From data to action: How findings from an interagency rapid qualitative assessment are stimulating action to support drought-affected communities in Zambia

Introduction

The Republic of Zambia is one of several countries in the Eastern and Southern Africa (ESAR) region that has been grappling with multiple concurrent emergencies that have affected the health and safety of the population. In February 2024, a national state of emergency was declared in Zambia due to a severe and prolonged drought affecting over half of the country. These emergencies have adversely affected women and children who are especially vulnerable to diseases, malnutrition and violence.

UNICEF Zambia is stepping up efforts to strengthen evidence-informed emergency preparedness and response in collaboration with government ministries and partners, and through the technical support of the Collective Service. The Collective Service – an interagency partnership between UNICEF, the World Health Organization and the International Federation of Red Cross and Red Crescent Societies – has been providing technical surge support on cholera and drought emergencies for countries in the ESAR region. In Zambia, support has been coordinated through UNICEF Zambia engaging national partners from the Ministry of Health, Zambia National Public Health Institute, Disaster Management and Mitigation Unit (DMMU), the University of Zambia School of Public Health, Public Private Dialogue Forum and the Zambia Red Cross Society. The support has leveraged collaborations with global partners, including UK Public Health Rapid Support Team, SSHAP and the US Centers for Disease Control and Prevention to conduct people-centred, rapid qualitative assessments (RQAs) to inform community engagement strategies and hold response actors accountable to affected populations.

Since November 2023, partners have supported the coordination of the Zambia Risk Communication and Community Engagement (RCCE) pillar through strengthened community feedback mechanisms, operational social science training and support, and shared data intelligence and analysis. Four RQAs, conducted in 2023 and 2024, focused on cholera; and two RQAs, conducted in 2024, focused on the impact of the drought across nutrition; water, sanitation and hygiene (WASH); and health and social protection. This brief summarises and shares information from the RQA, conducted from 28 May to 2 June 2024, of drought-related community perceptions and behaviours in Zambia.¹

Key considerations

• Rapid qualitative assessments (RQAs) have generated important evidence to support emergency responders in Zambia. This evidence has revealed emerging issues of particularly vulnerable populations (e.g., children, adolescent girls, pregnant and lactating women, fishers, farmers, truck drivers) due to prolonged drought conditions.
• Rapid qualitative assessments have provided real-time insights on drought related community perceptions, behaviours, and coping mechanisms. Daily debrief meetings and rapid preliminary analysis of field notes yield immediate operational insights for sharing with responders. Rapidly generated and analysed within a few days, RQAs play a pivotal role in tailoring context specific risk communication messages and interventions.
• Key findings from the RQAs highlighted:
  • A perceived increase in food insecurity which has driven communities to consume unconventional and potentially harmful foods.
  • A perceived increase in water shortages due to dried wells which has forced communities to rely on unsafe and untreated water sources.
  • A perceived increase in community adoption of negative coping mechanisms, including migration to seek economic opportunities (by men and adolescent boys in particular – and which can expose adolescent boys especially to exploitation), child marriage (e.g., in exchange for livestock), transactional sex among women and adolescent girls in particular (e.g., sex in exchange for food) and child labour (e.g., fishing activities and domestic work to generate income).
  • A perceived reduction in school attendance due to lack of concentration among students (who attend school all day on an empty stomach) as well as an increase in school dropouts, particularly in secondary schools where school feeding programmes were not implemented.
  • A reduction in health-seeking behaviour and treatment options, including mothers expressing reluctance to seek medical attention for underweight children due to shame and stigma, pregnant women forced to deliver at home due to lack of adequate food and financial resources to stay in health facilities during labour, individuals with chronic conditions (e.g., HIV/AIDS) discontinuing treatment and check-ups to avoid taking medication on an empty stomach, and disruption of critical community-based volunteer structures as members shift to focus on (survival) livelihood activities.
  • A perceived increase in mental health issues resulting from frustration and stress among parents due to their inability to provide for their families – with mental health awareness and services often severely restrained in drought-affected districts.
  • An increase in substance abuse among men and adolescent boys – an issue that is a driving factor for domestic violence and conflict.
• Promoting the uptake of findings and stimulating action requires constant advocacy. UNICEF Zambia designed multiple deliberate interventions to engage key policymakers and actors internally and from the Ministry of Health, Zambia National Public Health Institute, DMMU, Public Private Dialogue Forum and Zambia Red Cross Society throughout the RQA process to promote buy-in and uptake of the findings.

Context

Zambia is one of several countries in the Eastern and Southern African Region currently facing the negative effects of the climate crisis and has experienced disease outbreaks. On 29 February 2024, President Hakainde Hichilema declared a national state of emergency in recognition of the severe and prolonged drought affecting over 50% of the country – most of the Central, Eastern, Copperbelt, North-Western, Southern and Western Provinces. The drought has been compounded by the El Niño effect,² driving overall vulnerability and increasing the severity of food insecurity.

The health and safety of the population in Zambia has been affected by multiple determinants as a result of the drought and related crises. For example, the preliminary report of the 2024 ‘In-depth vulnerability and needs assessment’ for Zambia projected that between April and September 2024, 4.9 million people would need humanitarian assistance due to the acute food insecurity crisis caused by climate change.³ A further 5.9 million people were projected to be at risk of food insecurity from October 2024 to March 2025.³

Following the declaration of the national state of emergency, the DMMU activated clusters for the major drought responses, including the RCCE cluster. The RCCE cluster’s activities are under the overall coordination of the DMMU and co-chaired by the Public Private Dialogue Forum and UN Development Programme.

Measures were taken to ensure an evidence-driven RCCE response. UNICEF Zambia was tasked to lead on drought RQAs in 2024, working with multisectoral ministries and partners. This followed the successful integration of community data from RQAs conducted during the 2023 to 2024 cholera response. RQAs were determined as the best method to generate insights on community context, perceptions, behavioural dynamics and coping mechanisms related to the drought, and to inform the design and adaptation of targeted response interventions and community engagement actions.

Methodology

About RQAs: An RQA is an essential tool for understanding community perceptions and behavioural dynamics related to emergencies. RQA data collection is primarily conducted through observational activities, key informant interviews and focus group discussions to gain deeper understanding of context-driven behaviours and coping mechanisms among affected communities. RQAs are typically conducted over the course of a few days and with a small team, and they seek to answer operational research questions useful for informing emergency response operations.⁵

RQA focus for the drought response: For the RQAs that focused on the drought in Zambia, technical experts from drought-related sectors were requested to identify priority areas of enquiry around community coping mechanisms and the impacts of the drought. UNICEF Zambia, with support from the Collective Service, collaborated with the experts and the RQA data team to identify vulnerable populations and develop interview guides. The interview questions were adapted from a published SSHAP El Niño brief that focused on considerations for community engagement in the Eastern and Southern African Region context.² The local RQA team provided training on the new tools for the drought response and deployed to high-priority locations, as identified by DMMU, in Western and Southern Provinces.

The RQA was conducted from 28 May to 2 June 2024. The objective was to better understand the issues impacting drought-affected communities in four districts (Gwembe, Kazungula, Sikongo and Shang’ombo) across two provinces (Western and Southern) of Zambia. The focus of the RQA was on livelihoods, WASH, nutrition, health, education, child protection and social protection.

Participants across assessment sites included:

• People in community groups: pregnant and lactating women, adolescent girls and boys (in school and out of school), fishers, cattle farmers, agriculture farmers and truck drivers.
• Community leaders and committees: traditional leaders and village headmen and women, village WASH committees, Neighbourhood Health Committees and Community Welfare Assistant Committees).
• Local administration and service providers: District Commissioners, headteachers, health facility staff and community-based volunteers, local nongovernmental organisation staff and District Education Board members.

Data collection: The local RQA team collected data over six days. The team of 28 people was divided into four different groups to cover four sites across the two provinces (see image below). In total, 32 focus group discussions and 30 key informant interviews were conducted with 224 participants (see Table 1).

Table 1. Location, type and number of data collection activities

Source: Author’s own. Created using project data.

Tikulirekuti Banda conducts a focus group discussion with community leaders, Gwembe, Zambia, May 2024.
Credit: Lackson Nabulwe, UNICEF

Observational activities and photos of drought conditions complemented data collected from discussion and interview activities (see image below).

To rapidly analyse data collected by the field teams, SSHAP and the US Centers for Disease Control and Prevention supported remote data synthesis by utilising field notes and online discussions from daily team debrief meetings. This enabled an iterative process where recommendations for additional areas of enquiry were developed and added to the data collection plans for each district daily.

Insights and reporting: Key insights were shared among Cluster Coordination and cooperating partner platforms within a week after the assessment had concluded. UNICEF Zambia then developed the full narrative report, and DMMU cleared the report for publication.¹

Cattle drinking from a dried-up riverbed, Gwembe, Zambia, May 2024.
Credit: Shimeo Sakanya, UNZA
Note: Cattle owners must frequently resort to digging in the ground to find an available water source.

Findings

The drought in Zambia has caused a significant reduction in crop yields, which has led to increased food prices and heightened food insecurity. The scarcity of food has driven communities to consume unconventional and potentially harmful foods. Also, many families have adopted negative coping mechanisms, such as migration, child labour and transactional sex (among adolescents). The drying up of wells and boreholes has forced communities to rely on unsafe and untreated water sources, significantly increasing health risks.

Children and young people have been affected by the drought. A reduction in school attendance, lack of concentration among students (who attend school all day on an empty stomach) and an increase in students dropping out of school were highlighted, particularly in secondary schools where school feeding programmes were not implemented. Adolescent girls have also been absent from school due to water scarcity during menstruation. Children have been forced to stay home to take care of their younger siblings while their mothers look for food or to engage in child labour (e.g., fishing activities or domestic work) to generate income. Adolescent girls have been increasingly exposed to sexual exploitation and violence as they engage in transactional sex to sustain their families and feed themselves (e.g., sex in exchange for food). Some parents have opted to marry off their children in exchange for money or livestock. Adolescent boys have migrated to nearby towns and countries in search of jobs, leaving them susceptible to various forms of violence and exploitation.

Health-seeking behaviour has been adversely affected. Community members expressed reluctance to seek medical attention for underweight children due to shame and stigma; this has also affected the attendance of services like immunisation. Pregnant women have been increasingly forced to deliver at home due to lack of adequate food and resources to stay in health facilities during labour (e.g., inability to afford food as this is not provided at most health facilities), posing significant risks to maternal and child health. Individuals with chronic conditions, such as those living with HIV/AIDS, have been discontinuing their treatment and check-ups to avoid taking medication on an empty stomach.

Parents have been experiencing frustration and stress due to their inability to provide for their families. This has been causing mental health issues in the drought-affected districts where awareness and services are often severely restrained.

Increasing substance abuse among men and adolescent boys is driving domestic violence and conflict. Furthermore, the extreme economic hardship has led to a rise in criminal activities (e.g., livestock theft) and conflict, eroding trust and solidarity which are critical for building community resilience in times of crisis.¹

Critical community-based volunteer structures have been disrupted as most members are shifting to focus on (survival) livelihood activities.

Further research: Based on these findings, a second RQA was conducted on 17 July 2024 and specifically targeted key issues raised in the first RQA to gain deeper understanding of issues affecting communities impacted by the drought (e.g., child protection, mental health and sexual and reproductive health).⁴ Data for the second RQA was collected in four sites of Rufunsa District, Lusaka Province, in the Shikabeta, Chimusanya, Mpanshya and Lukwipa communities.

Translating findings into action

Translation of research evidence into policy and practice is fundamental to responding to emergencies. Yet policymakers and emergency actors in many countries face challenges in using evidence to inform emergency response. Some of the reasons include a lack of access to evidence sources, lack of time to review the findings and lack of skills to understand how to translate data to action.⁶

To mitigate the challenges of using research evidence in practice, UNICEF Zambia designed multiple deliberate interventions to engage key policymakers and actors internally and from the Ministry of Health, Zambia National Public Health Institute, DMMU, Public Private Dialogue Forum and Zambia Red Cross Society throughout the RQA process to promote buy-in and uptake of key findings. For instance, UNICEF Zambia engaged multisectoral actors from the start of the RQA process. Key actors from WASH, nutrition, child protection, social protection and health sectors participated in the development of data collection tools and in the data collection process. Preliminary findings were shared with and validated by multisectoral actors. A final round of validation was held at a meeting to present the evidence-based recommendations to various drought clusters. Sector-specific short-term and long-term recommendations were co-created during the meeting. Validated findings were then presented to the RCCE cluster, intercluster members and the Humanitarian Country Team. Within the RCCE cluster, further co-creation workshops were held to design multisectoral messages and tools for the public, frontline workers and call centre agents to promote protective behaviours.

As stated by National DMMU Coordinator, Dr Gabriel Pollen, in his opening remarks during a RQA validation workshop, ‘Our collective efforts to understand and address the impact of the drought across different communities are commendable. I believe that the insights gained from this assessment will be invaluable in shaping context-specific drought risk communication and community engagement activities.’⁷

The RQA findings and subsequent awareness-raising and data advocacy meetings to discuss the evidence underscores the urgent need for comprehensive and integrated interventions to across several areas (see Box 1). Evidence-based sectoral and cross-cutting recommendations are available in the final report.¹

Box 1. Areas for urgent comprehensive and integrated interventions

Source: Author’s own

References

1. Government of the Republic of Zambia (DMMU, PPDF, MOH, ZNPHI UNZA), & UNICEF. (2024). Rapid qualitative assessment of drought-related community perceptions and behaviors in Zambia. https://www.unicef.org/zambia/reports/rapid-qualitative-assessment-report
2. Rohan, H. (2023). Information preparedness and community engagement for El Niño in the Eastern and Southern Africa Region. Social Science in Humanitarian Action Platform (SSHAP). https://doi.org/www.doi.org/10.19088/SSHAP.2023.026
3. Government of the Republic of Zambia. (2024). In-depth vulnerability and needs assessment 2024: Preliminary report presentation [Unpublished document].
4. Johnson, G. A. (2024, August 28). Rapid Qualitative Assessments: Harnessing the explanatory power of social science for people-centred emergency response. Social Science in Humanitarian Action Platform (SSHAP). https://www.socialscienceinaction.org/blogs-and-news/rapid-qualitative-assessments-rqas-harnessing-the-explanatory-power-of-social-science-for-people-centred-emergency-response/
5. Johnson, G.A. & Vindrola-Padros, C. (2017). Rapid qualitative methods during complex health emergencies: A systematic review of the literature. Social Science & Medicine, 189: 63-75. https://doi.org/10.1016/j.socscimed.2017.07.029Get rights and content
6. Malama, A., Zulu, J. M., Nzala, S., Kombe, M. M., & Silumbwe, A. (2021). Health research knowledge translation into policy in Zambia: Policy-maker and researcher perspectives. Health Research Policy and Systems, 19(1), 42. https://doi.org/10.1186/s12961-020-00650-5
7. UNICEF Zambia. (2024, June 18). Today, UNICEF Zambia supported a crucial workshop to address the ongoing drought crisis ☀💧. The Drought Rapid Qualitative Assessment Validation Workshop [Update]. Facebook. https://www.facebook.com/login/?next=https%3A%2F%2Fwww.facebook.com%2Fstory.php%3Fstory_fbid%3D861691982659195%26id%3D100064552035358%26mibextid%3DoEMz7o%26rdid%3D0r5p2Wkq2lft707X&rdid=0r5p2Wkq2lft707X

Authors: Tikulirekuti Banda (UNICEF, [email protected]), Hanna Woldemeskel (UNICEF, [email protected]), Rachel James (Collective Service, [email protected]) and Ginger A. Johnson (SSHAP, [email protected])

Acknowledgements: With great thanks to the following organisations and persons for technical assistance and support provided: Purity Simasiku and Brian Mulubwa (Ministry of Health Zambia),  Kabukabu Akufuna (Zambia National Public Health Institute), Oliver Mweemba and Mulanda Mulawa (University of Zambia), Mwiza Munthali and Chabotta Siamubotu (DMMU), and Jacqueline Chishimba (Public Private Dialogue Forum). Editorial support provided by Harriet MacLehose. This brief is the responsibility of SSHAP.

Suggested citation: Banda, T., Woldemeskel, H., James, R. and Johnson, G.A. (2024). From data to action: How findings from an interagency rapid qualitative assessment are stimulating action to support drought-affected communities in Zambia. Social Science in Humanitarian Action (SSHAP). www.doi.org/10.19088/SSHAP.2024.043

Published by the Institute of Development Studies: October 2024.

Copyright: © Institute of Development Studies 2024. This is an Open Access paper distributed under the terms of the Creative Commons Attribution 4.0 International licence (CC BY 4.0). Except where otherwise stated, this permits unrestricted use, distribution, and reproduction in any medium, provided the original authors and source are credited and any modifications or adaptations are indicated.

Contact: If you have a direct request concerning the brief, tools, additional technical expertise or remote analysis, or should you like to be considered for the network of advisers, please contact the Social Science in Humanitarian Action Platform by emailing Annie Lowden ([email protected]) or Juliet Bedford ([email protected]).

About SSHAP: The Social Science in Humanitarian Action (SSHAP) is a partnership between the Institute of Development Studies, Anthrologica , CRCF Senegal, Gulu University, Le Groupe d’Etudes sur les Conflits et la Sécurité Humaine (GEC-SH), the London School of Hygiene and Tropical Medicine, the Sierra Leone Urban Research Centre, University of Ibadan, and the University of Juba. This work was supported by the UK Foreign, Commonwealth & Development Office (FCDO) and Wellcome 225449/Z/22/Z. The views expressed are those of the authors and do not necessarily reflect those of the funders, or the views or policies of the project partners.

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