CIDRZ shares research results at first 2018 MoH Scientific Research Meeting

Research in any country is vital especially in finding lasting solutions to health needs and more so is it more effective if its done in close partnership with the government and the communities as addressing health challenges becomes much easier and faster.

Through continued generous support from funders such as the United States (U.S) National Institutes of Health (NIH), Division of AIDS (DAIDS), Centers for Disease Control and Prevention (CDC), and other partners that include Bill & Melinda Gates Foundation, Aeras, TB REACH, Global Alliance for TB Drug Development; CIDRZ has been conducting locally relevant research aimed at improving the quality of health care in Zambia.

By working in close collaboration the Zambian Ministry of Health, CIDRZ aims to be a permanent resource to the government by answering locally relevant health questions using latest methodologies to generate high quality evidence to inform policy.

It in this regard that CIDRZ participates in the National Health Research Authority (NHRA) organized scientific research meetings, a national platform for dissemination of research information and research results.

The first 2018 scientific meeting was held at the UTH Paediatric Center of Excellence where CIDRZ shared research results from three projects namely:

  • A Rapid Qualitative Assessment Before, During and After the 2nd-dose OCV Campaign in Bauleni, Chawama and Kanyama compounds in Lusaka;
  • Costing and Cost Effectiveness Analysis of the Oral Cholera Vaccine (OCV) Campaign in Lusaka, Zambia in 2016, and
  • Recounting the numbers: Policy proposal to Reinforce Routine HIV Testing and Treatment among children in Zambia

 “There is need for all stakeholders involved in research to support research work if we are to improve the quality of health care in Zambia. We as CIDRZ look forward to listening to research work being done by other researchers as this meeting provides a platform to learn from each other,” CIDRZ CEO Dr Izukanji Sikazwe said.

Dr Sikazwe further added “The presentations CIDRZ is making today on cholera is driven by past outbreaks and through support from donors, we are looking at possibilities of how future outbreaks could be averted. One particular such study CIDRZ is carrying out is a cholera vaccine trial in the Lukanga Swamps. Another presentation will look at HIV in children and how to improve HIV interventions among children”.

Dr Anjali Sharma presented research findings on A rapid qualitative assessment before, during and after
the second-dose OCV campaign in Bauleni, Chawama and Kanyama compounds in Lusaka, a project that was aimed at  understanding community and healthcare worker perspectives and experience regarding both the reactive and preemptive OCV campaigns.

Taniya Tembo, presented on Costing Cholera Illness, Vaccine Delivery and Vaccination Campaigns in Zambia while Dr Mwanza Wa Mwanza presented on Routine HIV Testing and Treatment for Children and how the intervention can increase testing update for children.

 

CIDRZ screens 741, Initiates 15 on TB treatment during TB week in George Compound

CIDRZ staff screening at during the community drive campaign

CIDRZ with support from the Stop TB Partnerships/TB REACH and working with the Ministry of Health through the Lusaka District Health screened patients for TB treatment during the TB week.

With current statistics indicating that Zambia ranks 7th among 30 highest tuberculosis (TB) burden countries in the world, a lot of effort needs to be channeled towards ending the spread of TB.

As the world commemorated World TB Day this year, under the theme; Wanted: Leaders for a TB-Free World. You can make history. End TB, CIDRZ celebrated this year’s event with a TB screening drive in Lusaka’s George compound where close to 300 people were screened for TB as well as tested for HIV on a daily basis.

Matero Sub District TB Coordinator, Mercy Mwale said “in 2017, of 1693 patients on TB treatment,1451 are male and 242 female and from our observations men are at high risk of TB due to poor diet and excessive alcohol intake”.

Matero Sub District TB Coordinator Mercy Mwale during the commemoration

“CIDRZ has supported us with a mobile X- Ray machine and an X-pert machine, resulting in quick turnaround time for results of all TB tests we conduct and detection of 10 MDR (Multi Drug Resistant) TB cases. This has elated the community going by the demand for TB screening services. Through TB drives such as this one, we are able to reach out to as many as 300 people in a day and this is all through CIDRZ support”.

Catherine Nalumbwe, a former TB patient shared her experience, “through the TB services offered by CIDRZ, I was quickly linked to care after being screened and found with TB. Throughout the six months I was on medication, I received support from the health care providers and today I stand before you to tell you that early TB detection saves lives. I wish to thank Stop TB Partnership and TB REACH because without their support, a lot of lives could have been lost to TB”.

Ag Lusaka District Health Director, Dr. Khozya Zyambo

And acting Lusaka District Health Director Kozya Zyambo says “all stakeholders need to come on board and participate towards ending TB. The community needs to be informed about the symptoms of TB and engage with health facilities to access treatment. Early detection and screening is the surest way to prevent TB.”

CIDRZ Director of TB Programmes, Dr Monde Muyoyeta emphasized the importance of community involvement in the fight against TB.

Dr. Monde Muyoyeta, CIDRZ Director of TB Programmes

“Without the collaboration of the Community Volunteers, this work would not have been possible. Working with them and equipping them with knowledge about TB has resulted in increased case detection. We need to continue sensitizing people and encouraging them to screen for TB. Lastly I wish to thank our funders Stop TB Partnership/ TB REACH for their continued support in this drive to end TB”

CIDRZ begins offering Pre Exposure Services to at risk populations

 

PrEP Champions during the training workshop conducted by CIDRZ

According to UNAIDS, since 2010, the annual global number of new HIV infections among adults (15 years and older) has remained static, at an estimated 1.9 million with key populations accounting for 45% of all new HIV infections in 2015.

In some countries and regions, infection rates among key populations are extremely high. HIV prevalence among sex workers varies between 50% and 70% in several countries in southern Africa.

In Zambia, National AIDS Strategic Framework (NASF) reports that there are 46, 000 new infections in 2016 with most new infections happening among this population. With these statistics, several strategies such as condom use and treatment as prevention have been promoted among key populations.

However, HIV prevention needs change during a person’s lifetime and that a combination of interventions targeted at key populations are needed to halt the HIV epidemic.

CIDRZ with support from the United States President’s Emergency Plan for AIDS Relief (PEPFAR) and U.S Centers for Disease Control and Prevention (CDC) has moved a step up in its effort to ensure everyone has equal access to quality health care especially HIV services by introducing Pre Exposure Prophylaxis (PrEP) services to HIV uninfected Key populations.

CIDRZ Olipa Tembo is one of the key drivers of this initiative

The programme that started in February 2018 under the Pharmacy unit intends to initiate 236 people on PrEP in 2018 in Lusaka and 1197 for Lusaka and Western Provinces in 2019.

Muhau Mubiana of CIDRZ explains, “Introduction of PrEP in Zambia is yet another step towards achieving the 90-9-90 strategy. PrEP is a program that brings a paradigm shift from focusing only on HIV positive clients but also on the HIV negative at substantial risk of HIV infection”.

“High numbers of new infections become a motivating factor for Health care providers like me to drive and support implementation of new innovations intended to reduce HIV infection in our country. In my own words, PrEP is not only for the socially acceptable community but the marginalized population. It is an Extended Service Delivery that touches the lives of marginalized communities. The program comes as a restoration of the right to health care to the vulnerable and marginalized population. Everyone has the right to be prevented from HIV infection provided they are considered to be at substantial risk”.

In order to reach out to these at risk populations, CIDRZ conducted a training targeting 55 health care providers and 28 PrEP beneficiaries. For health care providers, the training was to impart them with the necessary skills to offer friendly services to key populations.

For PrEP beneficiaries, the training was to equip them knowledge as advocates for good health behavior and act as linkages to facility care among their peers in their respective communities. The beneficiaries will be involved as PrEP Champions after having being  on  PrEP for the past one month.

Carol 33, a PrEP Champion shared her experience “When I first learnt Pre Exposure Prophylaxis(PREP), I had my fears that probably if I accepted to be initiated on the drug after testing negative for HIV, it would turn out as a way of actually infecting me with HIV.  However, after intensified counseling and learning of the benefits and how that I was actually protecting myself from contracting HIV, I decided to agree to be initiated on PREP.”

“It is a good initiative to involve us the direct beneficiaries, because sex work is a job that is stigmatized and that makes it hard to go to the health facility and access services. Therefore, using a sex worker to reach out to another sex worker will create demand and uptake of services such as HIV testing and PrEP. To many, this will seem like a way to promote careless behavior but I tell you that our work really puts us at risk and we too need to have access to quality health care just like anybody else who is not doing our kind of business”

CIDRZ Clinical Care Specialist – Prevention, Dr Natalie Vlahakis during the training sessions

And Lwazo Akunfuna, a Clinical Officer at Kabwata health facility had this to say “This is a good initiative as the demand for the service is already there and will greatly impact on the fight against HIV. Key populations have the highest HIV rates in the country but the most difficult to reach and to see that CIDRZ has even managed to get some to access HIV services and become champions is commendable. These are people that we live with in our communities and offering them these services contributes to the well being of the community and Zambia as a whole and subsequently reduce the prevalent rate of HIV”.

CIDRZ calls for assessment of the duration of protection of One-dose cholera vaccine

 [CAPE TOWN] A dose of oral vaccine provides effective short-term protection against the cholera during an outbreak, a study in Zambia shows.

According to researchers, because of a shortage of global stockpile of cholera vaccines, an outbreak in Lusaka, Zambia, in February 2016 necessitated a need for single-dose vaccination.

An emergency single-dose oral vaccination campaign was implemented in April 2016, around Lusaka, targeting more than 500,000 people in the city’s overcrowded township areas.

Francisco Luquero, a co-author of the study and an expert in preventable diseases at the France-based Epicentre, the research arm of the Médecins Sans Frontières (MSF) or Doctors without Borders, says that studies have already proved that one oral cholera vaccine dose works, but they were conducted in countries that had recently experienced cholera.

The 2016 outbreak happened when Zambia had not reported a case of cholera in four years.

“Our results show that people vaccinated can be protected against cholera a few days after receiving one dose.”

Francisco Luquero, Médecins Sans Frontières (MSF)

Between 25 April 2016 and 15 June 2016, researchers enrolled 66 patients with confirmed cholera and 330 people without the disease but who were neighbours of the patients, and determined the effectiveness of the single-dose cholera vaccine.

According to the study published last month (8 February) in the New England Journal of Medicine, the effectiveness of the single dose vaccination was about 90 per cent.

“Our results show that people vaccinated can be protected against cholera a few days after receiving one dose, which is important in outbreaks because we need to protect people quickly, Luquero says.

Oral cholera vaccines are emerging as a new tool for cholera control and have been used in past years to successfully prevent outbreaks in complex emergencies, to curb cholera epidemics or to reduce burden in countries which are endemic but there is a current global shortage, MSF says.

The Lusaka outbreak ended quickly after the implementation of the vaccination campaign, thus limiting the number of cases recruited, Luquero explains.

The Ministry of Health offered a second vaccine eight months later in December 2016.

The WHO estimates that globally cholera infects one to four million people a year, resulting in 21 000 to 143 000 deaths, with countries in Sub-Saharan Africa at increased risk.

“This is an important study because it suggests that the world could face the challenges of cholera outbreak with a single dose,” says Roma Chilengi, chief scientific officer, Centre for Infectious Disease Research in Zambia, adding a single-dose vaccine is cheaper and could help countries with limited financial ability to control the disease.

But Chilengi tells SciDev.Net, “It would be helpful to be clear about the potential duration of the protection the single dose offers.”

This piece was produced by SciDev.Net’s Sub-Saharan Africa English desk.

References

Eva Ferreras and others Single-dose cholera vaccine in response to an outbreak in Zambia(New England Journal of Medicine, 8 February 2018)

Original Article: https://www.scidev.net/sub-saharan-africa/medicine/news/one-dose-cholera-vaccine-protection.html

Better Drug Storage Conditions Equals Quality Medication for Patients

Aircon installed at Katoba RHC in Chongwe

Even though there were adequate drugs to supply the patients, facilities in Chongwe district faced challenges in ensuring appropriate storage conditions for drugs.

The Centre for Infectious Disease Research in Zambia (CIDRZ) is currently supporting 29 facilities in Chongwe District. All the facilities including the district pharmacy had no functional air conditioners in the pharmacy store rooms to maintain appropriate temperatures for storage of drugs at the time CIDRZ started supporting Chongwe District. The few facilities with room thermometers recorded temperatures of above 35˚C to 40˚C especially in the hotter seasons. This is above the recommended temperature range of 15˚C to 30˚C. This exposure of drugs to uncontrolled temperatures is a risk to reduced potency of drugs, hence lowering their efficacy. Some facilities opted to ordering and storing fewer drugs so as to reduce on the period of exposure to the unfavorable storage conditions.

“I just notice color change in some drugs and guess that heat has damaged the product,” said the nurse at Katoba Rural Health Center.

The solution to this challenge was not to reduce stored quantities, but to have an effective temperature control system – air conditioners accompanied by room thermometers and temperature charts for daily monitoring of room temperatures.

In November 2017, CIDRZ, through the Pharmaceutical Services Department began an air conditioner installation exercise in Chongwe District. The District was supported with 14 air conditioners paired with installation accessories. This activity was done in close collaboration with the Chongwe district medical office whose technician was the installer.  In February 2018, we also distributed room thermometers and temperature charts to 10 facilities in Chongwe district.

Facility staff are confident that the improved storage conditions will help maintain drug’s effectiveness during the shelf life. This came with mentorship on the use of the equipment, temperature monitoring and maintaining the pharmacy store room in order. They gave an assurance of taking care of the items given to them.

“Temperature will be maintained in appropriate range all year round! I will no longer feel guilty when dispensing drugs because they were kept within recommended temperature range as I am assured of safety and efficacy.” said pharmacy technologist Ngwerere Main Clinic.

“The community of Katoba will no longer complain of coming across discoloured brittle-tearing latex male condoms.” said a peer based at Katoba Rural Health Center.

“Facilities can now keep adequate quantity of stock without worrying on the products deteriorating during its storage period.” said the district pharmacist.

Based on the success of improving storage conditions, the district medical office also supported 2 facilities with air conditioners. The status for storage now stands at 58% of facilities installed with air conditioners, 73% have room thermometers all with temperature logs and 86% have the store room arranged in appropriate order.

CIDRZ has in its plan to continue improving storage conditions of drugs to ensure that quality drug product is dispensed to the patient for desired therapeutic outcomes. It is planned that by the end of 2020, 90% of CIDRZ supported facilities in Chongwe adhere to recommended storage guidelines. This is one of the organisations ways to improve access to quality healthcare in Zambia.

CIDRZ employees donate blood

Dr Mulenga, Medical Director

The importance of blood in one’s life could never be overemphasized. The billions of cells in our bodies need a steady supply of oxygen to function properly, a function critical to blood.

Zambia for example collects an average of 115,742 units of blood annually (based on 1% of national population) currently short the 150,000 units the country needs to service everyone in need of this life saving fluid.  With high and rapidly increasing demand for blood and blood products, the annual units of blood needed are estimated at 300,000 units.

To support the Zambia National Blood Transfusion Service (ZNBTS), CIDRZ in collaboration with ZNBTS conducted a blood drive for its employees to donate blood to the blood bank, with 21 employees donating blood.

CIDRZ CEO, Dr Izukanji Sikazwe commended ZNBTS; “we appreciate the efforts of ZNBTS in saving the lives of millions of Zambian in need of blood. CIDRZ has benefited from your services because barely two weeks ago, one of our staff members life was saved through blood transfusion and as an organisation, we thought it would be prudent to support ZNBTS’s efforts through the blood donation drive we are having today”.

And Dr Joseph Mulenga, Medical Director at ZNBTS highlighted some of the challenges being faced by the blood bank in meeting its annual targets.

“Countrywide Scale up of cancer treatment, cardiac surgery, renal treatment, increased hospital bed space through the upgrading of hospitals and newly built hospitals country wide, high prevalence of HIV and Hepatitis B Virus in the general population, lack of a cost recovery or re-imbursement scheme to fill the financing gap and reliance only on government for funding are some of the challenges faced by ZNBTS”.

Dr Mulenga said added to the challenges is lack of Nucleic Acid Amplification Testing (NAT) to complement serologic tests for testing of blood for Transfusion Transmissible Infections such as HIV, Hepatitis B Virus and Hepatitis C Virus  and capacity for Apheresis, Stem Cell collection and processing, Leucodepletion and Gamma Irradiation of products, HLA, Tissue Typing and Pathogen Inactivation procedures.

To mitigate these challenges ZNBTS has established Provincial Blood Transfusion Centre in all the 10 provinces to mobilize and recruit more voluntary non remunerated blood donors, conduct blood donor counseling, implement blood donor retention programmes & promote repeat blood donations.

Other measures include collecting 300,000 blood units (2% of estimated national population) per year, scale up blood component production, implement Apheresis procedures at 10 Centre’s, collect Platelets, FFP, plasma, 2-RBCs, source plasma, granulocytes, HLA typing, Irradiation, leucodepletion stem cell harvesting, implement ID-NAT testing procedures, promotion of rational use of blood & blood products and introduction of a partial cost recovery programme.

Evidence Uptake: Where to Begin

Attendees during the research meeting

Quite often Research uptake is misunderstood to mean research dissemination or research communication. Dissemination is the distribution of information usually one way while communication is  two way but often at the end of the process. Research uptake however is engaging at the outset and often more holistic and involves thinking about a wider group of stakeholder.

To help understand more about Research uptake, Sophie Durrans a Research Uptake Officer at the London School of Hygiene and Tropical Medicine made a presentation on “Evidence Uptake: where to begin,” at the CIDRZ weekly research meeting.

Sophie’s presentation was aimed at giving an overview on evidence uptake with specific focus on evidence application, policy making process and stakeholder analysis, reaching policymakers and policy briefs

Research uptake can be done by dedicated staff working at the intersection of research and policy, or by researchers themselves who often develop policy expertise.

In policy making, “the term evidence informed decision making/policy making is now preferred to suggest how policy decisions are not made in a vacuum but also that other factors are also important such as political climate, appetite for policy change/evidence use etc. Also the fact that sometimes research findings are considered and rejected in the formulation of a policy it’s still evidence-informed”

Sophie points out that applied evidence leads to new or amended policies, recommendations adopted by implementers, guidelines, resources, toolkits revised reflecting evidence, inclusion on technical working group agenda and other key meetings, changes in levels or focus of funding, changes made to programs or services as well as  scale up of interventions and programmes.

“In the policy making process the assumption is that policymakers  are receptive to research findings and field evidence but the reality is different. Instead of developing policies based on recommendations, policymakers may ignore them or reject them”.

Sophie the policy making process doesn’t happen by itself  but often involves many stakeholders who hold the greatest deal-breaking influence and  may not always be those who on paper look most relevant.

She recommends conducting a stakeholder analysis in evidence uptake is very important as the process brings together more ideas, enables buy-in at an early stage, saves time further down the line and helps to work effectively. Further recommendations are understanding of the power and interests of various stakeholders and knowing who keep informed, manage closely, monitor with minimum effort and keep engaged. Develop relationships with policymakers and know how to contact them and Learn about their background, interests and preferences.

“Understand the national level structures and roles relating to your area of work, eg special policy processes or timings (eg. joint sector reviews), relevant teams responsible. The entry points to achieving all this could be through routine meetings such as technical Working Groups, Cyclical events, One-off events, emails, phone calls, face to face and policy briefs”.

Call for Abstracts for 2016 Pharmacy Research Conference – Deadline 30 June 2016

CALL FOR ABSTRACTS
For the 
3rd Annual Pharmacy Research Conference 19th-20th July at the Taj Pamodzi Hotel, in Lusaka

THEME:  Reducing Disease Burden through Pharmaceutical Care and Research

The Ministry of Health in collaboration with CIDRZ and the WHO will host the 3rd Annual Pharmacy Research Conference in Lusaka. The conference will provide plenary sessions, panel discussions, oral and poster presentations, discussions on current pharmacy practice and an opportunity to share ideas for successful programmes and research studies that have worked in other healthcare systems.

Suitable Abstracts from Pharmacy Students (under and post-graduate), Pharmacy Technologists and Pharmacists are invited for oral and poster presentation relevant to the following topics:

  • Paediatric Care
  • Women’s Health
  • Operational Research
  • Pharmacovigilance
  • Clinical Pharmacy
  • Logistics and Supply Chain

Submission Deadline: 11:59 pm CAT June 30, 2016           

Guidelines:
*Note that presenting an abstract is voluntary. 

  • All abstracts should be in English.
  • Incomplete or inaccurate abstracts will be rejected
  • No more than 02 abstracts per attendee: one oral and one poster.
  • Capitalize the first word of the title only
  • Provide a concise statement (max. 500 words) of the Background, Research Aims/Objectives, Methodology, Results/Findings and Conclusions. The title and author’s names are not included in the word limit.
  • Use Arial, 10pt font, single-spaced and left aligned. DO NOT use all caps.
    Use standard abbreviations only. Within the body of the abstract, spell out the name in full at the first mention and follow with the abbreviation in parenthesis. Abbreviations may be used in the title, provided the name in full is outlined in the body of the abstract.

To Submit your Abstract:
Email your completed abstract and the required information below to both:

Mr Boyd Mwanashimbala        chipoboyd@yahoo.com          0977 877 070
Ms Helen Bwalya Mulenga      helen.mulenga@cidrz.org      0977 780 594

Please Include in your email:

  • Abstract Title
  • Topic – (max. 500 words) in the following format
    • Background
    • Research Aims/Objectives
    • Methodology
    • Results/Findings
    • Conclusions
  • Presenting Author, institutional affiliation, contact details, and email
  • Name and Organisation of Co-Authors in the order they should appear in the Abstract book
  • A brief biography (no more than 50 words) of the Presenting Author
    Indicate Oral or Poster preference

Abstract Evaluation Process and Criteria:
The Pharmacy Scientific Programme Committee will review abstracts beginning 1st July 2016. Abstracts not meeting the criteria below, as determined by the Pharmacy Scientific Programme Committee, will be rejected. The Committee will contact authors with formal acceptance or rejection notices as soon as possible. All notifications will be sent to the email address provided during the abstract submission process. The Committee will indicate the format of presentation: either oral or poster.

Abstracts will be evaluated based on the following criteria:

  • —Scientific merit
  • Direct relevance to the field of pharmacy
  • Submission of a clearly written, well organised abstract
  • Adherence to the submission guidelines outlined above

Dissemination of Abstracts:

Abstracts will be published in the 2016 Pharmacy Conference Book of Abstracts and disseminated to all conference attendees in electronic format.

Withdrawal of Submitted Abstract:

If you withdraw your Abstract submission, please email chipoboyd@yahoo.com AND helen.mulenga@cidrz.org

Thank you for your interest in presenting at the conference

Head of Grants & Contracts

Reports to the Deputy Chief Executive Officer and is responsible for the oversight and management of all grants and contracts within CIDRZ.

Summary:
Serves as the lead expert for the planning, implementation and evaluation of grant proposals and provides guidance on cooperative agreements, cost-share agreements, participating agreements, collection agreements, inter-agency and intra-agency agreements and Memoranda of Understanding.

Leads the development of organisational strategies through the identification of gaps and issues in grant proposals.

Main Duties:

  • Serves as a key liaison between CIDRZ and local and international partnering organisations
  • Responsible for ensuring professional relationships are maintained with all partners
  • Develops and implements new and revised grants management policies, directives, standards and procedures
  • Maintains current knowledge of relevant information sources and key landscape events which may impact policies and procedures and provides strategic input to senior management
  • Provides detailed explanations of finding and recommendations regarding compliance with grant documents and recommendations
  • Develops, analyses, and interprets grant and/or cooperative agreement policies, Standard Operating Procedures, and guidelines
  • Develops training, technical assistance and guidelines, and provides oversight, expertise and consultation to internal staff, management and programme officials, awardees, review panels, applicants, recipients, and sub-recipients
  • Independently analyzes grant requests and provides recommendations to management; may decline or approve grants
  • Ensures all required legal and financial paperwork is properly reviewed by the Compliance Officer and is in line with CIDRZ policies
  • Facilitates pre-award negotiations on matters such as terms and conditions of awards, costs, schedules, and oversight responsibilities

Qualifications:

  • Master’s Degree in Business Administration/Accountancy or other relevant professional qualification with minimum of 7 years’ experience with private sector, NGO, or international organisation
  • Strong knowledge and training in U.S. Government, or other donor regulations and policies
  • Proven experience with budget development, monitoring and reporting, and strategic development
  • Demonstrates high degree of independence, requiring minimal supervision to accomplish complex project work assignments
  • Ability to proactively identify projects and initiatives, and eagerly accept challenges and new responsibilities
  • Ability to successfully interface with senior level colleagues in other organisations and maintain relationships with international partners

Suitably qualified candidates are invited to apply; only shortlisted candidates will be contacted.

Please send application letter quoting job title, relevant academic and professional certificates and detailed CV with day-time telephone to:

CIDRZ Director Human Resources
P. O. Box 34681, 
Plot 5032 Great North Road Lusaka

or Email: jobs@cidrz.org

Closing Date for applications 3rd December

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