Accurate and reliable data are essential for tracking progress and evaluating the effectiveness of road safety intervention measures. However, in many low- and medium-income countries, good quality data on road traffic crashes are often difficult to obtain. This situation has led to an underestimation of the severity of the problem and distortions in trends when the reporting changes over time. This study estimates the completeness of road traffic crash fatality data in Zambia. Data from the police, hospitals, and the civil registration and vital statistics (CRVS) databases was collected for the period 1st January to 31st December 2020 and analyzed using a three-source capture-recapture technique. A total of 666 unique records on mortalities as a result of road traffic crashes were collected from the three data sources during the period under review. The capture-recapture technique estimated the completeness of police, hospital, and CRVS databases to be 19%, 11% and 14% respectively. The combination of the three data sets was found to increase completeness to 37%. Based on this completion rate, we estimate that the actual number of people who died as a result of road traffic crashes in Lusaka Province in the year 2020 was approximately 1,786 (95% CI [1,448–2,274]). This corresponds to an estimated mortality rate of around 53 deaths per 100,000 population. There is no single database contains complete data to provide a comprehensive picture of Lusaka province and by extension the country’s road traffic injury burden. This study has shown how capture and recapture method can address this problem. It shows the need for the continuous review of the data collection processes and procedures in order to identify gaps and bottlenecks, improve efficiency, and increase the quality and completeness of road traffic data on injuries and fatalities. Based on the findings of this study, it is recommended that the city of Lusaka province and Zambia as a whole utilize more than one database for official reporting of road traffic fatalities to increase completeness.

Cholera has remained a persistent public health challenge in Zambia since the country’s first reported outbreak in 1977. The recent outbreak, which began in October 2023 and is ongoing as of June 2024, is the most severe in Zambia’s history and part of the larger 2022–2024 Southern Africa cholera outbreak, which has affected multiple countries in the region. This article describes the implementation of the integrated community strategy for cholera control (ICSCC) in three districts of the Copperbelt Province during this outbreak. The ICSCC is a comprehensive, community-centric public health approach that integrates surveillance, case management, water, sanitation and hygiene interventions, community engagement and infection prevention measures. The strategy’s implementation involved deploying multidisciplinary technical teams, training community-based volunteers and healthcare workers in the affected communities. This approach led to a rapid reduction in cholera cases and mortality, largely due to enhanced surveillance, community education sessions and improved sanitation practices. The ICSCC also improved stakeholder coordination and enabled rapid communication for early response to cholera hotspots. Key lessons learnt include the importance of robust coordination, early community involvement and context-specific adaptations. The strategy’s emphasis on data-driven decision-making and adaptation to local socio-cultural dynamics was crucial for its effectiveness. These findings underscore the potential of integrated community-based approaches in managing cholera outbreaks, enhancing public health preparedness and building long-term resilience. The ICSCC strategy offers a scalable model for regions facing similar public health challenges, providing valuable insights for policymakers and practitioners on the effectiveness of community involvement in managing public health crises.

Background: As urban populations rapidly expand across sub-Saharan Africa, promoting sustainable and efficient transportation systems is imperative for fostering economic growth and social inclusion by enhancing mobility and accessibility. Objectives: This study examines the travel mode choices and factors influencing the use of these modes among residents of Lusaka, Zambia, for their work or school trips. Method: A household survey ascertained mode choice, trip characteristics, and transportation challenges experienced. Descriptive, contingency table, and post hoc analyses explored relationships between mode and associated factors. Results: Public buses emerged as the predominant mode for work/school trips, followed by walking and private cars, highlighting public transit’s and non-motorised transport’s importance. However, travel behaviour varied significantly by residential density. High-density areas favoured public transit and walking, while low-density areas promoted greater private vehicle use, highlighting the influence of urban form on mode choice. Key mode choice factors included travel time, fares and safety, though environmental concerns had lesser impact. Crucially, socio-economic and demographic characteristics like age, gender, income, education, employment, car ownership, trip purpose, household composition, presence of children, and destination accessibility significantly influenced mode choices, revealing the complex interplay shaping mobility patterns. Conclusion: Findings underscore the need for policy interventions investing in public transportation infrastructure, enhancing pedestrian and cycling facilities, and prioritising walkability in urban planning to encourage sustainable transportation behaviours. Contribution: This study contributes to the discourse on urban sustainability by highlighting the importance of integrating social, economic, and environmental considerations into transportation planning and policymaking processes.

Zambia’s 2024 Measles-Rubella Supplementary Immunization Activity (SIA), conducted from 23 to 28 September across all 116 districts, targeted children aged 9–59 months to address immunization gaps exacerbated by COVID-19 disruptions and responding to ongoing measles outbreaks. This community case study evaluates the effectiveness of microplanning, the feasibility of real-time digital monitoring, and the equity of reaching zero-dose children during Zambia’s 2024 Measles-Rubella SIA, using a mixed-method approach to inform scalable immunization strategies in resource-limited settings. Through comprehensive microplanning, strategic community engagement, and real-time digital monitoring, the campaign achieved 97% national coverage and reached 165,000 previously zero-dose children in underserved communities. Implementation utilized Google Sheets and Open Data Kit tools, with quality assurance through over 7,500 supervisory visits. Despite achieving high overall coverage, several challenges emerged: funding delays, logistical constraints in remote areas, and data quality issues. Key lessons include the necessity of timely funding disbursement, strengthened cold chain infrastructure, and rigorous data verification processes. Community involvement through local leadership engagement and radio campaigns proved essential to success, while digital monitoring enabled rapid adaptation to emerging challenges. This case study provides actionable insights for designing equitable immunization campaigns in resource-limited settings, supporting global measles and rubella elimination goals through evidence of effectively tailored, data-driven strategies.

Measles & Rubella (MR) zero-dose children (unvaccinated for measles–rubella) cluster in underserved communities can sustain measles transmission. We estimated MR zero-dose prevalence after Zambia’s 2024 MR Supplementary Immunisation Activity (SIA) and identified associated risk factors and barriers. A coverage survey (two-stage stratified cluster design) across all 10 provinces, was conducted from 27 ^th December 2024–16 ^th January 2025, involved interviewing caregivers of children aged 9–59 months; vaccination status was verified by card (11.7%) or recall (88.3%). Data were analysed using survey-weighted methods and logistic regression, adjusting for stratification, clustering, and sampling weights. Among 8,634 children, MR zero-dose prevalence was 11.97% (95% CI: 11.03–12.91), highest in Central (19.15%) and Western (17.71%), lowest in Copperbelt (6.69%). Urban residence reduced odds by 24% vs. rural (aOR 0.76, 95% CI: 0.63–0.92). Risks rose with age (>36 months: aOR 1.60, 95% CI: 1.27–2.00), maternal absence (aOR 1.74, 95% CI: 1.33–2.27), or death (aOR 2.40, 95% CI: 1.23–4.68). Most zero-dose children (88.75%) lacked other vaccines, indicating systemic gaps. Key barriers included unawareness (42.58%) and travel time (>2 hours: aOR 3.20, 95% CI: 1.43–7.16). Nearly one in eight Zambian children remained MR zero-dose post-2024 SIA, concentrated in rural, high-prevalence areas, older children, and motherless households. Priorities include health worker-led awareness campaigns, mobile services to cut travel time, and integrated SIA-Routine Immunisation (RI) strategies (microplanning, tracing, catch-up) to address systemic gaps, supporting global measles elimination under Immunisation Agenda 2030.