties responded to the challenge of the resulting presidential by-election has three lessons to teach the emerging literature on political parties. First, Rupiah Banda's rise to power within the MMD demonstrates the extent to which intra-party machinations can leave a party saddled with an unpopular leader, and hence illustrates the great significance of succession struggles within dominant-party systems. Second, the main parties' continual repositioning of their electoral platforms reveals that not all African elections take place in an ideological vacuum, and shows that the platforms parties adopt can only be fully understood in the context of the wider party system and the way in which parties interact over time. Finally, the ability of controversial opposition leader Michael Sata to mobilize a diverse support base - by employing a 'populist' message in urban areas at the same time as receiving the support of his ethno-regional community in rural areas - lays bare the complexity of party strategies and the limits of the 'ethnic census' model of party support. Taken together, these findings suggest that the tendency to divorce the study of elections from the study of how parties function and interact impoverishes our understanding of African politics.