April 2019 
 Prepared by: 
Reuben M. Chongo 
Phillip Chikasa 
Pathmark Rural Development Consult 
Mid-Term Evaluation Report
For Zambia Family South Central 
(ZAMFAM SC) Project 
“Re - booting development interventions”
Cover Photo: Pupils reading and sharing ideas based on the contents of the Youth Club Program 
Manual. 
Photo: Courtesy of Promotion Team, DAPP Zambia 
Pathmark Rural Development Consult, Plot 545/401a St. Bonaventure. P.O. Box 39231, Lusaka.
Mobile: +260 979 632170. Email: Pathmarkruraldev0612@gmail.com
Published in April 2019.
© DAPP-ZAMFAM SC 
Suggested citation: Reuben M. Chongo and Phillip Chikasa Pathmark Rural Development Consult, 
2019. Mid-Term Evaluation Report: Zambia Family South Central (ZAMFAM SC) Project; Kabwe, Zambia
DISCLAIMER 
USAID Zambia Family (ZAMFAM) is funded by the American People through the United States 
Agency for International Development (USAID) and the U.S President's Emergency Plan for AIDS 
Relief (PEPFAR), and works closely with the Zambian Government line Ministries. The ideas 
expressed in this publication are those of the Pathmark Rural Development Consult and not 
necessarily of DAPP or USAID, PEPFAR, or the United States Government.
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TABLE OF CONTENTS 
TABLE OF CONTENTS ......................................................................................................................................... I
LIST OF TABLES .................................................................................................................................................II
LIST OF FIGURES ..............................................................................................................................................III
LIST OF ACRONYMS ........................................................................................................................................ IV
BASIC PROJECT INFORMATION ........................................................................................................................ V
ACKNOWLEDGEMENTS................................................................................................................................... VI
EXECUTIVE SUMMARY .................................................................................................................................. VII
1 INTRODUCTION ............................................................................................................................................. 1
2 THEORY OF CHANGE AND IMPLEMENTATION LOGIC MODEL ........................................................................ 2
3 MID – TERM EVALUATION RATIONALE, STAKEHOLDERS AND USERS’ OF FINDINGS ...................................... 4
3.1 RATIONALE....................................................................................................................................................... 4
3.2 STAKEHOLDERS.................................................................................................................................................. 4
3.3 USERS’ OF MTE FINDINGS .................................................................................................................................. 4
4 EVALUATION PURPOSE, OBJECTIVES AND SCOPE .......................................................................................... 5
4.1 PURPOSE ......................................................................................................................................................... 5
4.2 SPECIFIC OBJECTIVES .......................................................................................................................................... 5
4.3 SCOPE ............................................................................................................................................................. 5
5 EVALUATION QUESTIONS .............................................................................................................................. 6
6 EVALUATION DESIGN, METHODS AND LIMITATIONS ..................................................................................... 7
6.1 DOCUMENT AND SYSTEM REVIEW......................................................................................................................... 7
6.2 INCEPTION REPORT ............................................................................................................................................ 8
6.3 SAMPLING DESIGN............................................................................................................................................. 9
6.3.1 Focus Group Discussions .....................................................................................................................10
6.3.2 Key Informant Interviews ....................................................................................................................10
6.3.3 Direct Observations ............................................................................................................................10
6.3.4 Field Data Collection ...........................................................................................................................11
6.3.5 Open Data Kit Software ......................................................................................................................12
6.3.6 Study Instruments and Indicators .......................................................................................................12
6.3.7 DAPP ZAMFAM SC Data Collection Summary .....................................................................................13
6.3.8 Data Processing and Analysis .............................................................................................................14
6.3.9 Ethical Review .....................................................................................................................................14
6.4 ADJUSTMENTS TO THE APPROVED SCOPE OF WORK/PROTOCOL................................................................................15
6.5 PROCEDURES EMPLOYED TO ACHIEVE HIGH DATA QUALITY .......................................................................................16
6.6 LIMITATIONS OF DESIGN AND ANALYTIC METHODS ..................................................................................................17
7 FINDINGS AND DISCUSSIONS .......................................................................................................................18
7.1 SAMPLE CHARACTERISTICS................................................................................................................................. 18
7.2 ZAMFAM RESULT AREAS................................................................................................................................. 18
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7.2.1 Expected Result 1 ................................................................................................................................18
7.2.2 Expected Result 2 ................................................................................................................................28
7.3 KEY FINDINGS IN RELATION TO EVALUATION CRITERIA.............................................................................................32
7.3.1 Relevance ............................................................................................................................................35
7.3.2 Effectiveness .......................................................................................................................................39
7.3.3 Efficiency .............................................................................................................................................45
7.3.4 Exit and Sustainability .........................................................................................................................48
7.3.5 Cross – cutting Issues ..........................................................................................................................49
7.3.6 Monitoring and Evaluation Plan .........................................................................................................50
7.4 UNEXPECTED FINDINGS .....................................................................................................................................52
7.5 LESSONS LEARNT .............................................................................................................................................52
7.5.1 Private - public partnerships ...............................................................................................................52
7.5.2 Timing Mid – Term Evaluation ............................................................................................................53
8 CONCLUSION ...............................................................................................................................................53
9 RECOMMENDATIONS ..................................................................................................................................54
10 REFERENCES ..............................................................................................................................................56
11 APPENDICES ..............................................................................................................................................58
APPENDIX 1: SAMPLE SIZE DETERMINATION...............................................................................................................58
APPENDIX 2: DATA COLLECTION GARGET...................................................................................................................61
APPENDIX 3: DAPP ZAMFAM SC FIELD DATA COLLECTION SUMMARY REPORT............................................................62
APPENDIX 4: CAREGIVER AND HOUSEHOLD DEMOGRAPHIC CHARACTERISTICS FOR CENTRAL AND SOUTHERN PROVINCES ...........64
APPENDIX 5: KNOWLEDGE, PRACTICE AND ATTITUDE AMONG ADOLESCENTS AND YOUTH AGED 10 TO 17 YEARS ON HIV/AIDS 67
APPENDIX 6: PEPFAR MER ESSENTIAL INDICATORS FOR OVC PROGRAMS BY DAPP PROVINCES, AGE GROUP AND RESIDENCE 
FY18 ..................................................................................................................................................................68
APPENDIX 7: PEFPAR MER CORE INDICATORS, BY DAPP PROVINCES, AGE GROUP AND RESIDENCE .....................................70
APPENDIX 8: USAID ZAMBIA OVC RESULTS FRAMEWORK ...........................................................................................72
APPENDIX 9: USAID ZAMBIA OVC RESULTS FRAMEWORK ...........................................................................................74
APPENDIX 10: SUMMARY REPORT ON KEY INFORMANTS AND FOCUS GROUP ...................................................................76
APPENDIX 11: LIST OF KEY INFORMANTS ...................................................................................................................80
APPENDIX 12: LIST OF FOCUS GROUP DISCUSSION PARTICIPANTS ...................................................................................82
APPENDIX 13: TERMS OF REFERENCE .......................................................................................................................... 1
LIST OF TABLES 
Table 1: Basic project information ............................................................................................................ v
Table 2: Five Evaluation Thematic Area Criteria ................................................................................... 6
Table 3: Summary of components of the Mid-Term Evaluation......................................................... 9
Table 4: Survey interviews conducted in OVC households ................................................................ 12
Table 5: PEPFAR MER Essential Indicators....................................................................................... 13
Table 6: Summary of MTE Respondents .............................................................................................. 13
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Table 7: Some of the challenges and mitigation measures put in place during field work ............. 15
Table 8: Sample characteristics................................................................................................................ 18
Table 9: Information about caregivers and households ...................................................................... 20
Table 10: PEFPAR MER Essential Indicators for OVCs and household level .............................. 22
Table 11: PEFPAR MER Essential Indicators, by age group, residence, and sex FY18................ 23
Table 12: PEFPAR MER Core Indicators ............................................................................................ 25
Table 13: PEFPAR MER Core Indicators, by age group, residence and sex FY18........................ 26
Table 14: PEPFAR MER Essential Indicators..................................................................................... 29
Table 15: PEFPAR MER Core Indicators ............................................................................................ 31
Table 16: Updated Key Indicator Table ................................................................................................. 39
Table 17: Knowledge, Practice and Attitude among adolescents and youth about HIV.AIDs .... 44
Table 18: Currency exchange rates from 2015 to 2018 ....................................................................... 45
Table 19: DAPP ZAMFAM South Central Financial Report ............................................................ 46
Table 20: ZAMFAM SC M & E Framework ........................................................................................ 51
LIST OF FIGURES 
Figure 1: Percentage of OVC caregiving by gender............................................................................. 19
Figure 2: Mean age of OVC caregivers.................................................................................................. 20
Figure 3: Caregivers receiving goats as pass - on gifts ......................................................................... 21
Figure 4: Poultry from pass-on ................................................................................................................ 28
Figure 5: MUAC tape put to practice in undernourishment data capture ........................................ 28
Figure 6: Young children being stimulated by older ones ................................................................... 30
Figure 7: Knowledge and Awareness of OVC and HIV/AIDS ........................................................ 42
Figure 8: Knowledge, Practice and Attitude among adolescents and youth about HIV.AIDs ..... 43
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LIST OF ACRONYMS 
AIDS Acquired Immune Deficiency Syndrome 
ART Anti-retroviral 
CAG Community Action Group 
CCV Child Care Volunteer 
CHW Community Health Worker 
Creative Creative Associates International 
CWAC Community Welfare Assistance Committee 
DAC Development Assistance Committee 
DAPP Development Aid from People to People 
DMS Data Management System 
DWAC District Welfare Assistance Committee 
ERG Evaluation Reference Group 
FGD Focus Group Discussion 
GRZ Government of the Republic of Zambia 
HIV Human Immune-Deficiency Virus 
KAFHI Kabwe Adventist Family Health Institute 
KII Key Informant Interview 
M&E Monitoring and Evaluation 
MCDSS Ministry of Community Development and Social Services 
MTE Mid-Term Evaluation
NZP+ Network of Zambian People Living with HIV 
OECD Organisation for Economic Co-operation and Development 
OVC Orphans and Vulnerable Children 
PCSC Parent Community School Committees 
PLWHA People Living with HIV and AIDS 
SILC Savings and Internal Lending Communities 
USAID United States Agency for International Development 
WASHE Water Sanitation and Health Education 
YWCA Young Women Christian Association 
ZAMFAM SC Zambia Family South - Central Project 
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BASIC PROJECT INFORMATION 
Table 1: Basic project information 
Project Title USAID – DAPP ZAMFAM – South Central Project
Project Number Cooperative Agreement No. AID - 611 - A - 16 - 00002: 
Project Goal To improve the care and resilience of vulnerable populations in the Central 
and Southern Provinces of Zambia, specifically targeting OVC and PLWHA 
by supporting, protecting, and strengthening the capacity of children, families, 
and communities
Total Project Cost US$ 24,411,023.00
Finance Agency United States Agency for International Development (USAID)
Implementing 
Agency
Development Aid from People to People (DAPP)
Implementing 
Partners
Creative Associates International, Inc., Network of Zambian People 
Living with HIV and AIDS (NZP+), Kabwe Adventist Family Health 
Institute (KAFHI) and Young Women Christian Association (YWCA)
Project Location The project is operating in 10 districts of Zambia; 6 districts in Southern 
Province namely, Choma, Livingstone, Mazabuka, Monze, Namwala and 
Sinazongwe and 4 districts in Central Province namely Chibombo,
Kabwe, Kapiri Mposhi and Mumbwa
Expected Results i. Resilience of households to care for children and adolescents 
living with, affected by and/or vulnerable to HIV measurably 
increased.
ii. Child wellbeing status measurably improved due to provision and 
accessing of quality care and support services.
iii. Capacity of government and community structures to care for and 
support children and adolescents living with, affected by and/or 
vulnerable to HIV measurably increased.
iv. Shared learning and evidence - base to improve programming, 
inform policy and program investment strengthened.
Start Date 20 November 2015
End Date 19 November 2020
Final MTE Report 
Date
12 April 2019 
Source: Adapted from DAPP ZA MFAM SC Annual Report 2017 - 2018 
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ACKNOWLEDGEMENTS 
In undertaking the Mid - Term Evaluation (MTE) of Development Aids from People to People 
(DAPP) Zambia Family South - Central (ZAMFAM SC) project, PathMark Rural Development 
Consult received appreciable support and co-operation from a number of organizations and 
individuals. Therefore, we wish to take this opportunity to convey our profound gratitude to them. 
Our special gratitude is being extended to Ms. Elise Soerensen, DAPP Zambia Managing Director; 
Dr. Vincent Munene, DAPP ZAMFAM SC Chief of Party and all Evaluation Reference Group 
(ERG) members for giving us an opportunity to carry - out the MTE assignment. In addition, we 
acknowledge both guidance and support received from the ERG members throughout the 
assignment period. 
Furthermore, we convey our appreciation to other DAPP Zambia staff, especially the district 
coordinators, project leaders and community mobilizers in the sampled six project districts of 
Livingstone. Mazabuka, Kabwe, Kapiri Mposhi, Kabwe, Mumbwa and Chibombo. These staff 
mobilised targeted respondents for our evaluation meetings, especially caregivers, orphans and 
vulnerable children, members of Community Action Groups and other key stakeholders in their 
respective geographical districts. 
In addition, we extend our gratitude to Dr. Nkomba Kayeyi and Lyson Phiri of the Population 
Council for the information and experiences shared on the use of caregiver/children household 
questionnaires, processing and analysing gathered field data. 
We also thank the Ministries of Community Development and Social Services as well as Health 
Headquarters in Lusaka for granting us permission to work with their field staff in the sampled 
project districts. In the same vein, we appreciate the co-operation we received from school heads/ 
teachers of the schools interviewed. In addition, we extend our gratitude to Mr. Sitwala Mungunda, 
USAID representative, who accorded us time for an in-depth interview. 
Finally, we convey our appreciation to all the traditional and civic leaders as well as other people 
who spared some time from their schedules to be interviewed. 
Views and opinions expressed in this report do not represent those of DAPP Zambia or 
USAID Zambia office or the people interviewed. These are wholly attributed to the 
Evaluation team. 
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EXECUTIVE SUMMARY 
Introduction 
Zambia Family South – Central (ZAMFAM SC) is a five – year (2015 – 2020) integrated community 
project with overall goal of improving care and resilience of vulnerable populations, specifically 
targeting Orphan and Vulnerable Children (OVC) and People Living with HIV and AIDS 
(PLWHA). ZAMFAM SC Project is being implemented in 10 districts of Zambia by Development 
Aid from People to People (DAPP) in partnership with Creative Associates International, Kabwe 
Adventist Family Health Institute (KAFHI), Network of Zambian People Living with HIV and 
AIDS (NZP+) and Young Women Christian Association (YWCA). The project provides support 
and services to 72,219 households and 130,000 OVC each year. ZAMFAM SC receives financial 
and technical support from the United States Agency for International Development (USAID). 
Evaluation Purpose and Methodology 
As ZAMFAM SC Project reached half - way mark of its implementation period, DAPP 
commissioned a Mid – Term Evaluation (MTE) in accordance with the signed Cooperative 
Agreement. The MTE purpose was to assess progress made so far towards achieving ZAMFAM 
SC Project objectives, outcomes and drawing - out lessons on how the project performance can 
be improved during its remaining implementation period. PathMark Rural Development Consult 
was engaged to undertake the MTE assignment and employed mixed - methods approach gleaning 
both quantitative and qualitative data to inform the evaluation. The MTE was anchored on 
assessment of the four project result areas, namely, resilience of households to care for orphans 
and vulnerable children, child wellbeing status, capacity of government and community structures 
to care and support children as well as shared learning and evidence – base to improve 
programming. In addition, the MTE addressed the following assessment criteria with related 
evaluation questions:
Relevance: To what extent were operations and objectives of the ZAMFAM SC Project consistent 
with beneficiaries’ needs, GRZ and donors’ policies?
Effectiveness: What best practices can be documented with regard to service delivery and 
implementation? 
Efficiency: To what extent have project resources been efficiently utilized? 
Exit & Sustainability: What supportive mechanisms have been put in place for the household? 
Co-ordination, Gender & Environment. What have been environmental concerns? To what extent 
has project implementation mainstreamed gender issues? 
The Evaluation team utilised a Non-Experimental Design Study of 72,219 ZAMFAM beneficiary 
OVC households (represented by actual sample of 665 caregivers, 341 children (0 – 9 years) and 
139 children (10 – 17 years) in project communities of 6 selected districts. These districts are 
Livingstone and Mazabuka in Southern Province; Mumbwa, Chibombo, Kabwe and Kapiri 
Mposhi in Central Province. The survey districts were purposively- sampled on account of being 
in the project since its inception. Survey respondents were selected from DAPP ZAMFAM 
beneficiary lists which had been used during the benchmark survey but updated in the course of 
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project implementation. Using Sampling Proportional to Size technique, a total of 784 
caregivers/households were sampled for data collection. 
For consistency and compatibility of benchmark values with MTE findings, the Evaluation team 
used same caregivers/children questionnaires which had been used during the benchmark survey. 
Being a mixed – methods approach, data collection tools such as Focus Group Discussion (FGD) 
targeting Community Action Groups and Youth Clubs as well as Key Informants Interviews (KII) 
were utilised to enhance the depth and breadth of data collected. This approach also facilitated 
triangulation and cross - checking of the gathered data. Field data collection exercise in the sampled 
6 project districts was divided into two phases. Phase one covered Livingstone and Mazabuka 
districts and was carried - out from 15 – 21 December 2018. Phase two involving Kapiri, Kabwe, 
Chibombo and Mumbwa districts ran from 14 – 25 January 2019. As field data collection exercise 
was conducted during the rainy season, most targeted respondents could hardly be available for 
evaluation meetings because they were pre - occupied with farming activities. Moreover, due to 
impassable roads triggered by rains, a few sampled project areas and households also became 
inaccessible. Alternatively, the Evaluation team replaced inaccessible respondents with accessible 
ones as long as they had similar characteristics. 
Key Evaluation Findings 
Using Android smartphones loaded with caregiver/children questionnaires, the Evaluation team 
administered these questionnaires to 665 caregivers/households out - of the sampled 784 
respondents, representing 85% achievement. This result was due to inaccessibility of some sampled 
project areas and households caused by the rains. The Evaluation team also conducted 19 FGDs 
against 12 planned ones, representing 158% achievement and 65 KIIs against planned 24 ones, 
representing 271% achievement. More data was collected using FGDs and KIIs to augment 
caregiver/household data. 
At benchmark stage, 91.4% of households/caregivers interviewed were females and 8.6% were 
males. At MTE stage, 86.4% of households/caregivers interviewed were females and 13.6% were 
males. These results were statistically significant at z = 3.848, p = <.001. The results were also 
supported by information from FGDs where participants indicated that more males were taking 
up caregiving responsibilities. 
The mean years of schooling increased from 5.9 at benchmark stage to 7.9 at MTE and was 
statistically significant at z = 17.002, p < .001. In addition, the percentage of caregivers who could 
not read a sentence, significantly dropped from 33.4 % at benchmark stage to 16.0% at MTE stage 
(z = -9.851, p <.001). ZAMFAM SC puts emphasis on education of project population for both 
children and adults. This was noticed during the direct observations made by the Evaluation team 
at the project beneficiary schools especially those that had received reading and teaching materials. 
In addition, weekly trainings conducted by project leaders and community mobilisers for 
Community Action Group members inspired beneficiaries to take education more seriously. 
At benchmark stage, undernourishment was at 3.7%. At MTE, undernourishment was at 13.4%. 
The differences in percentages of undernourishment at benchmark stage and the MTE were 
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significant, z = -48.733, p < .001. According to the 2013 – 14 ZDHS, 40% of children Under 5 
were stunted, 6% were wasted and 15% were underweight. The MUAC tape measurement taken 
during both benchmark and MTE surveys speak more to underweight. The undernourishment 
value of 13.4% recorded during MTE is in closer sync with ZDHS’s underweight of 15%. On the 
basis of the ZDHS and MTE result values comparison, it is evident that there is a reduction in 
undernourishment among the children under 5 in the sampled project districts. 
The Wealth Mean (count type of 19 items) at benchmark stage was 4.9% and 4.2% at MTE. The 
drop was significant at z = -495.376, p <. 001. The drop-in wealth mean count was minimal and 
the difference could be attributed to the context in which the benchmark was conducted compare 
to the MTE. For example, the BM includes items like boats which are necessary in water bodies
while the MTE covered areas where there were no water bodies. 
At benchmark stage, 52.8% caregivers knew HIV status of their children. At MTE stage, the 
percentage increased to 98.6%. These results were significantly different at z = 51.198, p < .001. 
During FGDs, most of the participants had indicated that there was a lot of sensitisation activities 
about issues surrounding HIV and AIDS in particular VCT promoted under ZAMFAM project. 
These activities had raised their level of awareness about HIV and AIDS and they were keen on 
knowing HIV status of their children. The positive result on Caregivers knew HIV status of their 
children resonates with both the Ministry of Health National Health Strategy as well as National 
HIV and AIDS Strategy Framework 2017 – 2021. These strategic documents were formulated on 
UNAIDS 95 – 95 – 95 Fast-track Targets on epidemic elimination. The Caregiver knew HIV status 
indicator is a first step on the fast track indicators. 
The percentage of caregivers agreeing to claim that harsh punishment is appropriate discipline to 
be given to a child was at 38.5% during 
benchmark stage. The percentage dropped 
to 32.4% at MTE time. The drop was not 
statistically significant at z = -0.939, p = 
0.348. This means that there is still an 
appreciable number of respondents who 
believed that harsh punishment was 
appropriate way to discipline the child.
The survey found notable best practices for 
service delivery and implementation as 
harnessing comparative advantage of partner organisations in projects’ activities implementation. 
Creative Associates, KAFHI, YWCA and NZP+ bring to the partnerships their expertise in critical 
areas of project management. In addition, working with and through existing government and 
community structures which will continue functioning even after the project ends. The new 
approach of “TRIOS” in caring and supporting children on ART. This approach provides a back￾up person to encourage the person on treatment not to default. 
In all 6 project districts visited by the Evaluation team, the members found functional ZAMFAM 
SC Project structure of District Coordinator, project leaders and community mobilizers. In each 
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district, there are 8 - 10 project leaders. Each project leader is supported by three (3) community 
mobilizers in the operational area. Each community mobiliser manages about 250 households and 
500 OVCs. Each District Coordinator and project leader had been given some form of transport 
- motorbike and community mobilisers had also been given bicycles for transport. Mobile phones 
had been given to all full-time project staff in each district visited. Motorbikes, bicycles and mobile 
phones had improved the project staff mobility and communication. 
Notwithstanding the challenges experienced in administering the school block grants, particularly 
procurement of school desks, ZAMFAM SC is performing well on essential indicators such as 
Improvement in Child Status, Caregiver knows child’s HIV status and increasing number of men
taking up caregiving roles. DAPP ZAMFAM SC Project is leveraging the comparative advantage 
of its sub-grantees; NZP+, YWCA, Creative Associates and KAFHI in activities implementation. 
In addition, the project has innovated “TRIOs approach” in caring and supporting children on 
Anti-retroviral (ART). 
Key Recommendations 
Based on what DAPP ZAMFAM SC Project has hitherto achieved, it is most likely that it will 
achieve most project targets. Some of the key recommendations being advanced are as follows: 
i. Innovative and consistent caregiver/household economic strengthening interventions 
should be implemented to tackle the endemic household undernutrition on sustainable 
basis 
ii. Procurement of project materials, especially school desks, should be carried out in good 
time so as not to disrupt school attendance by targeted beneficiary pupils. 
iii. More efforts should be directed at facilitating establishment and strengthening savings and 
internal lending communities in project areas. 
iv. Community Action Group Training Manual, currently produced in English Language, be 
translated in at least two local languages to make the contents more user – friendly to 
trainers 
v. ZAMFAM has provided a huge market to equipment suppliers (motorbikes – Honda 
Zambia; bicycles – Buffalo & Zambike, mobile phones and airtime – MTN). As a normal 
business practice, these companies can be approached for project support/donations 
under their respective social investment strategy 
vi. Crucial Surveys, like Mid - Term Evaluation, should be conducted during dry season when 
accessibility to all sampled project areas, communities and households is feasible 
vii. Closer consultations to be made with Ministry of Fisheries and Livestock for technical 
advice and guidance on procurement of “pass – on” livestock (goats and chickens) and 
livestock movement ban. 
viii. More conscientization efforts to be made among project population to change endemic 
belief that harsh punishment is appropriate discipline to be given to the child. 
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1 INTRODUCTION 
The Zambia Family South - Central (ZAMFAM SC) is a five – year (2015 – 2020) integrated 
community project with main goal of improving care and resilience of vulnerable populations, 
specifically targeting Orphan and Vulnerable Children (OVC) and People Living with HIV and 
AIDS (PLWHA). ZAMFAM SC is being implemented by Development Aid from People to 
People (DAPP) in partnership with Creative Associates International, Kabwe Adventist Family 
Health Institute (KAFHI), Network of Zambian People Living with HIV and AIDS (NZP+) and 
Young Women Christian Association (YWCA) to strengthen comprehensive, integrated service 
delivery and support to children and adolescents living with, affected by, and /or vulnerable to 
HIV and their households.
The project is being implemented in ten (10) districts of Zambia; six in Southern Province (viz 
Choma, Livingstone, Mazabuka, Monze, Namwala and Sinazongwe) and four in Central Province 
(viz Chibombo, Kabwe, Kapiri Mposhi and Mumbwa). ZAMFAM SC is operationalized through
collaboration with government ministries of Health, Community Development and Social Services, 
General Education, Agriculture, Fisheries and Livestock providing services and support to 72,219 
households and 130,000 OVC each year. The project receives financial and technical support from 
the United States Agency for International Development (USAID).
As ZAMFAM SC Project reached half - way mark of its implementation period, DAPP 
commissioned a Mid – Term Evaluation (MTE) in accordance with the signed Cooperative 
Agreement to assess progress made so far towards achieving its objectives. In this regard, PathMark 
Rural Development Consult was engaged to conduct the evaluation assignment. 
The Mid- Term Evaluation Report is organised into eight chapters. Chapter one provides 
introduction and chapter two presents ZAMFAM SC Theory of Change and implementation logic. 
Chapter three gives the Mid – Term Evaluation Rationale, Stakeholders and users’ of findings and 
chapter four outlines the MTE purpose, objectives and scope. Chapter five shows the Evaluation 
questions and chapter six carries the Evaluation design, methods and limitations. Chapter seven 
provides the Findings and Conclusions and chapter eight presents recommendations. 
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2 THEORY OF CHANGE AND 
IMPLEMENTATION LOGIC MODEL 
The overall goal of ZAMFAM SC Project is to improve the care and resilience of OVC in the 
Central and Southern Provinces of Zambia, by supporting, protecting and strengthening capacity 
of children, families and communities. The project is underpinned by the following objectives:
 Increasing resilience of households to care for children and adolescents living with, affected 
by and/or vulnerable to HIV 
 Improving child wellbeing status due to provision and accessing of quality care and 
support services
 Increasing capacity of government and community structures to care for and support 
children and adolescents living with, affected by and/or vulnerable to HIV; and 
 Strengthening shared learning and evidence - base to improve programming and inform 
policy and program investment. 
ZAMFAM SC Project is premised on the hypothesis that accessing social services and economic 
support contributes to HIV and AIDS epidemic control and mitigation for OVCs and their 
households. It is assumed that positive change, as articulated in the foregoing project objectives, 
will be achieved through operationalising the following strategies: 
 Improving health and livelihood which should start with each individual: Sensitising 
all individuals including adults, adolescents and children that they themselves have the main 
responsibility for their own health and future 
 Strengthening families to improve care and support for OVC: Families have the social 
mandate and actual daily connections with OVC. These are primary organs responsible for 
welfare of OVC 
 Organisation and strengthening of community groups: Successful activities will be 
achieved through organising participating households into Community Action Groups 
(Village/Community Action Groups, Saving and Lending, Youth Clubs etc) in which they 
can provide mutual support. These act as structures through which to reach individuals 
with information and support services. 
 Strengthening of government structures to care for OVC: The project working with 
government structures at district and community levels i.e. District Welfare Assistance 
Committees (DWAC), district health office and follow up systems to provide HIV and 
other quality services for OVC wellbeing. 
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 Strengthen shared - learning and evidence to improve programming and inform 
policy as well as programme investment, sharing lessons – learnt, discussing 
successes and constraints with the community through community review 
meetings: These will improve community planning while sharing best practices, lessons 
learnt with civil society to improve planning and implementation at project level. 
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3 MID – TERM EVALUATION RATIONALE, 
STAKEHOLDERS AND USERS’ OF FINDINGS
3.1 Rationale 
The MTE was commissioned based on the following reasons: 
i. DAPP ZAMFAM SC Project conducted a baseline study before start of the project which 
provided a situational analysis. This informed establishment of the project indicator 
baseline information and verification of targets provided in the project agreement. This 
MTE will allow DAPP ZAMFAM SC to follow - up on the progress of project indicators 
measured against the baseline values 
ii. Project improvement, using MTE results as feedback to DAPP ZAMFAM SC Project, to 
make the project function more effectively and efficiently 
iii. Project accountability and transparency; so that stakeholders and funder alike, are aware of 
the project progress 
iv. Provide strategic and concrete evidence on the relevance, results, processes and utilization 
of resources by the project. 
3.2 Stakeholders 
A number of stakeholders, both inside and outside DAPP ZAMFAM SC Project, have keen 
interests in the evaluation findings. Predominantly, these stakeholders are individuals, groups and 
organisations who may affect, or perceive to be affected by decision, action or outcome of the 
project. DAPP ZAMFAM SC Project main stakeholders are the project staff, government 
ministries, beneficiaries (OVCs, care givers, youth), implementing partners, USAID, Ethical 
Boards etc. 
In conducting the evaluation, PathMark Rural Development Consult and internal Evaluation 
Reference Group (ERG) made every effort to ensure that respondents represented all key 
stakeholders. In addition, they ensured that all ethical review procedures and protocols were strictly 
followed. 
3.3 Users’ of MTE Findings 
The expected users of the MTE findings are primarily; the DAPP ZAMFAM SC Project team, 
DAPP Partnership Office, Government, USAID and implementing partners. 
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4 EVALUATION PURPOSE, OBJECTIVES AND 
SCOPE 
4.1 Purpose 
It was to assess progress made so far towards achieving project objectives, outcomes and drawing 
- out lessons on how ZAMFAM SC Project can be improved during the rest of its implementation 
period for a more positive impact. 
4.2 Specific Objectives 
In particular, the MTE aimed to: 
i. Assess relevance of ZAMFAM SC Project objectives and its approach. 
ii. Assess effectiveness and efficiency in implementation of ZAMFAM SC Project at province, 
district, and sub-district levels 
iii. Assess results achieved in ZAMFAM SC Project and extent to which sustainability 
considerations have been built-in
iv. Compare baseline data with the current evaluation data. Then provide insights into progress 
against the project targets 
v. Assess extent to which issues of gender equality, social inclusion and equity as well as 
environment have been taken into consideration 
vi. Assess extent of co -ordination with partners and other actors in the area of OVC HIV and 
AIDS with a view to strengthening partnerships; and 
vii. Identify lessons and good practice from ZAMFAM SC implementation, opportunities to 
improve current planning, project implementation and feed into the project improvement plan 
for the remaining two years of the project life. 
4.3 Scope 
The evaluation covers ZAMFAM SC Project interventions during the period November, 2015 –
September 2018. The evaluation is forward-looking and provide lessons and plausible 
recommendations to improve on the future performance of ZAMFAM SC Project for the
remaining implementation period. The geographical scope includes six sampled ZAMFAM SC 
operational districts, namely Mumbwa, Kapiri Mposhi, Kabwe and Chibombo; Mazabuka and 
Livingstone in Central and Southern Provinces respectively. 
Page | 6 
5 EVALUATION QUESTIONS 
Under the guidance of the ERG, PathMark Rural Development Consult team employed five￾evaluation thematic area criteria focusing mainly on the project process and outcome performance. 
The thematic areas and their respective key evaluation questions are tabulated in Table 2 below: 
Table 2: Five Evaluation Thematic Area Criteria
Thematic 
Area
Evaluation Questions
Relevance  To what extent were the operations and objectives of the ZAMFAM SC 
Project consistent with beneficiaries’ needs, GRZ and donors’ policies? 
 Were approaches and strategies used relevant to achieve the intended 
changes in the baseline values?
Effectiveness  What best practices can be documented with regard to service delivery and 
implementation?
 What is the level of knowledge and awareness of OVC around HIV/AIDS?
 What is the change in Knowledge, Practice and Attitude on HIV and AIDS 
among adolescents and youth? 
 How have rates of graduation of OVC due to decreased vulnerability 
changed over the course of implementation
Efficiency  To what extent have the resources of the project been efficiently utilized?
Exit & 
Sustainability
 What will household likely continue doing beyond the life of the project?
 What supportive mechanism have been put in place for the household?
Cross-cutting Issues
Coordination, 
Gender &
Environment.
 What has been the environmental concerns and what has been the 
mitigations this far?
 To what extent has the project implementation mainstreamed gender issues?
Source: Adapted from Revised MTE ToRs 
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6 EVALUATION DESIGN, METHODS AND 
LIMITATIONS 
For consistency and compatibility of MTE findings with Baseline values, the PathMark Rural 
Development Consult team predominantly utilized the caregiver/household questionnaires which 
had been used during the benchmark survey. As a way of deepening and widening scope of the 
evaluation, the Evaluation team used a mixed – methods approach to glean both quantitative and 
qualitative data. In this regard, the team used a wide array of data collection tools, which among 
others, included the following:
6.1 Document and System Review 
The Evaluation team undertook a desk interrogation of critical ZAMFAM SC Project documents 
such as the following: 
i. Signed USAID Co -operative Agreement which provides key guidelines on utilization, 
management of project grant and project implementation 
ii. Benchmark Assessment of Orphan and Vulnerable Children in Areas of the ZAMFAM 
SC Project Report. This Report compiled by the Population Council succinctly explains 
how the baseline was undertaken. It also presents baseline values on nine (9) PEPFAR 
OVC’s Outcome Indicators, the anchor of ZAMFAM SC M & E system 
iii. ZAMFAM SC Project Activity Monitoring and Evaluation Plan (AMEP). This plan 
provides project monitoring and evaluation system. It also articulates the project theory 
of change and its logical framework. 
iv. ZAMFAM SC Annual Operation Plans 2015 – 2016; 2017 – 2018 and 2018 – 2019. 
These plans give details on the planned activities in line with the project objectives and 
result areas for the project operational year under consideration 
v. ZAMFAM SC Annual Progress Reports 2015 – 2016; 2016 – 2017 and 2017 – 2018. 
Aside from Annual Reports, some Quarterly Reports were availed. The quarterly 
reports’ activities implementation status has been collated into Annual Reports. These 
reports provide key information required for evaluation assignment. 
vi. Ministry of Health’s National Health Strategic and Adolescent Health Strategic Plans 
2017 – 2021; National HIV and AIDS Strategic Framework 2017 – 2021. These plans 
postulate the government strategic direction on health, HIV and AIDS for driving 
towards attainment of UNAIDS 90 – 90 – 90 Fast Track Targets on Elimination of
HIV and AIDS. Ministry of General Education 2013 School Curriculum which has 
embraced comprehensive sexuality education in school learning. It resonates well with 
Page | 8 
ZAMFAM SC Project’s school – targeted HIV and AIDS as well as sexual reproductive 
health awareness interventions. 
vii. Internet Search on prominent global websites with information and education on HIV 
and AIDS such as www.avert.org. This provides latest information for selected 
countries (including Zambia). The website has availed information on Zambia’s 
Progress towards UNAIDS 90 - 90- 90 Targets, which by end of December 2018, was 
not available either at National AIDS Council or Ministry of Health institutions. 
6.2 Inception Report 
The first evaluation assignment meeting between PathMark Rural Development Consult and 
DAPP Zambia ERG to discuss the ZAMFAM SC MTE exercise was convened on 11 Oct. 2018 
in Kabwe. During this meeting, the PathMark Rural Development Consult team presented a 
proposed MTE design and plan. Subsequently, the team prepared a first draft Inception Report 
and submitted it to DAPP ERG. The Evaluation team and ERG discussed the proposed evaluation 
design, sampling methodology, work plan and time frame. 
On 22 October, 2018, an assignment contract involving PathMark Rural Development Consult 
and DAPP Zambia was signed. The MTE work plan and time frame were based on the timing that 
field visit to six selected project districts would be undertaken during the month of November, 
2018, just at the start of the rainy season. During this time, most sampled project areas and villages 
were accessible and targeted respondents were not yet fully immersed in seasonal crop farming 
activities. 
PathMark Rural Development Consult team employed a Non-Experimental Design Study of 
72,219 (represented by a sample of 665 households, 341 children age 0-9 years and 139 children 
aged 10-17 years old) ZAMFAM beneficiary OVC households in project target communities of 
selected 6 districts in Central and Southern Provinces, namely Livingstone and Mazabuka; 
Mumbwa, Chibombo, Kabwe and Kapiri Mposhi respectively. The survey districts were 
purposively- sampled on account of being under the project since its inception. This implied that 
new project districts were left out. The MTE was conducted after three years of ZAMFAM SC 
implementation and had the following components as indicated in Table 3:
Page | 9 
Table 3: Summary of components of the Mid-Term Evaluation
Study areas Central, Southern provinces: DAPP implementation areas
Study population ZAMFAM beneficiaries, specifically:
Primary caregivers (aged 18+ years old)
OVC aged 0–9 years (through caregiver interview)
OVC aged 10–17 years
Minimum sample size Targeted 784 Total OVC Hhouseholds in two provinces,
Targeted 784 Primary Ccaregivers & OVC aged 0–17 years
Method & location of survey Interviewer-administered survey questionnaire conducted either at 
Ccaregivers/OVC’s home or central place
Study instruments Caregiver Qquestionnaire 
OVC Qquestionnaires:
0–9 years; administered to Caregiver
10–17 years; administered directly to the child
Undernourishment measured by obtaining the mid-upper arm 
circumference (MUAC) for children 6–59 months
Timing Field data collection was split into two phases. Phase 1 (Livingstone & 
Mazabuka 15 - 21 Dec. 2018 & Phase 2 (Kapiri, Kabwe, Chibombo & 
Mumbwa 14 - 25 Jan. 2019
Source: Adopted and modified from Mbizvo et al. (2018)
6.3 Sampling Design 
PathMark Rural Development Consult used DAPP Lists of Household beneficiaries as the 
sampling frame. The aim of sampling was to represent OVC households in the two provinces, each 
ZAMFAM operating area and matching as best as possible, the varying urban and rural distribution 
in the two provinces. The idea was to ensure that both urban and rural project areas were 
represented in the study. Households that live in mixed urban /urban project areas were assigned 
as urban in the survey. 
When a number of project areas needed for sampling was determined, a two-stage sampling 
procedure, stratified by urban and rural, was implemented. Project areas were selected proportional 
to size of the OVC beneficiary population. A fixed number of households per project area was 
sampled. “Sampling Proportional to Size” allowed for households in project areas with greater 
numbers of eligible OVC population to have a higher selection probability. A fixed sampling size 
per project area allowed for a sample to be self-weighting at the analysis stage within each province 
(Groves et al. 2009 as cited in Mbizvo et al., 2018 p. 11). 
Once project areas were selected, OVC eligible households enrolled in the ZAMFAM project were 
randomly stratified/ordered and recruited for the mid-term survey. If a household was located or 
refused to participate, it was noted as a non-response and replaced by a subsequent household on 
the randomly stratified/ordered list.
The minimum sample size for MTE was 784 OVC households for all 6 sampled project districts. 
It was anticipated that this target number would be 1% higher than 776 households sampled at 
benchmark survey stage. The sample size of 784 was yielded from factoring a 3.5% margin of error 
in the sample size calculation formula by Puszcza et al. (2013) as adopted from (Conchran, 1963)
Page | 10 
See Appendix 1.The minimum sample size of caregiver and OVC participants needed for MTE 
was determined by setting a minimum acceptable confidence interval of ±5 percent for key study 
indicators for caregiver and 0–17 age group; marginally higher confidence intervals of ±8 percent 
and ±7 percent accepted for the 0 to <5 and 5 to 17 age groups, respectively. The estimated sample 
sizes accounted for impact of the clustered sampling approach on the confidence intervals. A total 
of 665 caregivers/households out of the targeted 784 caregivers was interviewed during the field 
survey, representing 85% coverage. The margin of error for the 665-sample size was 0.038.
6.3.1 Focus Group Discussions 
It was designed that two (2) Focus Group Discussions (FGDs) involving 10 participants, 
representing both females and males, would be conducted per district. Community Action Groups 
and School Clubs (Youth and Kids) as well as out – of – school clubs were targeted as key 
respondents. 
At the end of field data collection in all 6 sampled project districts, 19 FGDs were held out of the 
planned 12 FGDs, representing 158 % coverage. 
6.3.2 Key Informant Interviews 
Further, it was planned that the following key respondents, purposively – sampled, be interviewed 
based on their level of involvement and interest in the project. These were as follows: 
DAPP Zambia 
Managing Director, Director of Programmes, Chief of Party, Deputies Chief of Party M&E 
specialist, Finance Director, Community Mobilisation specialist, District Coordinators, Project 
Leaders, Community mobilizers 
Sub grantees 
Creative International (management team – small meeting), KAFHI, and NZP+ (management 
team). 
Government ministries 
Participating health centre, schools, community development/social welfare 
Other Key Informants 
USAID Zambia, Population Council 
The planned number of KIIs was 24 respondents from the aforementioned stakeholder 
organisations. The Evaluation team worked tirelessly and reached out to 65 respondents, 
representing 271% coverage. 
6.3.3 Direct Observations 
As field data collection was conducted during the rainy season, some initially sampled project areas 
and residential areas/villages became inaccessible due to impassable roads. Moreover, rains during 
Page | 11 
field visit period, made it difficult for the Evaluation team to reach some project areas. Worse still, 
schools had closed, pupils and teachers were on vacation and difficult to access. 
Hence, direct observations were confined to the few beneficiaries whose homesteads were visited 
by the Evaluation team. Direct observations focussed on checking homesteads’ sanitary and 
hygiene conditions (toilet, bath shelter, disk rack, rubbish pit), chickens /goats’ pen /shelter and 
demonstration gardens. In addition, observations were made at beneficiary schools that were 
visited. 
6.3.4 Field Data Collection 
a) Orientation of Research Assistants to Field Data Collection 
The PathMark Rural Development Consult team comprised thirteen (13) members. These were 
team leader (Reuben M. Chongo), ICT specialist/ field data collection supervisor ( Phillip Chikasa) 
both hold Master’s degree in agricultural and rural development and environment management 
respectively, OVC specialist ( Maurice M. Sepiso) holds Master’s degree in public health and 10 
research assistants comprising 5 UNZA School of Medicine graduates ( Patricia Ngoma, 
Nanyangwe Chikasa, Joy Lubasi, Kent Mutale and Samuel Chitupa); Master’s Degree in Business 
Administration holder (Mutinta B. Moonga), Bachelors in Business Administration holder (Mukate 
Mukate), Bachelors Arts Degree in Environmental Geography holder (Joackim Kapapa) and 
Computer Software and Hardware assistant engineer ( Chanda Mwape). 
For three full days (12 – 14 December, 2018) all 10 research assistants were trained in use of the 
field data collection instruments, especially the Mobile to Web - based Tool Kit (MWB) loaded 
with questionnaires for caregiver and OVC, the latter classified children aged 0 – 9 years and 
children aged 10 – 17 years. The orientation training covered both theoretical and practical aspects 
of MWB, participants sampling, interviewing techniques and ethics as well as use of Measure field 
data collection manual for research assistants and supervisors. 
On the second day of the training, the research assistants visited selected project operational areas 
in Chibombo District to pre- test data collection tools and practise field data collection techniques. 
Coincidentally, ZAMFAM SC field staff were distributing “pass – on” chickens to Community 
Action Groups in the project areas. The project staff were ‘‘overwhelmed with the chicken 
distribution exercise” but managed to organise sampled project areas and households for the pre￾testing exercise. Moreover, the rainy season had started and scattered showers fell during the pre￾testing day. As a result of the field challenges endured during the Chibombo pre- testing field visit, 
the Evaluation team and host district project staff agreed that instead of conducting house – to 
house interviews, sampled care givers/OVCs and CAG members should gather at an accessible 
homestead or central place where Evaluation team members could administer questionnaires to 
them. Then, the team leader and field supervisor selected 6 respondents with accessible homesteads 
Page | 12 
and visited their homesteads to check and verify erected project facilities (e.g. sanitary and hygiene, 
chickens/goats, demonstration plots). 
6.3.5 Open Data Kit Software 
Data was collected from sampled caregivers and children using Open Data Kit software (ODK) 
through an electronic survey interview conducted by research assistants on android/smart phone. 
There were no major challenges faced in the use of ODK because of the field pre- testing which 
had been conducted in Chibombo. During this exercise, research assistants were oriented to ODK
and interviewing styles as well as techniques. In addition, the contingent measure of acquiring back
-up smart phones and power banks worked very well. 
The Evaluation team strictly followed PEPFAR’s OVC survey guidelines i.e. no more than one 
OVC aged 0 - 9 or aged 10–17 was eligible for survey participation. If there were more than two 
children within these age groups in a household, then only one per age group was randomly
selected. This process is summarized in Table 4.
Table 4: Survey interviews conducted in OVC households 
Children in household Interviews to be conducted
Child 0–9 
No child 10–17
(x1) Caregiver
(x1) Caregiver
—Information about household & caregiver
—Information about selected child 0–9
No child 0–9
Child 10–17
(x1) Caregiver
(x1) Child
—Information about household & caregiver
—Information about selected child 10–17
Child 0–9 
Child 10–17 
(x1) Caregiver
(x1) Caregiver
(x1) Child
—Information about household & caregiver
—Information about select child 0–9
—Information about select child 10–17
Source: Adopted and modified from Mbizvo et al. (2018)
6.3.6 Study Instruments and Indicators 
Data collected for the MTE was based on adopted and modified study instruments and indicators 
developed by Mbizvo et al. (2018) at the time of conducting the benchmark survey (Table 5). Data 
was collected on OVC, caregiver and household economic status. 
Page | 13 
Table 5: PEPFAR MER Essential Indicators
No Indicator
NC.1 Percent of children whose primary caregiver knows the child’s HIV status
CW.1 Percent of children <5 years of age who are undernourished as measured by MUAC
CW.4 Percent of children too sick to participate in daily activities
CW.9 Percent of children who have a birth certificate, observed or self-reported
CW.11 Percent of children aged 5–17 years regularly attending school
CW.12 Percent of children aged 5–17 years who progressed in school during the last year
CW.13 Percent of children <5 years of age who recently engaged in stimulating activities with 
any household member over 15 years of age
CW.14 Percent of caregivers who agree that harsh physical punishment is an appropriate 
means of discipline or control in the home or school
HW.2 Percent of households able to access money to pay for unexpected household 
expenses
Source: Mbizvo et al. (2018) 
6.3.7 DAPP ZAMFAM SC Data Collection Summary 
After successfully conducting both Phases of field data collection to the 6 sampled districts and 
conducting KIIs in Lusaka, the Evaluation team interviewed the following respondents (Table 6): 
Table 6: Summary of MTE Respondents 
District Category Target Achieved Percent
Chibombo Household Questionnaires 111 114 103%
FGDs 2 3 150%
KIIs 6 15 250%
Kabwe Household Questionnaires 118 116 98%
FGDs 2 3 150%
KIIs 6 15 250%
Kapiri Household Questionnaires 157 100 64%
FGDs 2 3 150%
KIIs 6 12 200%
Mumbwa Household Questionnaires 95 103 108%
FGDs 2 3 150%
KIIs 6 12 200%
Livingstone Household Questionnaires 146 117 80%
FGDs 2 4 200%
KIIs 6 22 367%
Mazabuka Household Questionnaires 156 115 74%
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FGDs 2 3 150%
KIIs 6 16 267%
Overall Household Questionnaires 784 665 85%
FGDs 12 19 158%
KIIs 24 65 271%
Source: MTE Field Survey, 2019
As seen from Table 6, more FGDs and KIIs were interviewed than planned, so as to compensate 
for shortfall on caregiver respondents’ shortfall. 
6.3.8 Data Processing and Analysis 
Collected questionnaire data saved on the cloud - server was downloaded on a PC as a comma￾separated value (CSV) file and converted into an Excel format. Raw data was cleaned to remove 
any inconsistences. Data was then filtered to pick variables that were in line with the evaluation 
objectives. This data was further organised in an appropriate way for inputting into SPSS version 
23 for respective/required data analysis. Analysed data was produced in tabular SPSS Statistics 
Viewer output file format form. Required information was picked and used as needed. 
Data collected through the ODK was processed and analysed, generating MTE findings (values) 
which were compared with the benchmark values. Z - test was used to calculate statistical 
significance difference between the means. 
Qualitative data gleaned through KIIs, FGPs and direct observations was collated on common 
themes in line with the evaluation questions. See Appendix 10 for a Summary Report. Processed 
qualitative data was triangulated and cross- checked with processed caregivers/OVC data. This 
process assisted in validating and confirming MTE findings which were compared with benchmark 
values. 
For easy and convenient conducting of comparative analysis between benchmark values and MTE 
findings, both surveys’ results are shown in some of the tables and appendices. Benchmark values 
are shown in amber colour and MTE findings in green colour. 
6.3.9 Ethical Review 
a) Obtaining MTE Ethical Approvals 
In keeping up with the existing medical research ethical procedures and requirements in Zambia, 
PathMark Rural Development Consult submitted two separate applications to the Ministries of 
Community Development and Social Services and Health headquarters in Lusaka for MTE 
administrative consideration and approval. After about a fortnight, two separate approval letters 
were written and handed – over to PathMark Rural Development Consult team for survey use. 
Subsequently, PathMark Rural Development Consult, prepared prescribed MTE application and 
submitted it to ERES Converge Institutional Review Board (private body in Zambia that approves 
medical researches) for ethical review. Subsequently, ERES reviewed and approved the application. 
Page | 15 
6.4 Adjustments to the approved Scope of Work/Protocol 
The initial field visit plan was to visit 6 sampled project districts during October/November 2018, 
just before start of the rainy season. However, MTE assignment funds were made available in the 
first week of December, 2018. Inevitably, field data collection exercise was split into two phases. 
Phase one, covering Livingstone and Mazabuka districts, was conducted from 17 – 21 December 
2018. Thereafter, DAPP Zambia closed for Christmas break until 14 January 2019. Phase two, 
targeting Kabwe, Kapiri, Chibombo and Mumbwa districts was conducted from 15 - 25 January 
2019.
As the field data collection was undertaken during the rainy season, the season triggered serious 
operational challenges. Some of these challenges are enumerated in Table 7 below: 
Table 7: Some of the challenges and mitigation measures put in place during field work 
Challenges Mitigation measures
Some roads to sampled project areas and 
communities became impassable due to 
waterlogging, even for 4WD vehicles.
Substituting sampled project areas, villages and 
households which were not accessible with 
accessible ones. Efforts were made to ensure 
that replacements had same characteristics 
with inaccessible ones. In addition, the team 
managed to interview all available respondents.
As it was raining during field visit to Kapiri 
Mposhi and Kabwe districts, door – to – door 
interviews could not be conducted.
In order to meet the district sample targets, the 
Evaluation team had to work late in the 
evening to ensure that all available respondents 
were interviewed.
The Evaluation team purchased rain protective 
clothing (rain coats, umbrellas, plastic file 
carriers etc) for use during field visit
Most project beneficiaries especially care 
givers, children care volunteers, community 
health workers earn their living through 
seasonal crop farming. Hence, most of these 
targeted key respondents were not available for 
MTE meeting because they had gone out to 
work their crop fields
Exercised expediency in mobilising sampled 
project populations (project areas and villages) 
through project leaders, community mobilisers 
and CAG Co ordinators. PathMark assisted 
“some district contact persons” with mobile 
phone talk time to call selected respondents.
Schools had closed for end - of year holiday. 
Some teachers and pupils (especially children 
aged 10 – 17 years) could hardly be met as they 
had gone away for holiday. In fact, this 
situation resulted into the Evaluation team
interviewing more children (aged 0 – 9 years) 
than children (aged 10 – 17 years) 
Requested DAPP field office staff to inform 
and mobilise targeted project communities 
before Evaluation team visit.
Besides Livingstone, where DAPP district staff 
had informed and mobilized the project 
participants and other stakeholders 
beforehand, other project districts (Mazabuka, 
Kabwe and Kapiri) mobilized project 
Maximising on FGDs and KII gathering more 
data to compliment caregiver - household 
gathered data. Hence, more respondents than 
planned were interviewed through FGDs and 
Page | 16 
participants when the Evaluation team had 
arrived in the district. This delayed 
commencement of intra – district field data 
collection.
KII and data gathered used to compliment, 
cross – check and triangulate caregiver data.
There was immense duplication of interviews 
per household (Care giver, children aged 0 –
9 years and children aged 10 – 17 years). The 
questionnaire, especially for care giver, 
contained culturally -sensitive questions which 
consumed a lot of time to explain to the 
respondents. In fact, the entire household, if 
interviewed with all three questionnaires, took 
about 90 minutes to complete.
The research assistants’ orientation exercise 
was thorough and effective. It focussed on use 
of Mobile to Web – based Toolkit highlighting 
both the theoretical and practical components.
In addition, contingent plan effected (purchase 
of smart phones and power banks) worked 
very well
Long inter – household distances with some 
households lying about 3km apart. These long 
distances resulted in loss of time by the 
Evaluation team to reach targeted 
respondents.
Where possible and convenient, requested 
local project staff to assemble target 
respondents at a central place for interviews. 
Then, the team leader and assistant, visited a 
few accessible homesteads to check and verify 
their erected project facilities.
6.5 Procedures employed to achieve high data quality 
In order to enhance data quality, besides the measures effected as enumerated under section 6.6, 
the following steps were taken: 
i. Engagement of highly qualified and experienced research assistants (trained up to 
University Degree level). Five of the research assistants were University of Zambia School 
of Medicine graduates. 
ii. The research assistants were taken through a rigorous 3-day orientation programme which 
covered classroom training and pre- testing of data collection tools and ODK in project 
areas of Chibombo district. 
iii. A Mobile-to-Web based Data Collection Tool kit was developed for quantitative data 
collection using smart phones. This eliminated errors which occur at entering/re-entering 
data in computers when traditional paper-based questionnaires are used. 
iv. To ensure non - loss of collected data, power banks were acquired for use in the field in an 
event that batteries of some smart phones got drained during data collection. 
v. Collected data was cleaned before subjecting it to analysis using SPSS version 23 
vi. Triangulation, cross – checking and interrogation of data gathered through different 
collection tools (questionnaire, FGD and KIIs) 
vii. During field data collection exercise in all sampled 6 project districts, the Evaluation team 
used to convene daily evening review meetings. These meetings helped to exchange field 
experiences and resolving challenges. In addition, daily check of gathered data was 
conducted by the field supervisor. 
Page | 17 
6.6 Limitations of design and analytic methods 
Caregiver/OVC questionnaires used were adopted from the Benchmark report. Some respondents 
were finding problems in answering questions due to their sensitive nature e.g. “In the last 12 months, 
has this household experienced death of any household member? If indeed a person died recently, it invoked 
sad memories of their deceased loved ones. Inevitably, the research assistants had to spend more 
time with respondents to try and convince them answer such sensitive questions.
During ODK programming, some questions were not validated. This in some instances resulted 
in research assistants missing out on collecting some data. Hence, the Evaluation team had to rely 
on other data collection tools – FGDs, KIIs and direct observations to provide the missing data.
As the field data collection exercise was conducted at the peak of the rainy season, some sampled 
project areas and households could not be reached due to impassable roads. However, inaccessible 
respondents were replaced with those who could be reached and had similar characteristics.
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7 FINDINGS AND DISCUSSIONS 
7.1 Sample Characteristics 
As shown in Table 8 below; in all 6 sampled project districts, 27 operational areas were visited. A 
total of 665 caregivers/ households, taking care of 341 children aged 0- 9 years and 139 children 
aged 10 – 17 years were interviewed. In addition, 19 FGDs involving 10 participants each and 65 
KIIs were conducted. 
Table 8: Sample characteristics
Element Sample size
Districts 6
Operational Areas 27
Households 665
Children (0-9 years) 341
Children (10-17 years) 139
FGDs 19
Participants per FGD 10
KII 65
Source: MTE Field Survey, 2019 
7.2 ZAMFAM Result Areas 
7.2.1 Expected Result 1 
Resilience of households to care for children and adolescents living with, affected by 
and/or vulnerable to HIV measurably increased. 
Result 1 was addressed using data gathered from “caregiver and household demographic 
characteristics”, “PEFPAR MER Essential Indicators, by age group, residence, and sex” and 
“PEFPAR MER Core Indicators, by age group, residence and sex”. 
a) Caregiver and household demographic characteristics 
Caregivers by gender: At benchmark stage, 91.4% of the households/caregivers interviewed 
were females and 8.6% were males. At MTE stage, 86.4% of the sampled households/caregivers 
interviewed were females and 13.6% were males. These results were statistically significant at z = 
3.848, p = <.001 (Figure 1 and Appendix 4). The results were also supported by data from FGDs 
where participants indicated that more males were taking up caregiving responsibilities. 
Furthermore, the Evaluation team observed that there was a considerable number of male 
participants in FGDs who also participated actively in the discussions. In between these two 
Page | 19 
surveys, the number of male caregivers had increased by 5% and this may be attributed to 
ZAMFAM SC gender promotion activities. Appendix 4 provides more data on caregivers by 
gender. 
Figure 1: Percentage of OVC caregiving by gender
Source: MTE Field Survey 2019 and Mbizvo, et al. 2018
Mean age of caregivers: At benchmark stage, the mean age of caregivers was 43 years. At MTE 
stage, the mean age rose to 44 years. Differences in the mean age were statistically significant at z 
= -4.191, p = <.001 (Figure 2 and Appendix 4). It means that older caregivers were getting more 
involved in OVC caregiving compared to previous years when there were many young people 
taking care of the OVC. These results were supported by what caregivers reported during the MTE 
FGDs. 
91.4%
8.6%
86.4%
13.6%
0%
20%
40%
60%
80%
100%
120%
Female Male Female Male
Benchmark MTE
Percentage of respondents
Gender & Project Stage
*
***
Page | 20 
Figure 2: Mean age of OVC caregivers
Source: MTE Field Survey 2019 and Mbizvo, et al. 2018
Education of caregivers: The mean years of schooling increased from 5.9 at benchmark stage to
7.9 at MTE and were statistically significant at z = 17.002, p < .001 (Table 8 and Appendix 4). In 
addition, the percentage of caregivers who could not read a sentence, significantly dropped from 
33.4 % at benchmark stage to 16.0% at MTE stage (z = -9.851, p <.001). 
ZAMFAM SC puts emphasis on education of project population for both children and adults. This 
was confirmed from direct observations made by the Evaluation team when members found that 
teaching materials had been distributed to schools and CAGs. Furthermore, collaborating data 
obtained from both FGDs and KIIs presented the same picture. (i.e. ZAMFAM SC Project was 
placing great emphasis on education for both young and elderly people). 
Table 9: Information about caregivers and households 
Variable Benchmark (%) MTE (%) Statistics
Education
• Years of schooling 5.9 7.9 z = 17.002, p < .001
• Can’t read sentence 33.4 14.0 z = -9.851, p <.001
Wealth mean (count type of 19 
items)
4.9 4.2 z = -495.376, p < 
.001
Livestock ownership 47.7 50.7 z = -2372.325, p < 
.001
Source: MTE Field Survey 2019 and Mbizvo, et al. 2018
Wealth mean (Count of 19 items): At benchmark stage, the wealth mean was 4.9% and it 
dropped to 4.2% at MT stage. The drop was significant at z = -495.376, p < .001 (Table 8 and 
45
43
41 42 43 44 45 46
MTE
Benchmark
Mean age (years)
Project Stage
***
Page | 21 
Appendix 4). The drop-in wealth mean count was minimal and the difference could be attributed 
to the context in which the benchmark was conducted compared to the MTE. For example, the 
BM includes items like boats which are necessary in water bodies while the MTE covered areas 
where there were no water bodies. 
Own livestock: At benchmark stage, 47.7% owned livestock and increased to 50.7% at MTE. 
This was significant at z = -2372.325, p < .001 (Table 8 and Appendix 4). The project had been 
providing goats and chickens through 
“pass – on” arrangement (Figure 3). 
This practice resulted in a steady 
increase of livestock numbers at 
household level. Pass-ons were 
conducted together with training of the 
recipients in general animal husbandry. 
During FGDs and KIIs, the 
participants reported that livestock 
numbers were going up and that 
ZAMFAM SC Project was supporting 
households on best practices in rearing 
of goats and chickens. 
Figure 3: Caregivers receiving goats as pass - on gifts 
Photo: Courtesy of David Mwale 2019, District Coordinator, Chibombo District, Kabwe 
b) PEFPAR MER Essential Indicators, by age group, residence, and sex 
NC.1 Caregiver knows child’s HIV status
At benchmark stage, 52.8% of caregivers knew about HIV status of the OVCs who were under 
their care. At MTE stage, the percentage increased to 98.6%. These results were significantly 
different at z = 51.198, p < .001 (Tables 9, 10 and Appendix 6). 
During FGDs, most of the participants had indicated that there were a lot of sensitisation activities 
about issues surrounding HIV and AIDS, in particular VCT promoted under ZAMFAM project. 
These activities had raised participants’ level of awareness about HIV and AIDS and they were 
keen on knowing HIV status of their children. The positive result on Caregiver knows HIV status 
of children resonates with both the Ministry of Health National Health Strategy as well as National 
HIV and AIDS Strategy Framework 2017 – 2021 goals. These strategic documents were 
formulated on UNAIDS 90 – 90 – 90 Fast Track Targets on epidemic elimination. The Caregiver 
knows the child HIV status which is the first indicator on the fast-track targets continuum. 
Page | 22 
Table 10: PEFPAR MER Essential Indicators for OVCs and household level
Indicator BM 
(%)
MTE 
(%)
Statistics Projection 
to 2020 (%)
NC.1 Caregiver knows child’s HIV 
status
52.8 98.6 z = 51.198, p < .001 68.8
HW.2 Household able to access money 
to pay for unexpected household 
expenses
50.9 58.5 z = 2.269, p = 0.023 11.8
CW.14 Caregiver agrees harsh 
punishment is appropriate 
discipline for the child
38.5 32.4 z = -0.939, p = 0.348 -12.6
Source: MTE Field Survey 2019 and Mbizvo, et al. 2018
HW.2 Household able to access money to pay for unexpected households.
The percentage of households that indicated they were able to access money to pay for unexpected 
household expenses was 50.9% at benchmark stage. It increased to 58.5% at MTE stage. 
Percentage mean differences were significant, z = 2.269, p = 0.023 (Tables 9, 10 and Appendix 6). 
During FGDs and KIIs, it was revealed that disposable income at household level had increased 
as beneficiary households were able to access money to pay for unexpected expenses. It was 
explained that project interventions such as savings internal lending committees, entrepreneurship 
training spurred increase in household income. FGDs participants mentioned that they participated 
in gardening, through which they grew vegetables (rape, cabbage, onion, impwa etc). The produce 
was retained for household consumption and the surplus sold to realise cash income. In addition, 
the participants reported that they had received “pass-ons” (legume crops, goats and chicken in 
rural areas) and cash (loan) in urban areas. In Mazabuka, some beneficiary households showed the 
Evaluation team the small groceries they had invested in their cash loans. 
CW.14 Caregiver agrees harsh punishment is appropriate discipline for the child. 
At benchmark stage, the percentage of 
caregivers agreeing to harsh punishment 
is appropriate discipline for the child was 
38.5%. The percentage dropped to 32.4% 
at MTE stage. The drop was not 
statistically significant at z = -0.939, p = 
0.348 (Tables 9, 10 and Appendix 6). This 
means that there was still an appreciable 
number of respondents who believed that 
harsh punishment was appropriate way to discipline the child. 
Page | 23 
Table 11: PEFPAR MER Essential Indicators, by age group, residence, and sex FY18 
0-4
n = 417
5-9
n = 943
10-14
n =1,129 
15-17
n= 422
Total
n = 2911
Total rural
n = 1,123
Total urban
n = 1,788
Total female
n = 1,435
Total male
n = 1,476
% CI % CI % CI % CI % CI % CI % CI % CI % CI
OVC
NC.1 Caregiver knows child’s HIV status (n=2,791)
 No 38.4 33.3–43.8 43.5 39.0–48.1 52.9 48.5–57.3 48.3 42.3–54.3 47.2 43.6–50.9 52.8 47.6–58.0 44.0 39.1–49.0 48.5 44.5–52.5 46.0 41.9–50.2
 Yes 61.6 56.2–66.7 56.5 51.9–61.0 47.1 42.7–51.5 51.7 45.7–57.7 52.8 49.1–56.4 47.2 42.0–52.4 56.0 51.0–60.9 51.5 47.5–55.5 54.0 49.8–58.1
 No (n = 418) 1.0 0.0-2.1 0 --- 1.9 0.6-3.2 0 --- 1.6 0.8-2.4 1.6 -0.2-3.5 0.5 -0.5-1.6 1.7 0.4-3.1 1.7 0.4-3.1
 Yes (n = 418) 99.0 97.9-100 100 --- 98.1 96.8-99.4 100 --- 98.6 97.6-99.2 98.4 96.5-100.2 99.5 98.4-100.5 98.3 96.9-99.6 98.3 96.9-99.6
CW.1 Undernourished (n = 2,791)
 No 96.3 93.8–97.8 — — — — — — 96.3 93.8–97.8 96.8 91.9–98.8 95.9 92.6–97.7 96.7 93.3–98.4 95.9 92.1–98.0
 Yes 3.7 2.2–6.2 — — — — — — 3.7 2.2–6.2 3.2 1.2–8.1 4.1 2.3–7.4 3.3 1.6–6.7 4.1 2.0–7.9
 No (n = 82) 88.6 79.1-94.1 --- --- --- --- --- --- 86.6 79.1-94.1 83.3 64.3-102.4 94.4 82.7-106.2 88.9 72.8-105 94.4 82.7-106.2
 Yes (n = 82) 13.4 5.9-20.9 --- --- --- --- --- --- 13.4 5.9-20.9 16.7 -2.4-35.7 5.6 -6.2-17.3 11.1 -5.0-27.2 5.6 -6.2-17.3
CW.4 Too sick to participate in daily activities (n = 2,791)
 No 56.6 51.2–61.9 67.0 63.6–70.3 63.1 60.1–66.1 63.6 58.2–68.6 63.5 61.3–65.7 63.4 60.9–65.8 63.6 60.3–66.7 63.6 61.2–65.9 63.5 60.5–66.3
 Yes 43.4 38.1–48.8 33.0 29.7–36.4 36.9 33.9–39.9 36.4 31.4–41.8 36.5 34.3–38.7 36.6 34.2–39.1 36.4 33.3–39.7 36.4 34.1–38.8 36.5 33.7–39.5
 No (n = 470) 79.5 71.9-87.1 75.9 67.8-83.9 100 --- 100 --- 87.0 84.0-90.1 100 --- 100 --- 100 --- 100 ---
 Yes (n = 470) 20.5 12.9-28.1 24.1 16.1-32.2 0 --- 0 --- 13.0 9.9-16.0 0 --- 0 --- 0 --- 0 ---
CW.9 Has a birth certificate (n = 2,791)
 No 76.2 70.4–81.3 88.8 85.8–91.2 94.8 93.1–96.1 96.1 93.7–97.6 90.5 88.5–92.1 87.3 83.4–90.4 92.2 89.9–94.0 91.6 89.6–93.2 89.4 86.8–91.5
 Yes 23.8 18.7–29.6 11.2 8.8–14.2 5.2 3.9–6.9 3.9 2.4–6.3 9.5 7.9–11.5 12.7 9.6–16.6 7.8 6.0–10.1 8.4 6.8–10.4 10.6 8.5–13.2
 No (n = 33) 72.7 56.7-88.8 66.7 49.7-83.6 78.8 64.1-93.5 78.8 64.1-95.5 72.7 56.7-88.8 69.7 53.1-86.2 75.8 60.3-91.2 75.8 60.3-91.2 72.7 56.7-88.8
 Yes (n = 33) 27.3 11.2-43.3 33.3 16.4-50.3 21.2 6.5-35.9 21.2 6.5-35.9 22.2 18.4-26.0 30.3 13.8-46.9 24.2 8.8-39.7 24.2 8.8-39.7 27.3 11.2-43.3
CW.11 Regularly attends school (n = 2,791)
 No — — 69.3 65.4–72.8 59.2 55.3–63.0 58.5 52.2–64.5 62.8 59.8–65.8 64.3 60.6–67.9 62.1 57.9–66.1 62.9 59.7–66.1 62.8 59.0–66.4
 Yes — — 30.7 27.2–34.6 40.8 37.0–44.7 41.5 35.5–47.8 37.2 34.2–40.2 35.7 32.1–39.4 37.9 33.9–42.1 37.1 33.9–40.3 37.2 33.6–41.0
Page | 24 
 No (n = 152) --- --- 17.8 11.6-23.9 21.3 12.1-30.4 24.1 7.6-40.7 19.5 14.7-24.4 29.6 11.2-48.0 25.9 8.3-43.6 33.3 14.3-52.3 22.2 5.5-39.0
 Yes (n = 152) --- --- 82.2 76.1-88.4 78.8 69.6-87.9 75.9 59.3-92.4 80.5 75.6-85.3 70.4 52.0-88.8 74.1 56.4-91.7 66.7 47.7-85.7 77.8 61.0-94.5
CW.12 Progressed in school during the last year (n=1,854)
 No — — 46.8 41.3–52.5 10.0 8.3–12.0 18.8 15.0–23.2 21.1 19.1–23.3 23.1 20.0–26.5 20.0 17.5–22.9 21.0 18.4–23.8 21.2 18.2–24.7
 Yes — — 53.2 47.5–58.7 90.0 88.0–91.7 81.2 76.8–85.0 78.9 76.7–80.9 76.9 73.5–80.0 80.0 77.1–82.5 79.0 76.2–81.6 78.8 75.3–81.8
 No (n = 160) --- --- 35.0 22.6-47.4 30.3 13.8-46.9 5.0 -5.5-15.5 0.6 -0.5-1.9 3.0 -1.2-7.2 50.0 36.2-63.8 3.6 -0.5-7.7 14.9 6.6-23.2
 Yes (n = 160) --- --- 65.0 52.6-77.4 69.7 53.1-86.2 95.0 84.5-105.5 81.5 98.1-100.6 97.0 92.8-101.2 50.0 36.2-63.8 96.4 92.3-100.5 85.1 76.8-93.4
CW.13 Children <5 years of age who recently engaged in stimulating activities with any household member over 15 years of age (n=328) *
 No 6.8 4.3–10.6 — — — — — — 6.8 4.3–10.6 8.1 4.5–14.0 5.7 2.8–11.5 7.4 4.2–12.9 6.2 3.5–10.8
 Yes 93.2 89.4–95.7 — — — — — — 93.2 89.4–95.7 91.9 86.0–95.5 94.3 88.5–97.2 92.6 87.1–95.8 93.8 89.2–96.5
 No (n = 8) 31.3 5.0-57.5 --- --- --- --- --- --- 31.3 5.0-57.5 35.7 7.0-64.5 38.9 -24.4-102.1 26.7 -18.7-72.0
 Yes (n = 8) 68.7 42.5-95.0 --- --- --- --- --- --- 68.7 42.5-95.0 64.3 35.5-93.0 61.1 -2.1-124.4 73.3 28.0-118.7
Household level indicators
HW.2 Household able to access money to pay for unexpected household expenses (n=1,098)
 No — — — — — — — — 49.5 45.3–53.7 38.9 32.1–46.1 54.9 49.6–60.0 — — — —
 Yes — — — — — — — — 50.5 46.3–54.7 61.1 53.9–67.9 45.1 40.0–50.4 — — — —
 No (n = 20) --- --- --- --- --- --- --- --- 60.0 36.5-83.5 60.0 36.5-83.5 45.0 21.1-68.9 --- --- --- ---
 Yes (n = 20) --- --- --- --- --- --- --- --- 58.5 35.5-63.5 40.0 16.5-63.5 55.0 31.1-78.9 --- --- --- ---
CW.14 Caregiver agrees harsh punishment is appropriate discipline (n=1,098)
 No — — — — — — — — 61.5 58.9–64.1 56.4 51.9–60.9 64.4 61.3–67.5 — — — —
 Yes — — — — — — — — 38.5 35.9–41.1 43.6 39.1–48.1 35.6 32.5–38.7 — — — —
 No (n = 319) --- --- --- --- --- --- --- --- 69.9 64.8-75.0 69.6 64.5-74.7 67.4 62.2-72.6 --- --- --- ---
 Yes (n = 319) --- --- --- --- --- --- --- --- 32.4 25.0-35.2 30.4 25.3-35.5 32.6 27.4-37.8 --- --- --- ---
*Stimulating activities = Read books to a child, tell stories to a child, sing songs to a child, take child outside home, play with the child and name things/count/draw things with a child 
Source: MTE Field Survey 2019 and Mbizvo, et al. 2018
Page | 25 
c) PEPFAR MER Core Indicators, by age group, residence and sex
HW.1 Caregiver has basic support in 4 domains 
At benchmark stage, 46.9% of caregivers indicated that they had basic support in the 4 domains. 
At MTE stage, the percentage of caregivers who indicated that they had basic support in the 4 
domains increased to 76.2%. The difference in mean percentage were significant at z = -2157.958, 
p < .001 (Tables 11, 12 and Appendix 7). Findings were supported by information obtained from 
FGDs and KIIs where participants indicated that ZAMFAM SC had activities put in place to 
support caregivers in the 4 basic domains. Generally, ZAMFAM SC Project had a number of 
activities addressing issues relating to basic support to caregivers in the 4 domains. 
Table 12: PEFPAR MER Core Indicators
Indicator BM (%) MTE (%) Statistics Projection 
to 2020 (%)
HW.1 Caregiver has basic support in 4 
domains*
46.9 76.2 z = -2157.958, p < .001 49.5
HW.2 Household able to access money to 
pay for food related expenses
42.9 92.3 z = 35.044, p < .001 91.3
HW.2 Household able to access money to 
pay for school-related expenses
33.8 46.7 z = 7.227, p < .001 30.3
HW.3 Household food insecure (ever no 
food in past 4 weeks)
74.0 65.6 z = 6.881, p <.001 -9.0
*Domains of child development = Physical, social-emotional, cognitive, communicative-language and adaptive 
Source: MTE Field Survey 2019 and Mbizvo, et al. 2018
HW.2 Household able to access money to pay for food - related expenses 
The percentage of households/caregivers that were able to access money to pay for food - related 
expenses at benchmark stage was 42.9%. The percentage increased to 92.3% at MTE. The increase 
was significantly different at z = 35.044, p < .001 (Tables 11, 12 and Appendix 7). Households had 
been accessing money from their small businesses and other monetary related benefits such as 
money from SILC groups after sharing the profits. These money sources came out prominently 
during FGDs. 
HW.2 Household able to access money to pay for school-related expenses 
Money to pay for school-related expenses was accessed by 33.8% of households at benchmark 
stage. The percentage significantly rose to 46.7% at MTE with z = 7.227, p < .001 (Tables 11, 12 
and Appendix 7). During FGDs, caregivers said that chickens from the pass-ons were acting as 
banks where they were “locking their money” only to be accessed when need arose (like paying 
their children’s school requirements) through sale of chickens. Such initiatives of keeping money 
in liquid assets like chickens were brought out and discussed during ZAMFAM SC group trainings.
Page | 26 
Table 13: PEFPAR MER Core Indicators, by age group, residence and sex FY18
0-4
n = 417
5-9
n = 943
10-14
n =1,129 
15-17
n = 422
Total
n = 2911
Total rural
n = 1,123
Total urban
n = 1,788
Total female
n = 1,435
Total male
n = 1,476
% CI % CI % CI % CI % CI % CI % CI % CI % CI
OVC
CW.2 Diarrhoea in past 2 weeks 
 No 66.6 61.6–71.2 — — — — — — 66.6 61.6–71.2 67.1 60.1–73.4 66.2 59.1–72.6 66.7 60.1–72.7 66.5 58.7–73.5
 Yes 33.4 28.8–38.4 — — — — — — 33.4 28.8–38.4 32.9 26.6–39.9 33.8 27.4–40.9 33.3 27.3–39.9 33.5 26.5–41.3
 No (n = 48) 77.1 64.8-89.4 --- --- --- --- --- --- 85.3 81.5-89.1 83.3 72.4-94.3 75.0 62.3-87.7 81.3 69.8-92.7 77.1 64.8-89.4
 Yes (n = 48) 22.9 10.6-35.2 --- --- --- --- --- --- 14.7 10.9-18.5 16.7 5.7-27.6 25.0 12.3-37.7 18.8 7.3-30.2 22.9 10.6-35.2
CW.3 Fever in past 2 weeks
 No 56.8 50.9–62.5 — — — — — — 56.8 50.9–62.5 53.9 44.5–63.1 59.2 51.9–66.2 59.0 51.6–66.1 54.6 46.9–62.0
 Yes 43.2 37.5–49.1 — — — — — — 43.2 37.5–49.1 46.1 36.9–55.5 40.8 33.8–48.1 41.0 33.9–48.4 45.4 38.0–53.1
 No (n = 48) 64.6 50.5-78.6 --- --- --- --- --- --- 76.8 68.8-84.7 77.1 64.8-89.4 68.8 55.1-82.4 70.8 57.5-84.2 77.1 64.8-89.4
 Yes (n = 48) 35.4 21.4-49.5 --- --- --- --- --- --- 23.2 15.3-31.2 22.9 10.6-35.2 31.3 17.6-44.9 29.2 15.8-42.5 22.9 10.6-35.2
CW.5 Day without eating in last 4 weeks (Age 2 – 17, n = 2,819)
 No 76.5 70.5–81.6 68.7 64.5–72.5 75.4 71.8–78.7 74.4 69.9–78.5 73.1 70.3–75.8 77.2 72.7–81.1 70.9 67.2–74.4 75.4 72.0–78.5 70.9 67.7–74.0
 Yes 23.5 18.4–29.5 31.3 27.5–35.5 24.6 21.3–28.2 25.6 21.5–30.1 26.9 24.2–29.7 22.8 18.9–27.3 29.1 25.6–32.8 24.6 21.5–28.0 29.1 26.0–32.3
 No (n = 14) 92.9 77.4-108.3 71.4 44.4-98.5 85.7 64.7-106.7 78.6 54.-103.2 83.0 79.4-86.7 64.3 35.6-93.0 71.4 44.4-98.5 57.1 27.5-86.8 92.9 77.4-108.3
 Yes (n = 14) 7.1 -8.3-22.6 28.6 1.5-55.6 14.3 -6.7-35.3 21.4 -3.2-46.0 17.0 13.3-20.6 35.7 7.0-64.4 28.6 1.5-55.6 42.9 13.2-72.5 7.1 -8.3-22.6
CW.6 Fully immunized (Age 1 – 4, n = 390)
 No 47.0 42.3–51.7 — — — — — — 47.0 42.3–51.7 43.4 36.9–50.0 49.8 43.5–56.1 48.5 41.2–55.9 45.4 38.5–52.5
 Yes 53.0 48.3–57.7 — — — — — — 53.0 48.3–57.7 56.6 50.0–63.1 50.2 43.9–56.5 51.5 44.1–58.8 54.6 47.5–61.5
 No (n = 105) 0 --- --- --- --- --- --- --- 0 --- 0 --- 0 --- 0 --- 0 ---
 Yes (n = 105) 100 --- --- --- --- --- --- --- 100 --- 100 --- 100 --- 100 --- 100 ---
CW.7 Has basic shelter
 No — — — — — — — — 12.5 10.9–14.3 14.8 12.1–18.0 11.2 9.2–13.5 — — — —
 Yes — — — — — — — — 87.5 85.7–89.1 85.2 82.0–87.9 88.8 86.5–90.8 — — — —
 No (n = 321) --- --- --- --- --- --- --- --- 19.4 16.4-22.4 20.2 15.8-24.7 18.1 13.8-22.3 --- --- --- ---
 Yes (n = 321) --- --- --- --- --- --- --- --- 80.6 77.6-83.6 79.8 75.3-84.2 81.9 77.7-86.2 --- --- --- ---
CW.8 Child has basic support in 4 domains*
 No — — — — 56.1 52.4–59.8 64.1 59.7–68.2 58.3 55.1–61.5 58.9 52.7–64.8 58.1 54.4–61.7 60.3 56.2–64.1 56.5 51.9–60.9
 Yes — — — — 43.9 40.2–47.6 35.9 31.8–40.3 41.7 38.5–44.9 41.1 35.2–47.3 41.9 38.3–45.6 39.7 35.9–43.8 43.5 39.1–48.1
 No (n = 83) --- --- --- --- 0 --- 0 --- 0 --- 0 --- 0 --- 0 --- 0 ---
 Yes (n = 83) --- --- --- --- 100 --- 100 --- 100 --- 100 --- 100 --- 100 --- 100 ---
CW.10 Currently enrolled in school
Page | 27 
 No — — 34.4 30.3–38.9 11.4 9.2–14.1 24.6 21.0–28.7 22.3 19.8–25.1 21.8 18.0–26.0 22.6 19.4–26.2 21.3 18.5–24.4 23.3 20.1–26.9
 Yes — — 65.6 61.1–69.7 88.6 85.9–90.8 75.4 71.3–79.0 77.7 74.9–80.2 78.2 74.0–82.0 77.4 73.8–80.6 78.7 75.6–81.5 76.7 73.1–79.9
 No (n = 151) --- --- 6.0 2.1-9.8 0 --- 0 --- 3.4 1.2-5.7 2.8 -0.4-5.9 3.9 0.8-7.0 1.1 -1.1-3.2 5.4 0.7-10.2
 Yes (n = 151) --- --- 94.0 90.2-97.9 100 --- 100 --- 96.6 94.3-98.8 97.2 94.1-100.4 96.1 93.0-99.2 98.9 96.8-101.1 94.6 89.8-99.3
Household level indicators
HW.1 Caregiver has basic support in 4 domains*
 No — — — — — — — — 53.1 50.2–56.0 53.8 49.3–58.1 52.7 48.9–56.5 — — — —
 Yes — — — — — — — — 46.9 44.0–49.8 46.2 41.9–50.7 47.3 43.5–51.1 — — — —
 No (n = 311) --- --- --- --- --- --- --- --- 23.8 19.0-28.6 15.4 11.4-19.5 23.5 18.7-28.2 --- --- --- ---
 Yes (n = 311) --- --- --- --- --- --- --- --- 76.2 71.4-81.0 84.6 80.5-88.6 76.5 71.8-81.3 --- --- --- ---
HW.2 Household able to access money to pay for food related expenses (n = 1,812)
 No — — — — — — — — 57.1 52.2–61.8 47.6 39.7–55.6 62.1 55.8–68.0 — — — —
 Yes — — — — — — — — 42.9 38.2–47.8 52.4 44.4–60.3 37.9 32.0–44.2 — — — —
 No (n = 323) --- --- --- --- --- --- --- --- 7.7 4.8-10.7 6.2 3.5-8.8 5.0 2.6-7.3 --- --- --- ---
 Yes (n = 323) --- --- --- --- --- --- --- --- 92.3 89.3-95.2 93.8 91.2-96.5 95.0 92.7-97.4 --- --- --- ---
HW.2 Household able to access money to pay for school-related expenses (n=1,412)
 No — — — — — — — — 66.2 61.8–70.3 58.9 51.6–65.7 70.8 65.2–75.8 — — — —
 Yes — — — — — — — — 33.8 29.7–38.2 41.1 34.3–48.4 29.2 24.2–34.8 — — — —
 No (n = 199) --- --- --- --- --- --- --- --- 53.3 46.3-60.3 47.2 40.2-54.2 53.8 46.8-60.8 --- --- --- ---
 Yes (n = 199) --- --- --- --- --- --- --- --- 46.7 39.7-53.7 52.8 45.8-59.8 46.2 39.2-53.2 --- --- --- ---
HW.3 Household food insecure (ever no food in past 4 weeks)
 No — — — — — — — — 26.0 22.7–29.6 35.5 29.1–42.5 20.6 17.1–24.6 — — — —
 Yes — — — — — — — — 74.0 70.4–77.3 64.5 57.5–70.9 79.4 75.4–82.9 — — — —
 No (n = 320) --- --- --- --- --- --- --- --- 34.4 29.1-39.6 49.7 44.2-55.2 35.0 29.7-40.3 --- --- --- ---
 Yes (n = 320) --- --- --- --- --- --- --- --- 65.6 60.4-70.9 50.3 44.8-55.8 65.0 59.7-70.3 --- --- --- ---
*Domains of child development = Physical, social-emotional, cognitive, communicative-language and adaptive 
Source: MTE Field Survey 2019 and Mbizvo, et al. 2018
Page | 28 
HW.3 Household food insecure (ever no food in past 4 weeks) 
At benchmark stage, 74.0% of households agreed that they ever had no food in past 4 weeks. At 
MTE, a positive development was noted where the percentage of households who were food 
insecure dropped to 65.6%. The drop was significant at z = 6.881, p <.001 (Tables 11, 12 and 
Appendix 7). During FGDs and direct observation by Evaluation team, it was noted that most 
households visited had become active in the back-yard gardens teeming with a variety of crops 
growing. Households with small back 
yards or no back yards (especially in 
urban areas) were growing their 
vegetables in disused contains. Other 
households had poultry which they got 
as “pass-on” gifts (Figure 4). 
Deliberations from FGDs reviewed 
that knowledge on food security was 
passed-on to the caregivers by 
ZAMFAM SC Project staff during 
training sessions. 
Figure 4: Poultry from pass-on
Phots: © Phillip Chikasa, PathMark Rural Development Consult, Lusaka 
7.2.2 Expected Result 2 
Child wellbeing status measurably improved due to provision and accessing of quality care 
and support services 
a) PEPFAR MER Essential Indicators, by age group, residence, and sex
CW.1 Undernourished: A MUAC tape was used (Figure 5) to capture data on undernourishment 
for children aged 0-5 years. All the children that 
measured less than 125mm, as specified in 
PEPFAR guidelines, were undernourished. 
At benchmark stage, undernourishment was at 
3.7%. At MTE, undernourishment was at 
13.4%. The differences in percentages of 
undernourishment at benchmark stage and the 
MTE were significant, z = -48.733, p < .001
(Tables 13,10 and Appendix 6).
Figure 5: MUAC tape put to practice in undernourishment data capture 
Photo: Courtesy of DAPP Promotion Team, Zambia 
Page | 29 
According to the 2013 – 14 ZDHS, 40% of children Under 5 were stunted, 6% were wasted and 
15% were underweight. The MUAC tape measurement taken during both benchmark and MTE 
surveys speak more to underweight. The undernourishment value of 13.4% recorded during MTE 
is in closer sync with ZDHS’s underweight of 15%. On the basis of the ZDHS and MTE result 
values comparison, it is evident that there is a reduction in undernourishment among the children 
under 5 in the sampled project districts. ZAMFAM with its child wellbeing activities (especially 
nutrition – related activities) has contributed to the recorded reduction in undernourishment 
among the children in the project areas. 
Table 14: PEPFAR MER Essential Indicators
Indicator BM 
(%)
MTE 
(%)
Statistics Projection 
to 2020 (%)
CW.1 Undernourished 3.7 13.4 z = -48.733, p < .001 207.9
CW.9 Has a birth certificate 9.5 22.2 z= -5.536, p< .001 106.0
CW.11 Regularly attends school 37.2 80.5 z = -12.012, p = < .001 92.3
CW.12 Progressed in school during the last year 78.9 81.5 z= -2797.017, < .001 2.6
CW.13 Children <5 years of age who recently engaged 
in stimulating activities with any household 
member over 15 years of age*
93.2 60.0 z = -419.001, p < .001 -28.3
* = Read books to a child, tell stories to a child, sing songs to a child, take child outside home, play with the child and 
name things/count/draw things with a child 
Source: MTE Field Survey 2019 and Mbizvo, et al. 2018
CW.9 Has a birth certificate: At benchmark stage, the percentage of children with birth 
certificates was 9.5%, it rose to 22.2% at MTE. There were significant differences in percentages 
at BM and MTE z= -5.536, p< .001 (Tables 13,10 and Appendix 6). This positive change (increase 
in obtaining birth certificate) may be attributed to ZAMFAM awareness activities on the 
importance of obtaining birth certificates).
In Zambia, issuance of a birth certificate is a legal requirement for children. PEPFAR also considers 
birth certificate a critical indicator of the rights of the child and confirming their right to access 
public services from the government such as health and education. 
CW.11 Regularly attends school: The percentage of pupils regularly attending school was 37.2% 
at benchmark stage. The percentage rose to 80.5% at MTE and results were significantly different 
at z = -12.012, p = < .001 (Tables 13,10 and Appendix 6). Interventions being advanced by 
ZAMFAM to ensuring that pupils were attending classes on regular basis were yielding positive 
results. This information was supported by submissions from caregivers during FGDs and 
augmented by evidence gathered from school authorities during KIIs.
Page | 30 
CW.12 Progressed in school during the last year:
At benchmark stage, percentage total/overall progression in school during the last year was 78.9%. 
At MTE, the percentage significantly increased (z= -2797.017, < .001) to 81.5% (Tables 13,10 and 
Appendix 6). The increase is linked to interventions put in place by ZAMFAM SC Project which 
were encouraging pupils to be in school such as increased support by Caregivers, implementing 
the go - back to school campaign and provision of teaching materials to schools. The increase was 
also supported by information obtained from both FGDs and KIIs which was praising ZAMFAM 
SC Project about the good works done by the project through its project staff. The good works 
included provision of desks, books and teaching charts to schools, conducting awareness sessions 
with youth and kids’ clubs on a range of topics as guided by the DAPP ZAMFAM SC Youth Club 
Program Manual.
CW.13 Children <5 years of age who recently engaged in stimulating activities with any 
household member over 15 years of age: 
Children less than 5 years of age, who recently 
engaged in stimulating activities (stimulating 
activities refer to reading books to a child, telling stories to 
a child, singing songs to a child, taking child outside home, 
Playing with the child and naming/counting/drawing 
things with a child) with any household member 
over 15 years of age stood at 93.2% at benchmark 
stage. The percentage dropped to 60% at MTE 
time. Results were statistically significant at z = -
419.001, p < .001 (Tables 13,10 and Appendix 6).
The reason for the drop could be due to the 
period the MTE was conducted. Most of the 
older household members were engaged in 
farming activities at the time. This left younger 
children to be stimulated by fellow children 
below the age of 15 years in some cases (Figure 
6).
Figure 6: Young children being stimulated by older ones 
Photo: Courtesy of David Mwale 2019, District Coordinator, Chibombo District, Kabwe 
b) PEPFAR MER Core Indicators, by age group, residence and sex
CW.2 Diarrhoea in past 2 weeks: The percentage of diarrhoeal cases was 33.4% at benchmark 
stage. The percentage dropped to 14.7% at MTE. The results were statistically significant at z = -
6.296, p = < .001 (Tables 14, 12 and Appendix 7). Reduction in the number of diarrhoeal cases 
was attributed to WASH activities implemented by the ZAMFAM SC Project and partner staff. 
During FGDs, caregivers said that they had been taught about proper disposal of kitchen and other 
household solid wastes, use of toilets when defecating and the importance of having a toilet. 
Page | 31 
Washing hands using tip tap with either soap or ash after using the toilet. Washing hands before 
and after eating. Importance of having a dish drying rack. Keeping homesteads clean and general 
personal body hygiene. According to the FGDs participants, teachings from the ZAMFAM SC 
Project on WASH greatly contributed to the reduction of diarrhoea cases. Staff from health centres, 
although they did not provide statistics due to ethical issues, confirmed that there was a steady 
decline in diarrhoea and diarrhoeal - related cases treated at their health centres. 
Table 15: PEFPAR MER Core Indicators
Indicator BM 
(%)
MTE 
(%)
Statistics Projection 
to 2020 (%)
CW.2 Diarrhoea in past 2 weeks 33.4 14.7 z = -6.296, p = < .001 -44.4
CW.3 Fever in past 2 weeks 43.2 23.2 z = -3.848, p = < .001 -36.7
CW.5 Day without eating in last 4 
weeks
26.9 17.0 z = -4.558, p < .001
-29.2
CW.6 Fully immunized (Age 1 – 4) 53.0 100 z = -7353840.488, p < .001 70.3
CW.7 Has basic shelter 87.5 80.6 z = -5620.487, p < .001 -6.3
CW.8 Child has basic support in 4 
domains*
41.7 100 z = -181995.253, p < .001
110.9
CW.10 Currently enrolled in school 77.7 96.6 z = 13.445, p < .001 19.3
*Domains of child development = Physical, social-emotional, cognitive, communicative-language and adaptive 
Source: MTE Field Survey 2019 and Mbizvo, et al. 2018
CW.3 Fever in past 2 weeks: At benchmark stage, 43.2% had fever in the past 2 weeks. At MTE, 
the percentage of children significantly dropped to 23.2% (z = -3.848, p = < .001). (Tables 14, 12 
and Appendix 7). Results were supported by information gathered during FGDs where participants 
indicated that most of the OVCs were sleeping under mosquito nets, hence reducing incidences of 
malaria cases, one of the diseases causing fever in human beings. Awareness creation and teachings 
about the importance of sleeping under a mosquito net being promoted by ZAMFAM SC Project 
staff in collaboration with CHWs and health centre staff. Furthermore, confirmation on reduced 
incidences of fever was made by staff at health centres during KIIs. Here again, statistics on fever 
cases could not be availed to the Evaluation team by health centre staff due to medical 
confidentiality of patients’ information. 
CW.5 Day without eating in last 4 weeks: At benchmark stage, 26.9% of the respondents had 
agreed that OVCs had spent a day without eating in the last 4 weeks. At MTE, 17.0% of the 
respondents said that OVCs had spent a day without eating in the last 4 weeks. The drop from 
26.9% at benchmark stage to 17.0% at MTE was statistically significant at z = -4.558, p < .001 
(Tables 14, 12 and Appendix 7). The positive development was as a result of interventions put in 
Page | 32 
place by the ZAMFAM SC Project aimed at alleviating hunger in the project areas. Information 
from FGDs showed that incidences of OVCs going hungry for days had been minimised as 
households were at least having something to eat in one way or another. Backyard gardens, poultry 
rearing and small businesses were assisting in household’s food provisions. However, as reported 
under CW 1. Undernourishment for under 5 children was rife in some households, especially 
during the lean period (November – March) when food was scarce. 
CW.6 Fully immunized (Age 1 – 4): At benchmark stage, the percentage of OVCs fully 
immunised was 53.0%. At MTE, the percentage significantly increased to 100% at z = -
7353840.488, p < .001 (Tables 14, 12 and Appendix 7). Campaigns by ZAMFAM SC Project staff 
on the importance of immunising children was yielding fruits. This quantitative data was supported 
by information gathered from FGDs where participants indicated that there was a lot of emphasis 
placed on immunising children. Consequently, several children, although their statistics were 
unavailable, had been immunised. Again here, immunization figures could not be provided by 
health facility staff. 
CW.7 Has basic shelter: Percentage of OVCs with basic shelter was 87.5% at benchmark stage. 
The percentage significantly (z = -5620.487, p < .001) dropped to 80.6% at MTE (Tables 14, 12 
and Appendix 7). This reduction was due to some shelters being affected by rain water, with a few 
becoming inhabitable/abandoned. However, from what was coming out of FGDs, some 
households had been selling their pieces of land on which their shelter/houses were located and 
moved to other areas.
CW.8 Child has basic support in 4 domains: At benchmark stage, 41.7% of the children had 
basic support in 4 domains. The percentage rose to 100% at MTE and was significantly different 
at z = -181995.253, p < .001 (Tables 14, 12 and Appendix 7). The increase was attributed to 
ZAMFAM SC Project activities which had incorporated children’s welfare into the activities. 
Results were supported from information gathered during FGDs (with caregivers) and KIIs (with 
ZAMFAM SC staff, school teachers and health care providers at health centres) where respondents 
reported that children were being supported in the 4 basic domains. 
CW.10 Currently enrolled in school: The percentage of pupils enrolled in schools at benchmark 
stage was 77.7%. At MTE, it was 96.6%. The increase in percentage was statistically significant at 
z = 13.445, p < .001 (Tables 14, 12 and Appendix 7). The increase was attributed to ZAMFAM 
SC Project efforts in seeing to it that every child was educated. (Campaign, youth and kids’ clubs). 
The ministry of education is promoting education for all campaign through which all children who 
are eligible to be in school are encouraged to get into school. All the teachers interviewed from the 
9 schools interviewed reported that due to the government policy of education policy has bolstered 
school enrolment, with class size in some schools reaching 80 pupils per class. 
7.3 Key Findings in relation to Evaluation Criteria 
Result Area 3: Capacity of government and community structures to care for and 
support children and adolescents living with, affected by and/or vulnerable to HIV 
measurably increased.
Page | 33 
The Evaluation team visited 27 operational areas and conducted FGDs with CAG, Youth and 
Kids Clubs. The team also conducted KIIs with school/heads/teachers, government ministries 
(health, community development and social services, education) officials, parents, traditional and 
civic leaders. In these interviews, the respondents reported that ZAMFAM project staff (project 
leaders, community mobilizers, CAG Coordinators) work with community structures (CAG, 
traditional (especially chiefs and village headpersons) and civic authorities (ward development 
committees), parents and teachers associations in carrying - out project activities. The Evaluation 
team found that there were also other community structures such as V- WASHE committees, 
community welfare and assistance committees (CWACs), neighbourhood health committees and 
community support groups. According to the KIIs and FGDs, community structures were trained 
by project staff in governance and leadership. 
According to Peter Banda, a community mobiliser in Nangoma/Mumba scheme in Nakasaka ward 
under Chief Mumba in Mumbwa District, works with CAGs to build capacity of community- based 
structures in caring for and supporting children and adolescents living with, affected by /or 
vulnerable to HIV. Households who are keeping vulnerable children are the members of the 
community structures. Each week, Mr. Banda conducts meeting with CAG members and during 
the fourth week meeting, the group draws up action plan and which is then implemented by the 
group. Every month, the community mobiliser with involvement of the CAG Coordinator 
conducts planning meeting with the action group. The community mobiliser conducts training 
sessions with CAG using the Community Action Group Manual produced by ZAMFAM SC 
annually. 
According to data gathered during the FGDs and KIIs, each group prepares an action plan in the 
fourth week of a month after undergoing training based on Community Action Group training 
manual. It was a good training guide written in English Language but contained some technical 
jargons which were difficult to understand and interpret in the local language. 
The FGDs and KII confirmed that project leaders and community mobilisers drew up their 
workplan which they shared with District Coordinator. Each month, the District Coordinator 
convened a planning and review meeting. This meeting was meant for project leaders so share their 
plans and review the previous activities implemented. At community level, community dialogue 
drawing participants from all key stakeholders – traditional and civic leadership, schools, health 
centers, churches etc. convened to share information and ideas about ZAMFAM project and 
related development matters. 
In addition, the District Coordinators on quarterly basis convened stakeholders meeting which was 
attended by the sub- grantees to share their plans and reports for the previous quarters. In face to 
face interviews with KAFHI, NZP+ and YWCA representatives, they all confirmed that they 
participated in the quarterly stakeholders during which time they share their plans and reports for 
the previous period. 
Page | 34 
On quarterly basis, each of the two ZAMFAM Deputy Chief of Party (Central and Southern 
provinces) also convened stakeholder meetings to share information on implementation of the 
project activities. 
At national level, DAPP ZAMFAM SC is a member of the National Technical Working Group on 
OVCs. This Group meets every quarter to share information and experiences amongst 
participating organisations. 
In collaboration with five health centres visited by the team, the project frontline staff (CHWs) 
conducted HIV screening and testing of OVC. Those found positive were enrolled onto the project 
and linked to health facility for ART. ZAMFAM SC engaged CHWs and gave them a monthly 
incentive of K200.00. These in-community staff visited ART clients regularly to ensure that they 
took medicine as prescribed. The CHWs were supplied with tools for work including bicycles, rain 
coats, T – shirts and hard- cover book for recording results and activities. 
The project staff work with government (e.g. District Welfare Assistance Committees, District 
medical office, health centres) and community structures (e.g. Community Action Groups, 
Community Welfare Assistance Committees, Neighbourhood health committees, parents and 
teachers’ associations, traditional leadership, elected civic leadership etc) to provide care and 
support to the OVC and people living with HIV and AIDS. These structures were trained in 
governance and leadership, recording and monitoring the impact of the project care system for 
OVC. 
Result Area 4: Shared learning and evidence - base to improve programming, inform 
policy and program investment strengthened.
According to the KIIs and Direct Observations conducted by the Evaluation team, the project 
staff documented best practices and lessons learnt and these were shared with the government, 
implementing and co -o perating partners through district, provincial and national working groups. 
Every quarter, at the district and provincial levels, the project staff conducted stakeholder meetings 
to share and disseminate project related information. They also utilised other platforms – meetings 
organised by other organisations e.g. agricultural ward and district shows -to showcase the project 
activities and experiences.
In addition, the KIIs held with ZAMFAM SC staff, revealed that DAPP Zambia was a member of 
the national OVC steering committee whose meetings were held every quarter to share and discuss 
related - subject matters. ZAMFAM SC Project also produced and aired interactive community 
radio programmes on local radio stations such as KNC Radio in Kabwe and Mosi O Tunya Radio 
in Livingstone. The feedback to the radio programmes was that the programmes were educative 
and provided relevant information about health issues which were affecting most people in the 
community. 
The KIIs and FGDs further reviewed that through training teachers in project schools, there was 
an exchange of information and experiences between the project staff and teachers. The teachers 
shared information on their experiences with all school pupils, including those who were not direct 
Page | 35 
beneficiaries. The exchange and learning also extended to parents through the parents and teachers 
associations during the trainings conducted by the project leaders and community mobilizers. 
It was further learnt that the cross learning 
was also taking place during the training 
with traditional and civic leaders as duty￾bearers. These gatekeepers were 
instrumental in explaining to the local 
community members the importance of 
participating in the project activities. They 
explained the importance and benefits of 
the project to their right holders. Mr. Bornwell Shambwalu is senior village head man Chimoto 
serving 146 households in Mumbwa District. According to the village headman about 90% of his 
subjects were project beneficiaries. They participated in ZAMFAM project activities such as 
gardening, savings and internal lending schemes. 
According to KIIs conducted with project staff, community dialogues were held every quarter in 
each project area. Community dialogues were platform attended by government officials 
(agriculture, health, education, community development) community- based organisations 
operating in the area, traditional and civic leaders, local community members, church leaders etc. 
Project information was disseminated during the dialogue meetings and other development related 
matters discussed during the same fora.
7.3.1 Relevance 
During the field visit conducted by the Evaluation team in the 27 project operational areas in 6 
sampled project districts using the data collection instruments of questionnaires, FGDs, KIIs and 
direct observation gathered critical project data. The data provided insight on key project activities 
which had been carried out during the three-year project implementation and are outlined below: 
i. Community Action Groups in their respective operational areas meeting and implementing 
project activities such as monthly meetings, weekly training sessions, developing action 
plans in the fourth week and subsequently carrying - out planned activities 
ii. Some Community Action Group members (at least 8 members in each) received and 
planted vegetable seeds (cabbage, onion, rape, tomatoes etc) and legumes seeds (cowpeas, 
pigeon peas and soybeans). For legumes, recipients harvested and passed - on the seeds to 
other group members. The surplus harvest was consumed within the household and sold 
to raise income for the household. The “pass – on” was also done through goats and 
chickens. In Chibombo, Mumbwa, Kabwe and Kapiri Mposhi project areas, it was reported 
that several chickens had died within few days of being distributed. The team established 
from the Department of Veterinary that there was an outbreak of new castle disease in 
these project districts which had decimated chickens in the areas. In Mazabuka, 
Livingstone, Kabwe and Kapiri urban project areas, the team saw small businesses (e.g. 
selling second-hand clothes, broiler chicken rearing) financed by pass-on grants given to 
group members 
“I have encouraged my subjects to get involved in 
ZAMFAM project and about 90% of them are 
benefitting from project activities. I have also made an 
appeal to men to join the project and this call has 
increased men’s participation in the project” remarked 
Senior Village Headman Chimoto. 
Page | 36 
iii. Establishing and strengthening Savings and Internal Lending Communities (SILC). In all 
27 operational areas visited by the team members, they were told by the beneficiary group 
members that they had set up savings and lending groups of 10 members each. These 
members were saving cash amounts (ranging from ZMW 2.00 to 50.00) and giving small 
loans to their members (ranging from ZMW 200 to ZMW500 each member) which they 
paid back with small interest (ranging from 5 – 10%). The loanees were using the borrowed 
money to finance their small businesses, pay school fees for their children etc. 
iv. 6 out of 9 schools, representing 67%, visited by the team, reported that had received desks, 
exercise books and teaching charts from ZAMFAM SC. The desks had greatly alleviated 
the desk shortage at their schools. In addition, school fees had been waived for selected 
orphans and vulnerable children which enabled the beneficiary pupils attend school 
consistently without being bothered about school fees payment. Interviewed school 
teachers, even if they could give actual figures, reported that waiving school fees for 
targeted OVC pupils was helpful and kept beneficiary pupils in school 
v. The team established that all interviewed Community Action Group members were being 
trained in OVC care, support, protection and child assessment, using the Child Status Index 
Tool. These Community Action Groups were platforms for provision of support and 
services to OVC which bolstered their wellbeing. The extended services were 
predominantly related to education, health, water, sanitation, hygiene and issuance of birth 
certificates 
vi. In collaboration with five health centres visited by the team, the project frontline staff 
(CHWs) conducted HIV screening and testing of OVC. Those found positive are enrolled 
onto the project and linked to health facility for ART. ZAMFAM SC engages CHWs and 
gives them a monthly incentive of ZMW200. These in-community staff visits ART clients 
regularly to ensure that they take medicine as prescribed. The CHWs are supplied with 
tools for work including bicycles, rain coats, T – shirts and hard- cover book for recording 
results and activities 
vii. The project staff work with government (e.g. District Welfare Assistance Committees, 
District medical office, health centres) and community structures (e.g. Community Action 
Groups, Community Welfare Assistance Committees, Neighbourhood health committees, 
parents and teachers’ associations, traditional leadership, elected civic leadership etc) to 
provide care and support to the OVC and people living with HIV and AIDS. These 
structures are trained in governance and leadership, recording and monitoring the impact 
of the project care system for OVC. 
viii. The project staff document best practices and lessons learnt and these are shared with the 
government, implementing and co-operating partners through district, provincial and 
national working groups. Every quarter, at the district and provincial levels, the project 
staff conduct stakeholder meetings to share and disseminate project related information. 
They also exploit other platforms – meetings organised by other organisations – e.g. 
agricultural ward and district shows -to showcase the project activities and experiences. 
ix. DAPP ZAMFAM SC is a member of the national OVC steering committee which meets 
every quarter to share and discuss related - subject matters. The project also produces and 
Page | 37 
airs interactive community radio programmes on local radio stations such as KNC Radio 
in Kabwe and Mosi-O-Tunya Radio in Livingstone. 
DAPP Zambia 
The organisation works with those in need in a collective process that supports them to effect 
changes, improve their lives and solve their problems. DAPP believes that poverty and other social 
vices can be overcome through co-ordinated, community - wide approaches which combine 
education and literacy, health and hygiene, improved livelihoods and sustainable agriculture. The 
organisation works with long term sustainable programmes that address needs of families and 
communities by empowering people to take action to improve their circumstance in a collective 
and collaborative way. 
Under ZAMFAM, DAPP is working with care givers, local communities and other stakeholders 
(ministries of health, community development, agriculture, education etc) to provide care and 
support to OVC. The care givers use their own resources and are organized in Community Action 
Groups provide parenting skills and menu of essential services to OVC. 
Zambian Government 
The government of Zambia, through the ministry of health has developed and rolled out National 
Health Strategy Plan and National HIV and AIDS Strategic Framework 2017 – 2021. These 
frameworks aim at reposition prevention of new HIV infections as the main focus of the national 
multi- sectoral HIV and AIDS response. In addition, the ministry of general education revised its 
school curriculum in 2013 which included integration of comprehensive sexuality education in all 
public schools. The ministry of community development and social services has a mandate to 
provide basic social protection services and programmes offering social assistance and 
promotional services (livelihood and empowerment) to the poor and vulnerable people in society. 
USAID Zambia Office 
It supports Zambia in strengthening its public health system at the national, provincial, and 
community levels. USAID in collaboration with the Ministry of Health, work towards supporting 
prevention and treatment of diseases such as HIV/AIDS, malaria, and tuberculosis, increasing the 
overall quality of health care, changing attitudes and behavior on maternal and child health, 
nutrition, family planning, gender-based violence. USAID through the United States President’s
Emergency Plan for AIDS Relief (PEPFAR) supports scaling - up integrated prevention, care, and 
treatment programs and lessen the impact of HIV/AIDS.As part of its strategy of disease 
prevention, management, and mitigation, USAID supports services to over 400,000 children. The 
agency supports parenting programs, life-skills training for adolescents and young women, access 
to education through school block grants, access to HIV treatment and household economic 
strengthening. The agency also helps build capacity of HIV/AIDS-affected communities to access 
effective, quality HIV/AIDS prevention services, including counseling and testing, voluntary male 
circumcision, and the prevention of mother-to-child transmission of HIV. It actively works with 
communities and leaders to create a unified and strengthened response to HIV/AIDS. 
Page | 38 
On the basis of the foregoing Evaluation team field survey findings, DAPP Zambia’s operational 
strategic framework, the Zambian government strategic direction on HIV and AIDS prevention, 
care and support, the USAID policy on strengthening the Zambia’s health public health system
and controlling HIV/AIDS, it is plausible that ZAMFAM strategies and objectives resonate well 
with these key stakeholder’s policies and strategies. 
Implementing approaches and strategies 
The Evaluation team succeeded in conducting in – depth interview with key staff of the 
implementing partners involved in carrying - out project activities. These partners are as follows: 
i. Creative Associates who spearheaded building capacities in the areas of financial 
management, strategic plan development and implementation, proposal writing and 
human resource management. Through participatory process, Creative Associates 
facilitated identification of capacity needs, development of capacity building plan and 
providing technical support during the plan implementation 
ii. Young Women Christian Association (YWCA) took a lead on training DAPP and 
partner organisations on psychosocial counselling and gender- based violence 
management 
iii. Network of People Living with HIV (NZP+) with its specialization in forming support 
groups for people living with HIV which provides counselling, support and 
encouraging members to adhere to treatment programme. It also encourages people 
living with HIV to take HIV test to establish their status. 
iv. Kabwe Adventist Family Health Institute (KAFHI) implementing the project in all four 
result areas namely increasing household resilience, improving child wellbeing status, 
increasing capacity of government and community structures and strengthening shared 
learning and evidence – base. 
DAPP ZAMFAM SC, through partnership with the four implementing partners, is leveraging 
competences and expertise of these organisations in implementing the project. These organisations 
have been operating in their fields of specialization for a considerable time and acquired expertise 
in those areas. 
ZAMFAM SC is working with and through government and community structures. The project 
is working in schools and targeting young people as the primary beneficiaries, teachers and parents 
as secondary beneficiaries. In the project areas visited by the Evaluation team, the project has 
established linkages with the health centres: CHW working as volunteers availing health services 
to targeted OVCs. In addition, CWAC members, work as volunteers and participate in assessing 
and identifying children to be enrolled onto the project. As mentioned earlier on, the project is 
reaching out to parents through parents’ teachers association. Parents participate in making 
decisions on the school block grant.
The Evaluation team established and found that the existing project approaches and strategies as 
outlined in the preceding sections are appropriate and effective in achieving the intended positive 
changes in the project targeted OVCs.
Page | 39 
7.3.2 Effectiveness 
Table 16: Updated Key Indicator Table
No Indicator LOP
Targets
Year 1 Results Year 2
Targets
Jan 2015- Dec 
2016
Year 2
Results
Oct 2016 -
Sept 2017
Year 3
Targets
Oct 2017 –
Sept 2018
Year 3
Results Oct 
2017 - Sept 
2018
Percent of LOP 
Targets
(%)
1 Number of active beneficiaries served by 
PEPFAR OVC programs for children 
and families affected by HIV/AIDS 
OVC_SERV
125,000 129,913 125,000 130,549 130,000 127,239 97.8
1.1 Number of OVC received parenting/ 
caregiver services
125,000 0 100,000 127,445 125,000 117,283 93.8
1.2 Number of OVC received social 
protection services
100,000 0 16,0001 100,805 100,000 118,860 118.8
1.3 Number of OVC received education 
services
17,000 0 18,000 18,543 17,000 10,861 63.8
1.4 Number of OVC received economic 
strengthening services
100,000 0 100,000 118,321 100,000 101,633 101.6
1.4.1 Number of target families who received 
pass-on gifts 
26,000 0 18,000 48,548 23,500 12,267 52
2 Number of OVC beneficiaries who 
know their HIV status and have self￾disclosed HIV status to OVC 
implementing partners. 
OVC_HIVSTAT
60,000 57,166 60,000 67,776 124,000 109,949 90
3 Number of OVC who completed a 
standardized HIV prevention 
intervention
30,000 0 30,000 12,133 30,000 32,456 108.2
 
1 When settings goals in the AMEP we did not count on services provided through the kids and youth clubs, which is a reason for this goal being low compared to 
achieved
Page | 40 
No Indicator LOP
Targets
Year 1 Results Year 2
Targets
Jan 2015- Dec 
2016
Year 2
Results
Oct 2016 -
Sept 2017
Year 3
Targets
Oct 2017 –
Sept 2018
Year 3
Results Oct 
2017 - Sept 
2018
Percent of LOP 
Targets
(%)
4 Number of active Community Action 
Groups 
2,500 1,703 2,500 2,463 2,500 2,836 113.4
5 Number of families who are members of
Community Action Groups
40,000 42,575 40,000 72,219 60,000 72,000 120
6 Number of youth and kids’ clubs (ANTI 
AIDS and ZAMFAM School clubs and 
Out of School Clubs)
800 0 800 646 950 894 94
7 Number of children who are members 
of Youth Clubs and Kids Clubs 
16,000 0 16,000 9,989 16,000 13,684 85.5
8 Number of CWACs strengthened 500 0 500 412 500 516 103.2
9 Number of local leaders trained to 
support OVC programs
2,400 0 2,400 3,448 3,000 3,480 116.0
10 Number of school block grants provided 460 1 160 210 420 195 46.4
11 Number of Children graduated 0 0 0 2,014 5000
12 Number of Children transitioned 0 0 0 80 2000 32,513 361
13 Number of Children left without 
graduation/ transitioning
0 0 0 1,555 2000
Source: DAPP ZAMFAM SC Annual Report 2017 - 2018
The Report noted that Indicator 1.5 was low due to a gap in Data capturing on this indicator. In mitigation, the reporting formats for the Community Health Workers 
(CHWs) and Project Leaders and Community Mobilizers to ensure the data is captured.
Page | 41 
As seen under Table 16: Updated Key Indicators, ZAMFAM SC had performed exceptionally well 
on the following main and subsidiary indicators: 
1.0, 1.1, 1.2, 1.3, 1.4,1.4.1, 1.5; 2,3, 4, 5, 6, 7, 8 and 9. The impressive performance on the foregoing 
indicators may be attributed to best practices adopted regarding service delivery and 
implementation as elucidated under Section 7.3.2.1 
Conversely, the project has not performed well on indicators 1.3, 1.5 and 10. This project dismal 
performance may be explained as outlined below: 
Indicator 1.3: Number of OVCs received education strengthening services was low – standing at 
63.8%. This indicator is directly linked to Indicator 10.0 Number of Block grants provided –
46.4%. This situation is due to the challenges encountered in the procurement of school materials. 
As mentioned under section., 6 out of 9 visited schools, had not received school block grant. 
Therefore, would - be school fees - waiver beneficiaries were not able to attend school regularly 
due to outstanding school fees. 
Indicator 1.4: Number of families who received “pass-ons” is low due to procurement challenges 
which delayed distribution targeted beneficiary families. This had a knock - on effect on the pass￾on. 
a) Best Practices regarding service delivery and implementation 
DAPP ZAMFAM SC has demonstrated vibrancy in some practices which have been adopted. 
Some of these are outlined below: 
a. Leveraging comparative advantage of partner organisations in implementing projects 
activities. Creative Associates and KAFHI, YWCA, NZP+ which bring to the partnerships 
their expertise in relevant areas of project management 
b. Working with and through existing government as well as community structures. These 
will continue functioning even after the project end. 
c. Primary care givers/households, using their own resources and “given a booster by the 
project” to propel them in their livelihood activities - as the main means of their economic 
empowerment. The pass - ons given to Community Action Group members – legume 
seeds, goats, chickens, whose products and off springs they give out to other group 
members. In addition, pass-ons are providing food and income security to group members 
through own consumption and sale of surplus produce. 
d. Block grants given to selected schools and in return school fees of targeted school pupils 
being waived. This non- cash transaction ameliorates accountability challenges encountered 
by most project when they give out cash for pupils’ sponsorship 
e. The involvement of key stakeholders in the project i.e. traditional leaders, church 
leadership, schools, health centres, private sector players and government ministries. After 
serious challenges experienced with centralized procurement of project materials, the 
project management adopted local procurement system which is empowering local 
Page | 42 
suppliers. This is in line with the government policy of empowering local entrepreneurs by 
giving them a share of materials supply business 
f. Integration of Savings and Internal Lending in Communities which give opportunities to 
households to save and borrow money on more flexible terms. The loan is invested in 
some business or procuring capital item for the households 
g. New approach of “TRIOS” in caring and supporting children on ART. This approach 
provides a back - person to encourage the person on treatment does not default. 
h. According to ZAMFAM SC Project Annual Report FY18, the project increased number 
of children on ART from 7,562 to 13,063 during the period under review. The report 
further states that 95% of the children living with HIV are on ART. As the project is ending 
in the next two years, DAPP Zambia has started negotiations with the Ministry of 
Community Development and Social Services to take over supporting the children on 
ART. 
b) Level of Knowledge and Awareness of OVC around HIV/AIDS 
This is demonstrated in a number of ways and some of them are shown here below in Figure 7: 
As shown in Table 10. which presents PEPFAR MER Essential Indicators shows that the Indicator 
Care giver knows child’s HIV status, was as follows: 
Figure 7: Knowledge and Awareness of OVC and HIV/AIDS 
Source: MTE Field Survey 2019 and Mbizvo, et al. 2018
Benchmark MTE
55.1%
44.9% 44.1%
55.9%
3.0%
97.0%
1.6%
98.4%
0.0%
20.0%
40.0%
60.0%
80.0%
100.0%
120.0%
No Yes No Yes No Yes No Yes
Rural Urban Rural Urban
Percentage of respondents
**
Page | 43 
From Figure 6 above, the percentage of Caregivers who know Child’s HIV status in both rural and
urban areas has sharply increased from 44.9% in rural areas, 55.9% in urban areas to 97.0% and 
98.4% respectively. Conversely, the percentage of Care givers who do not know Child’s HIV status 
has reduced from 55.1% in rural areas to 3% and 44.1% in urban areas to 1.6%. The foregoing 
situation is attributed to increased level of knowledge and awareness of OVC around HIV/AIDS 
by the project caregivers. The table also confirms a well-known phenomenon that people in urban 
areas are more aware about OVC around HIV/AIDS than those in rural areas. 
c) Knowledge, Practice and Attitude Among Adolescents and Youth on HIV/AIDs 
The baseline survey does not provide either indicators or values on which to measure Knowledge, 
Practice and Attitude (KPA) among adolescents and youth. Consequently, the MTE KPA findings 
enumerated in Figure 8, will be used as benchmark values for future evaluations. 
Figure 8: Knowledge, Practice and Attitude among adolescents and youth about HIV.AIDs 
Source: MTE Field Survey 2019
More insight about KPA with regard to HIV/AIDs among children aged 10-17 years is provided 
in Table 17. Further details about the same can be obtained in Appendix 4.
94.7% 95.5%
84.7%
93.4%
66.3%
0.0%
20.0%
40.0%
60.0%
80.0%
100.0%
120.0%
Heard about
AIDs
Knows HIV
status
Knows where to
test for HIV
Abstenance (no
sex)
HIV+ Students
treatedkindly by
other students
Knowledge Practice Altitude
Percentage of repondents (10-17 years)
Knowledge, Practice and Altitude
Page | 44 
Table 17: Knowledge, Practice and Attitude among adolescents and youth about HIV.AIDs 
Category Variable
% response
No Yes
Knowledge
Child has heard of illness called AIDS 5.3 94.7
Child knows HIV status 66.3 33.7
Child knows where people can test for HIV 15.3 84.7
Practice
Child had sex in past one year 93.4 6.6
Altitude
HIV + Students treated unkindly by other students 66.3 33.7
Source: MTE Field Survey 2019
Almost 94% of children aged 10 to 17 years had no sex in past one year 
Analysis of PEPFAR MER Essential Indicators for OVC Programmes by DAPP MTE 
Provinces, Age Group and Residence FY18 
d) OVC graduation process 
ZAMFAM primary target group are orphans and vulnerable children in two age groups (0 – 9 
years) and children (10 – 17 years). The project is designed that when a child reaches 17 years of 
age, he/she can manage without consistent project support and moves out of the project 
mainstream support. The graduation takes a form of being referred to in or out of school club 
and the “graduate” can be monitored through CCV and NHW volunteers. 
Peter Banda is a Community Mobilizer in Nangoma /Mumba Scheme in Nakasaka ward under 
Chieftainship Mumba in Mumbwa District. In an interview with Peter, he outlined a Case 
Management Process that ZAMFAM SC is following. He outlined the process as follows: 
i. Child identification which is conducted at the community by a committee comprising 
representatives from CWACs, local traditional and civic leadership, CVs, CHW and 
local churches. Using OVC guidelines developed by the Ministry of Community 
Development and Social Services, the committee identifies OVCs in their catchment 
areas. 
ii. Enrolment of selected children. This involves the OVC registered with DAPP 
ZAMFAM project by completing the prescribed child registration form 
iii. After formal registration of the child, using a Child Index Assessment tool, pressing 
needs of the child are identified and prioritised 
iv. Subsequently, a Child Development Plan is developed and locked in a book in 
readiness for implementation 
v. With the support of Community Action Group and the host caregiver/household, 
implementation of the child development plan commences. 
Page | 45 
vi. As the child development plan is being implemented, it is closely monitored by the 
community mobiliser and project leader using developed assessment indicators and 
targets. After six months of implementation, an assessment of the child using Child 
Index Assessment is conducted.
vii. Follow up is undertaken: no child is enrolled to the Project before assessment and after 
12 months of a child participating in the Project, a second assessment is done. 
In all 27 operational areas visited by the Evaluation team, they did not meet a child who had 
graduated. According to most CCVs interviewed, some children are due for scheduled graduation 
in the first quarter of 2019. 
The team learnt that those who are being reported under graduated population are largely those 
whose caregivers/parents have migrated to non- ZAMFAM areas. 
7.3.3 Efficiency 
In ZAMFAM SC Project Monitoring and Evaluation Plan, there are no dedicated indicators to 
measure the project efficiency. However, project efficiency has been measured in terms of the 
following factors: 
i.In November 2015 when ZAMFAM SC Project implementation commenced, the Zambian 
Kwacha traded with US Dollar at 1 US $ = ZMW 10.33. In November 2016, the Kwacha 
appreciated and traded at 1 US$ = ZMW 9.82. In November 2017, the exchange rate rose 
marginally to 1US$ = ZMW 9.97 and in November 2018, it rose to 1US$ = ZMW 11.88. The 
volatility of the Kwacha against the US $ led to periodic exchange gain and loss of the kwacha 
(Table 18). 
Table 18: Currency exchange rates from 2015 to 2018 
Period
Exchange rate
US$ ZMW
November 2015 1 10.33
November, 2016 1 9.82
November 2017 1 9.97
November 2018 1 11.88
As the USAID Zambia office disburses to DAPP Zambia the project grant in Zambian Kwacha, 
it means the office manages the Kwacha exchange gain and losses. 
a) Extent to which project resources have been efficiently utilised 
The Extent to which project resources have been efficiently utilised is indicated in Table 19. 
Page | 46 
Table 19: DAPP ZAMFAM South Central Financial Report
AWARD NUMBER: AID-A-611-A-16-00002
START DATE: 20.11.2015 END DATE: 19.11.2020 (all amounts are in US$) 
Budget Line Budget Obligated 
Amount to Date
Expenditures 
through Sept 2018
Difference against 
lifetime budget
Difference against 
current obligation
% Against 
obligation
Projected expenditure 
to Nov 2020
Personnel 5,236,078 2,661,929.75 2,421,167.01 2,814,910.99 240,762.75 91.0% 1,505,049.76
Fringe Benefits 2,673,290 1,384,627.27 1,301,763.99 1,371,526.01 82,863.28 94.0% 809,204.64
Travel 1,429,450 865,559.64 739,900.32 689,549.68 125,659.32 85.5% 459,938.04
Equipment 280,000 447,683.69 240,848.00 39,152.00 206,835.69 53.8% 149,716.32
Supplies 1,192,845 1,944,701.20 1,598,390.43 (405,545.43) 346,310.77 82.2% 993,594.05
Contractual 5,525,625 4,200,744.23 2,560,227.82 2,965,397.18 1,640,516.41 60.9% 1,591,492.97
Other Direct 
Costs (ODC)
3,839,880 3,603,725.89 2,629,124.17 1,210,755.83 974,601.72 73.0% 1,634,320.43
Training 2,495,721 2,022,116.37 1,517,742.51 977,978.49 504,373.86 75.1% 943,461.56
Indirect Costs 1,738,134 1,310,152.97 1,014,316.84 723,817.16 295,836.12 77.4% 630,521.28
TOTAL COSTS 24,411,023 18,441,241.00 14,023,481.08 10,387,541.92 4,417,759.91 76.0% 8,717,299.05
Source: DAPPZAMFAM SC FY 18 Financial Report 
Overall view on Total Projections: 22,740,780.13 Total expenditure to Nov 2020 based on current expenditure rate
- 4,299,539.13 Over expenditure based on what is currently obligated
OBLIGATION ANALYSIS 
Current Obligation $18,441,241.00 
Expenditures through Sept 2018 $14,023,481.08 
Remaining Amount Obligated $4,417,759.91 
Historical Burn Rate $465,649 
As shown in the Financial Report, the least burning budget item is Equipment which stands at 53.8% of the obligated amount. The second lowest burning budget item 
is Contractual which stands at 60.9% of the obligated amount. 
The personnel salaries and fringe benefits are burning close to the full amounts and should be kept under strict scrutiny to avoid overburning 
Page | 47 
As shown in Table 19: DAPP ZAMFAM South Central Financial Report as at 30 September 2018, 
the project had an obligated amount of US$18.4 million and out of which US$ 14 million had been 
spent, representing 76% expenditure. In comparison with the project performance as captured 
under Table 16: Updated Key Indicators, it is indicative of a situation that project funds were to 
some extent prudently used in implementing project activities. It is highly possible that the unspent 
obligated funds as well as unobligated, if the whole project amount will be drawn down, will be 
adequate to cover all planned project activities and expenditure. 
In all 6 project districts visited by the Evaluation team, they worked with the District Coordinator, 
project leaders and community mobilizers. In each district, there are 8 - 10 project leaders, who 
each one of them is supported by three (3) community mobilizers in the operational area. Each 
community mobiliser manages about 500 households and 1,000 OVCs. Each District Coordinator 
and project leader has been given a motorbike and community mobilisers bicycles for transport. 
These modes of transport and mobile phone given to each project staff have improved their 
mobility and communication. 
ZAMFAM SC Project planning is conducted periodically at all levels. According to the Key 
Informant from the Project staff who took part in the in-depth interviews, all Community Action 
Groups and Community Mobilisers/Project leaders, undertake weekly trainings and in the fourth 
session develop work plans for their respective structures. The Project leaders and District 
Coordinators also develop monthly and quarterly work plans which are linked to the work plans 
formulated at community level. In the quarterly planning meetings, implementing partners also 
take part and share their work plans which are in tandem with the ZAMFAM project work plan. 
The quarterly plans for all project districts are collated as the project work plans. At national level, 
district plans are collated and annual work plans for the whole project formulated and shared with 
implementing partners and the funding partner – USAID. 
The planning system as explained in the preceding paragraphs is comprehensive and periodically 
undertaken at all levels of the project. It accords an opportunity for the community members, 
project staff and implementing partners to take part in reviewing the current/ending plan and 
provide informed- input into the upcoming plan. The planning meetings are participatory and 
provide space to adjust strategies and activities to make them appropriate to the prevailing project 
environment. The “Action and Reflection” meetings have enabled the project management to 
make adjustment to project activities. For example, at the start of the project, project materials 
such as desks, were centrally procured but this posed challenges in procuring and delivering the 
materials to the intended project users. Through action and reflection process, the project 
management learnt that central procurement was not effective and decided to adopt decentralised 
procurement through which required project materials are procured in districts. 
ZAMFAM SC Data Management System (DMS) is elaborate and cascades down to the community 
level as presented in Table 20: ZAMAFAM SC M & E framework. At the community level, data 
is collected on services provided by CHWs, Community Action Groups and other community 
structures under the guidance of community mobilisers who pass-on the collected data to project 
leaders and verifies through field visit. After verification, data forms are passed on to the District 
Coordinator who reviews and verifies them and subsequently passes approved data forms to Data 
Page | 48 
clerks for reviewing and entering into the computer data base. Hard copies are kept in a safe place. 
Data entered into the data software is received and checked by the monitoring and evaluation 
officers who check and verify it. 
According to the data clerks interviewed, when they receive data forms from the field, they check 
data for errors, completeness and omissions. Periodically, they also go in the field to check how 
data forms are completed by the Community Action Groups, CHWS, CCVs and Schools with 
guidance from the community mobilisers. These field trips give them an opportunity to 
understand project activities as they are implemented in the field and checking how data forms are 
completed. They also take advantage of the field to explain to the field staff how the forms should 
be completed, common errors observed in completion of the data forms and explain how the 
errors can be minimised or avoided. 
The project data base is supposed to be connected to the national data management system so that 
project data is accessible to the government and other stakeholders entitled to access it for their 
official use. However, the national data management system has not been operationalised. The 
ZAMFAM SC data management system is exceptionally good and worth the investment which 
had been made into it. Hence, it should be properly maintained and kept for both current and 
future use. 
7.3.4 Exit and Sustainability 
a) Activities households are likely to continue conducting beyond project life 
i. Savings and Internal Lending Communities (SILC): All the 190 interviewed FGDs 
participants confirmed that they had been trained in saving and lending money. 
ii. Basic entrepreneurial activities such as trading in basic commodities like rice, beans, fish 
making flitters, African colony (chikunga) etc. 
iii. Pass-ons (goats, chickens and legume seeds) and have been training in basic animal 
husbandry and crop production 
iv. Have been empowered with information on HIV/AIDs (causes, prevention, care, support 
and treatment) 
v. Parenting skills have been imparted in care givers 
vi. Environmental protection: Unsafe disposal of waste, smart agriculture 
vii. Have been trained and empowered with knowledge on water sanitation and hygiene. 
Which include having clean and usable pit latrines, access to clean and safe water, practice 
of hand washing after use of toilet and hand washing before and after eating. 
viii.Governance and leadership: Learnt how to govern and lead groups/people in 
communities. 
Page | 49 
b) Supportive mechanisms put in place for household 
i. Community structures like VAGs and SILC which are platforms to provide support and 
services to households. 
ii. In schools, PTAs have been trained to work with parents/households in providing good 
education to their children 
iii. Through Community health workers and children care volunteers, in taking care of 
children, counselling, testing and treatment 
iv. Selected schools have been given block grants through which desks and learning materials 
are given to schools, which result in waving of school fees for some pupils. 
v. Traditional and civic leaders have been trained and are aware about the project’s activities. 
They appreciate the project and support implementation activities. 
vi. Households have been trained in the construction housing for livestock 
vii. Structures such as CWAC and neighbourhood health communities have been strengthened 
in providing support and services to households. 
viii. Strengthen unity and corporation within communities 
7.3.5 Cross – cutting Issues 
a) Coordination 
At Community Action Group level, each group prepares an action plan in the fourth week of a 
month after undergoing training based on Community Action Group Programme Manual. 
On monthly basis, project leaders and community mobilisers draw up their work plan which they 
share with District Coordinator. Each month, the District Coordinator convenes a planning and 
review meeting. This meeting is meant for project leaders so share their plans and review the 
previous activities implementation. At community level, community dialogue drawing participants 
from all key stakeholders – traditional and civic leadership, schools, health centres, churches etc 
are convened to share information and ideas about ZAMFAM project and related development 
matters. 
On quarterly basis, the district Coordinators convene stakeholders meeting which is attended by 
the sub- grantees to share their plans and reports for the previous quarters. In face to face 
interviews with KAFHI, NZP+ and YWCA representatives, they all confirmed that they 
participate in the quarterly stakeholders during which time they share their plans and reports for 
the previous period. 
On quarterly basis, each of the two ZAMFAM Deputy Chief of Party (Central and Southern 
provinces) also convene stakeholder meetings to share information on implementation of the 
project activities. 
At national level, DAPP ZAMFAM SC is a member of the National Technical Working Group 
on OVCs. This Group meets every quarter to share information and experiences amongst 
participating organisations. 
Page | 50 
As shown in the foregoing explanation, DAPP ZAMFAM has platforms at the community, 
district, province and national levels for coordination, sharing key information and experiences 
with stakeholders. 
b) Gender Inclusion 
At benchmark stage, there were less men involved in giving care to OVCs. In fact, there were 
12.2% and 8.6% for rural and urban areas respectively. At MTE level, percentages had increased 
to 17.0% and 12.1% for rural and urban areas respectively (See Figure 1 and Appendix 4).
Furthermore, the percentage of total females regularly attending school increased from 37.1% to 
66.7%. At benchmark stage, the percentage of total females and total males regularly attending 
school was 37.1% and 37.2% respectively. At MTE level, the percentage increased to 66.7% and 
77.8% for females and males respectively (See Figure 1 and Appendix 4). 
c) Age Inclusion 
At benchmark stage, there was pressure on responsibilities of care giving for OVCs which was 
more on people as young as 18 years old. It stood at 7.2% and reduced to 4.4% for the same age 
group (See Figure 1 and Appendix 4). This positive situation frees young people from caregiving 
responsibilities and thereby they focus more on other things such as education. Comparatively, old 
people were made to understand and appreciate the importance of taking take of their relatives’
orphaned children as evidenced in the age range of 45-50 years old where there was a percentage 
increase from 9.8% to 15.6% (See Figure 1 and Appendix 4). 
d) Environmental - related issues 
From the FGDs, it clearly emerged that caregivers, youth and kids’ clubs were receiving a lot of 
training on agricultural activities which included climate smart agriculture to mitigate effects of 
global warming. Most of the teachings came from the Youth Club Program Manual, training 
programme guidelines produced by DAPP ZAMFAM for use among youth, those in and out of 
school. 
Besides smart agriculture training, the youth were also receiving lessons on solid waste 
management, water and sanitation as well as hygiene. In these trainings, greater emphasis was 
placed on preserving the environment. 
It was clear from the FGDs, that Community Action Groups, during their weekly meetings were 
also trained on smart agriculture, solid waste management, water, sanitation and hygiene. FGDs 
are trained by community mobilisers with support from project area leaders. Community Action 
Groups were also trained from the Community Action Group manual. These guidelines are 
produced annually and contain key areas on human development. 
7.3.6 Monitoring and Evaluation Plan 
DAPP ZAMFAM SC Project has a robust monitoring and evaluation system referred to as Activity 
Monitoring and Evaluation Plan (AMEP). It provides guidance on monitoring and evaluating 
project activities. It provides mechanisms for checking whether the project activities are on course 
or not. The document is also used as standardized reference for indicator definitions and 
reporting. It was envisaged that AMEP would provide a reporting system that feed into the 
Zambian national data sources and data collection tools, data analysis, dissemination and use. 
Page | 51 
AMEP contains both PEPFAR MER Essential Indicators for OVC programmes and DAPP 
ZAMFAM Key Output Indicators which makes it possible for the project to capture both its 
process and outcome performance. The M & E system with key roles and responsibilities at all 
project levels can be presented as shown below: 
Table 20: ZAMFAM SC M & E Framework 
Key Position Core Responsibilities
Chief of Party Provide guidance on all ZAMFAM SC M & E activities 
Ensure reports are checked and approved before being distributed
M & E Specialist Coordinate and oversee implementation and manage ZAMFAM SC 
M & E system
Provide technical assistance to community- based organisations 
during project implementation
Assistant M & E Officer Work in collaboration with M & E Specialist in implementing 
AMEP
Train CBOs and sub partners in use of M & E tools
Data Clerks & Data Assistants Transcribe data from community registers and ensure that data 
captured on hard copy forms corresponds with what is on source 
documents (registers or data forms)
District Coordinators Review reports and other data before delivering to data clerks for 
entering into data base
Take part in quarterly data quality control visits in project areas and 
conduct progress monitoring visits
Project Leaders Receive and verify data through regular field visits
Facilitate quarterly performance community review and palling 
meetings
Community mobilisers Collect data from community volunteers and community structures 
responsible to provide services such as CHWs, schools and 
Community Action Groups
Community health workers and 
Village Action Groups
Collect data from the field on services provided by CHWs, Village 
Community Action Groups and other community structures
Source: Adapted ZAMFAM SC AMEP Document
During in- depth interviews with data clerks in the field, they reported that on quarterly basis, they 
send out data capturing forms to project leaders/community mobilizers for completion. These are 
as follows: 
Child Registration Form, Child Status Index, Community Health Worker Service Report, 
Community Action Group Child Service Report, Pass-on Gift Report, School OVC Service 
Report etc 
When the foregoing data capturing forms are completed by field staff, they are returned to the 
District Coordinator who checks them before passing them onto data clerks for entering into data 
base. The main challenge being experienced as regards submission of completed data from was 
largely delayed submission of completed and some forms contain errors. In collaboration with 
district Coordinators, data clerks tackle the challenges. 
Page | 52 
The Evaluation team also interviewed project leaders who reported that on monthly basis, they 
receive log books from Community Action Groups which provide details on activities carried out. 
In collaboration with community mobilisers, they receive and check data capturing forms before 
submitting them to the district office. On quarterly basis, they prepare activities reports which they 
submit to the district office. These reports are checked against submitted quarterly plans. 
The Evaluation team observed that all ZAMFAM SC Annual Reports (2015/2016, 2016/2017 and 
2017/2018) covered activities implementation status and analysis of Output Indicators. The 
reports do not cover PEPFAR MTE Essential Indicator which are Outcome focussed. These show 
changes that have occurred in the primary target group (caregivers and OVCs.) lives. As the project 
is in its two year, it is advisable that an Outcome Assessment be undertaken to bring out more 
information and lessons – learnt. 
7.4 Unexpected findings 
ZAMFAM SC Project performance has stagnated /retarded on two PEPFAR MTE Essential 
Indicators and its own Output Indicators as outlined below: 
Own livestock: At benchmark stage, 47.7% owned livestock, it increased to 50.7% at MTE. This 
suggested that the “pass-on” arrangement, involving goats was making an addition to beneficiary 
livestock herd. 
Challenges in procurement of school block grant materials (desks & teaching materials) 
6 out of 9 visited project schools, had received school block grant. 3 schools that had not received 
the grant experienced irregular school attendance and low number of pupils who progressed in 
school last year. The procurement challenge had also a knock - on effect on Number of families 
who received pass-on gifts (52% as per Annual Report FY18) and Number of school block grants 
provided (46.4%) 
The Evaluation team visited a total of 56 homesteads for caregivers/CCVs to check on existence 
and condition of project facilities. For sanitary and hygiene facilities, only 4 out of 56 homesteads 
had functional pit latrines with tip tap, disk rack and rubbish pit. The rest had pit latrines without 
tip tap, disk rack and rubbish pit. Tip tap is least popular amongst all visited homesteads and yet 
it is a convenient facility for handwashing in homes. 
7.5 Lessons Learnt 
7.5.1 Private - public partnerships 
ZAMFAM SC Project is a large – multi annual integrated project with overall budget of US$24 
million, employing more than 368 fulltime staff and working with more than four implementing 
partners. The project has produced a big market to a number of private companies supplying 
various project commodities and services. These companies are MTN supplied mobile phones and 
project staff using the phones continually buying airtime from the company; Honda Zambia 
supplied more than 37 motorbikes; local supplier of buffalo and Zambike bicycles, supplier of 
Page | 53 
school desks and yellow Chitenge materials and t- shirts given to CHWs and CCVs as well as 
commercial banks providing banking services. If DAPP Zambia approaches these private 
companies’ suppliers, it is most likely that it can secure support, either cash or in kind, towards 
financing project activities. 
7.5.2 Timing Mid – Term Evaluation 
A mid- term evaluation is an assignment which requires extensive travel to all sampled project 
areas and households. During the dry season, it is possible to access all sampled project sites 
because access roads are passable and most targeted beneficiaries are available in their homesteads. 
The benchmark survey carried – out by the Population Council, was conducted during May/ June 
period, in the dry season and crop harvest season. As it was in the dry season with most sampled 
project areas and households being accessible, the research team managed to reach to most 
targeted respondents. Conversely, the MTE survey was undertaken during (Nov/Dec/Jan) period 
at the peak of the rainy season. The rains rendered some access roads impassable thereby making 
some sampled project areas and households accessible. Moreover, some project households were 
busy with crop farming activities and not available for evaluation meetings when the Evaluation 
team visited their areas. A critical project assignment, like MTE, which requires extensive visit to 
all sampled project areas, should be undertaken during the dry season when access roads are 
passable and targeted households free from farming activities. 
8 CONCLUSION 
The Mid – Term Evaluation has revealed that DAPP ZAMFAM SC Family Activity Project has 
made tremendous progress on PEPFAR MER Essential Outcome Indicators, especially Caregiver 
knows child’s HIV status, too sick to participate in daily activities, Has a birth certificate, Regularly 
attends school, progressed in school during the last year and Children ≤ 5 years of age who recently 
engaged in stimulating activities with any household member. In addition, the project has made 
progress on Key Output Indicators, particularly Number of active beneficiaries served by 
PEPFAR programmes, Number of OVC received parenting caregiver services, Number of OVC 
received economic strengthening, Number of active Community Action Groups, Number of local 
leaders trained to support OVC programmes. 
The achievement attained on the foregoing Outcome and Key Output Indicators are attributed 
effective strategies and approaches employed in the implementation of the project activities, These, 
among other practices, include leveraging comparative advantage of partner organisations in 
implementing projects activities. Creative Associates and KAFHI, YWCA, NZP+ which bring to 
the partnerships their expertise in relevant areas of project management, working with and through 
existing government as well as community structures. These will continue functioning even after 
the project end, primary care givers/households, using their own resources and “given a booster 
by the project” to propel them in their livelihood activities - as the main means of their economic 
empowerment. The pass - on given to Community Action Group members – legume seeds, goats, 
Page | 54 
chickens, whose products and off springs they give out to other group members and involvement 
of key stakeholders in the project i.e. traditional leaders, church leadership, schools, health centres, 
private sector players and government ministries. 
However, DAPP ZAMFAM SC Project faces an uphill battle on changing the common belief that 
harsh punishment to children is appropriate punishment. This works against the internationally 
practice of protecting children against child abuse. Moreover, maintaining proper records on pass 
– ons to keep track of the intervention progress and effectiveness. 
DAPP ZAMFAM SC contributed towards establishing community structures like CAGs and SILC 
and strengthening government structures which are platforms to providing support and services 
to households. In schools, PTAs have been trained to work with parents/households in providing 
good education to their children. In addition, Community health workers and children care 
volunteers are active in taking care of children, counselling, testing and treatment 
It is highly possible that DAPP ZAMFAM can make more achievement and impact on target 
communities if positive changes hitherto achieved can be consolidated and expanded. At the same 
time, weak areas be addressed aggressively to optimise the project performance and impact. The 
project is on a positive trajectory towards the fulfilment of its goals. 
9 RECOMMENDATIONS 
DAPP ZAMFAM SC Family Activity project has demonstrated clear progress on both PEPFAR 
MER Essential Indicators and Key Output Indicators. The project should consolidate positive 
improvements achieved in its operationalization. In addition, ZAMFAM should consider adopting 
the proposed recommendations which are aimed at addressing weaknesses found in its planning 
and implementation approach. 
9.1 Innovative and consistent caregiver/household economic strengthening 
interventions should be implemented to tackle the endemic household 
undernutrition on sustainable basis 
9.2 Procurement of project materials, especially school desks, should be carried out in 
good time so as not to disrupt school attendance by targeted beneficiary pupils. 
9.3 More efforts should be directed at facilitating establishment and strengthening 
savings and internal lending communities in project areas 
9.4 Community Action Group Training Manual, currently produced in English 
Language, be translated in at least two local languages to make the contents more 
user – friendly to trainers 
9.5 ZAMFAM has provided a huge market to equipment suppliers (motorbikes –
Honda Zambia; bicycles – Buffalo & Zambike, mobile phones and airtime –
MTN). As a normal business practice, these companies can be approached for 
project support/donations under their respective social investment strategy 
9.6 Crucial Surveys, like Mid - Term Evaluation, should be conducted during dry 
season when accessibility to all sampled project areas, communities and 
households is feasible 
Page | 55 
9.7 Closer consultations to be made with Ministry of Fisheries and Livestock for 
technical advice and guidance on procurement of “pass – on” livestock (goats and 
chickens) and livestock movement ban 
9.8 In the same vein, at least one Outcome Survey focusing on PEPFAR Essential 
Indicators, be carried out to provide more comprehensive and current information 
before the project end 
9.9 Community Action Group Training Manual, currently produced in English 
Language, be translated in at least two local languages to make the contents more 
user – friendly to the trainers (especially some community mobilizers 
9.10 More conscientization efforts to be made among project population to change 
endemic belief that harsh punishment is appropriate discipline to be given to the 
child. 
9.11 Improving record keeping on “pass on” to keep track of the intervention progress 
and effectiveness. 
Page | 56 
10 REFERENCES
AVERT (1986). AVERT 1986 – 2017. Retrieved on November 4, 2018, from, 
https://www.avert.org. 
Central Statistical Office (CSO) [Zambia], Ministry of Health (MOH) [Zambia], and ICF 
International. 2014. Zambia Demographic and Health Survey 2013-14. Rockville, 
Maryland, USA: Central Statistical Office, Ministry of Health, and ICF International. 
Dworkin, S.L. (2012). Sample Size Policy for Qualitative Studies Using In-Depth Interviews. Arch 
Sex Behav 41(6)1319–1320 
Mbizvo, M., Hewett, P.C., Kayeyi, N., Phiri, L., Mulenga, S.N., Mushiki, B., Chibuye, M. and 
Digitale, J. (2018). Benchmark assessment of orphaned and vulnerable children in areas of the Zambia 
Family (ZAMFAM) Project, Project SOAR Final Report. Population Council. Washington, 
D.C., USA.
Ministry of Health (2017). Ministry of Health’s National Health Strategic and Adolescent Health 
Strategic Plans 2017 – 2021. Ministry of Health, Lusaka, Zambia 
Ministry of Health (2017). National Health Strategy 2017 – 2021, Lusaka, Zambia 
Ministry of Health (2017). National HIV and AIDS Strategic Framework 2017 – 2021. Ministry 
of Health, Lusaka, Zambia 
National AIDS Council (2017). National HIV and AIDS Strategic Framework, Lusaka, Zambia 
Onoka, K. (2017). Challenges in Using Mobile Technology for Data Collection in Research 
Settings. International Journal of Innovative Research in Computer and Communication Engineering, 
5(11), Retrieved on October 12, 2018, from http://www.rroij.com/open￾access/challenges-in-using-mobile-technology-for-data-collection-in-research-settings-
.pdf
Pussycat, K., Fronczyk, A. And Urbański, M. (2013). Task force on quality of BCS data. Analysis 
of sample size in consumer surveys, Economics Research Centre, University of Cyprus, 
Cyprus. 
Radio Phoenix. (2019). News Item from the Ministry of Vice President on Thursday 21 February 
2019 by Hon Silvia Chalikosa. Radio Phoenix, Lusaka, Zambia 
Save the Children. (2016). Malunion in Zambia: Harnessing Social Protection for the Most 
Vulnerable 2016. St Johns Lane London ECIM 4AR, United Kingdom 
StatTrek. (2017). Sample Size: Stratified Random Samples. Available from: 
http://stattrek.com/sample-size/stratified-sample.aspx. (Accessed on 15 October 2018).
Theme Horse. (2017). 10% Condition in Statistics: What is it? Available from: 
http://www.statisticshowto.com/10-condition/, (Accessed on 15 October 2018).
UNICEF. (2014). Choosing the sample. Available from: 
http://mics.unicef.org/files?job=W1siZiIsIjIwMTUvMDQvMDMvMDYvNDIvNDgv
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Mjg2L2NoYXAwNC5wZGYiXV0&sha=d31cdb905d60500d. (Accessed on 18 October 
2018).
ZAMFAM SC (2015). ZAMFAM SC Annual Operation Plans 2015 – 2016. ZAMFAM SC, 
Kabwe, Zambia. 
ZAMFAM SC (2016). ZAMFAM SC Annual Progress Reports 2015 – 2016. ZAMFAM SC, 
Kabwe, Zambia. 
ZAMFAM SC (2017). ZAMFAM SC Annual Operation Plans 2017 – 2018. ZAMFAM SC, 
Kabwe, Zambia. 
ZAMFAM SC (2017). ZAMFAM SC Annual Progress Reports 2016 – 2017. ZAMFAM SC, 
Kabwe, Zambia. 
ZAMFAM SC (2018). ZAMFAM SC Annual Operation Plans 2018 – 2019. ZAMFAM SC, 
Kabwe, Zambia.
ZAMFAM SC (2018). ZAMFAM SC Annual Progress Reports 2017 – 2018. ZAMFAM SC, 
Kabwe, Zambia. 
ZICTA. (2018). All type approved equipment. Retrieved on October 12, 2018, from 
https://www.zicta.zm/Downloads/Type%20Approval/All%20Type%20Approved%20
Equipment.pdf
Page | 58 
11 APPENDICES 
Appendix 1: Sample Size Determination 
The required sample size will be calculated based on a formula by Puszcza et al. (2013) as adopted 
from (Conchran, 1963). In this MTE, the acceptable sampling error will be adjusted from 0.05 
down to 0.035 to achieve the desired household sample size of 784. The formula consists of two 
equations as indicated below.
𝑛0 =
𝑍
2𝑝𝑞
𝑒
2
Equation 1: Formula for calculating a sample for proportions 
n0 - The sample size 
Z
2
- The abscissa of the normal curve that cuts off an area α at the tails or the critical value, 1.96
e - The acceptable sampling error or the desired level of precision i.e. 95% confidence level, 0.035
p - The estimated proportion of an attribute that is present in the population or maximum 
variability, assume p = 0.5 
q - This is 1-p, 0.5
In the event that the number of households falls below 10,000, an adjustment formula as shown 
below will be used.
Equation 2: Finite population correction for proportions 
𝑛 =
𝑛𝑜
1 + (𝑛0 − 1)
𝑁
Where: 
n - Adjusted sample size 
N - The population size. 
For the 6 ZAMFAM districts,
n0 is 784, N is 72,219 and thus inputting into the above formula yields a sample size of 784
Page | 59 
Study Sample Size per district
In view of the high degree of variations in the sizes of households in the project districts, a multi￾stage sampling technique will be employed (UNICEF, 2014). The following steps are to be 
followed:
1. Data on household numbers will be obtained from DAPP and presented in form of a table
2. Add up all the households per district to obtain the population of households for the 6 
districts. 
3. Subject the household numbers to Proposal Size Sampling to obtain the desired household 
sample sizes for the districts. 
4. Get household data for each of the district projects 
5. List projects (with corresponding household data) for each district in tabular form 
6. Determination of the number of projects to be sampled for a particular district will be 
done by using the formula: 
√(𝒏𝒖𝒎𝒃𝒆𝒓 𝒐𝒇 𝒘𝒂𝒓𝒅𝒔 𝒇𝒐𝒓 𝒕𝒉𝒂𝒕 𝒑𝒂𝒓𝒕𝒊𝒄𝒖𝒍𝒂𝒓 𝒅𝒊𝒔𝒕𝒓𝒊𝒄𝒕) i.e. Square root of the 
number of projects. 
7. Determination of the minimum and maximum numbers of households for each of the 
projects in a particular district.
8. Organise the projects into strata based on their household numbers (as population sizes) 
at an interval determined by using the formula: Total number of households in all the 
projects for a particular district divided by the desired project sample size obtained in stage 
6.
9. Use Proportionate stratification method where the sample size of each stratum will be
proportionate to the population size of the stratum. Strata sample sizes will be determined 
using the following equation:
nh = (Nh / N) * n 
Where nh is the sample size for stratum h, Nh is the population size for stratum h, N is total 
population size, and n is total sample size (StatTrek, 2017) 
10. Project sample size in each stratum will follow the 10% rule. Which according to Theme 
Horse (2017), states that sample sizes should be no more than 10% of the population. The 
resulting project sample size in the first to the fifth strata will be subjected to Probability 
proportional to size sampling technique to yield the selected projects. The corresponding 
household sample size for each stratum will be considered.
11. Villages that fall under the respective projects will be selected using Probability 
Proportional to Sample size as explained earlier in the selection of projects.
Page | 60 
12. Systematic Randomised Sampling will be applied in the selection of households in the 
selected villages.
The interval will be obtained by using the following formula:
Total number of households /Target number of Household to be interviewed 
Sample Size for Qualitative Data Collection 
While the concept of “saturation” may be ideal or a guiding principle when it comes to the 
determination of the sample size in qualitative research, it is still hotly debated, and some say little 
understood (Mason, 2010). Since the approach will be based on Action research, as a rule of 
thumb, 20-30 people will typically be enough to reach saturation. This will equally suffice when 
the rule of thumb is based on data collection method, to interview approximately 20 people during 
In-depth interviews and approximately 5 people for Key Informants’ interviews. The sample size 
to be used in qualitative research methods will often be smaller than that used in quantitative 
research methods. This is because qualitative research methods will often be concerned with 
garnering an in-depth understanding of a phenomenon (Dworkin, 2012). 
Page | 61 
Appendix 2: Data Collection Garget 
Android/Smart phone
Version of Android: Operating System (OS) Android 4.3.1 or better is required; Android 5.0+ is 
strongly recommended. – RAM Minimum 1.5GB – Memory 8GB of flash memory storage. At 
least 1GB of available space must be available for ODK’s use. Enough space on phone will be 
required during the operation of the software. The ultimate requirements for space depend on the 
kind of survey (questionnaire) and the mode of use of the phone (number of assignments, 
simultaneously started assignments, rejections, etc. Better technical characteristics will improve
responsiveness of the program.
All Android gargets should be ZICTA type approved for quality data collection. “These Type 
Approval Guidelines covering all types of Radio and Telecommunication Terminal Equipment 
(RTTE) are issued by the Zambia Information Communication Technology Authority (ZICTA) 
in line with Type Approval Policy as well as Statutory Instruments (SIs) 6 and 65 of 2011 under 
the ICT Act No.” https://www.zicta.zm/Views/Articles/Type%20Approval%20Guidelines.htm
Computer 
Windows-based computer, OS Windows 7, Windows 8, or Windows 10; 4GB RAM, 120GB hard 
drive space (solid-state drive (SSD) drive is preferable); If the supervisor is working in the field, 
then connectivity from the field via 3G or 4G, (built-in, USB, or external wireless modem, or a 
similar device).
Page | 62 
Appendix 3: DAPP ZAMFAM SC Field Data Collection Summary Report 
Household Questionnaires Focus Group Discussions Key Informants Interviews
Chibombo Category Target Achieved Percent FGDs Target Achieved Percent KIIs Target Achieved Percent
Caregiver (Household) 111 114 103% 2 3 150% 6 15 250%
Children 0 - 9 yrs 59
Children 10 - 17 yrs 10
Sub Total 183 Sub Total Sub Total
Kabwe Category Target Achieved Percent FGDs Target Achieved Percent KIIs Target Achieved Percent
Caregiver (Household) 118 116 98% 2 3 150% 6 15 250%
Children 0 - 9 yrs 49
Children 10 - 17 yrs 16
Sub Total 181 Sub Total Sub Total
Kapiri Category Target Achieved Percent FGDs Target Achieved Percent KIIs Target Achieved Percent
Caregiver (Household) 157 100 64% 2 3 150% 6 12 200%
Children 0 - 9 yrs 54
Children 10 - 17 yrs 12
Sub Total 166 Sub Total Sub Total
Mumbwa Category Target Achieved Percent FGDs Target Achieved Percent KIIs Target Achieved Percent
Caregiver (Household) 95 103 108% 2 3 150% 6 12 200%
Children 0 - 9 yrs 51
Children 10 - 17 yrs 15
Sub Total 169 Sub Total Sub Total
Livingstone Category Target Achieved Percent FGDs Target Achieved Percent KIIs Target Achieved Percent
Caregiver (Household) 146 117 80% 6 22 367%
Children 0 - 9 yrs 57 2 4 200%
Children 10 - 17 yrs 59
Sub Total 233 Sub Total Sub Total
Page | 63 
Mazabuka Category Target Achieved Percent FGDs Target Achieved Percent KIIs Target Achieved Percent
Caregiver (Household) 156 115 74% 2 3 150% 6 16 267%
Children 0 - 9 yrs 71
Children 10 - 17 yrs 27
Sub Total 213 Sub Total Sub Total
Overall Category Target Achieved Percent Overall Target Achieved Percent KIIs Target Achieved Percent
Caregiver (Household) 784 665 85% 12 19 158% 24 65 271%
Children 0 - 9 yrs 341
Children 10 - 17 yrs 139
TOTAL
 
1,145 TOTAL 12 19 158% TOTAL 24 65 271%
Source: MTE Field Survey, 2019
Page | 64 
Appendix 4: Caregiver and household demographic characteristics for Central and Southern Provinces 
Total
n=665
Total Central/Southern
Rural
n=116
Urban
n=113
Rural
n=35
Urban
n=64
% CI % CI % CI % CI % CI
Caregiver
Sex
 Female 91.4 89.9-92.7 89.0 86.9-90.8 92.8 90.7-94.5 87.8 85.0-90.1 91.4 88.7-93.5
 Male 8.6 7.3–10.1 11.0 9.2–13.1 7.2 5.5–9.3 12.2 9.9–15.0 8.6 6.5–11.3
 Female (n=323) 86.4 82.6-90.1 83.0 78.9-87.1 87.9 84.4-91.5 83.0 78.9-87.1 87.9 84.4-91.5
 Male (n=323) 13.6 9.9-17.4 17.0 12.9-21.1 12.1 8.5-15.6 17.0 12.9-21.1 12.1 8.5-15.6
Age
 Age (mean) 43.1 42.1–44.1 41.2 39.4–43.0 44.1 42.9–45.3 41.2 39.0–43.5 44.3 43.0–45.5
 18-24 7.2 5.8–8.8 10.9 8.0–14.8 5.0 3.9–6.5 10.9 7.6–15.4 5.4 4.0–7.4
 25-29 10.1 8.6–11.8 11.5 8.8–14.9 9.3 7.6–11.3 11.0 8.6–14.1 9.4 7.1–12.3
 30-34 13.7 12.0–15.6 14.6 11.8–17.9 13.2 11.2–15.6 15.1 11.7–19.2 12.3 9.5–15.9
 35-39 15.0 13.3–16.9 14.3 12.1–16.9 15.4 13.1–18.1 13.4 11.1–16.1 15.3 12.1–19.1
 40-44 11.8 10.4–13.4 12.4 10.1–15.3 11.5 9.8–13.4 13.2 10.7–16.3 13.2 10.6–16.3
 45-50 9.8 8.5–11.3 9.7 7.4–12.6 9.9 8.4–11.6 9.2 7.1–11.8 10.7 8.4–13.5
 50+ 32.4 29.4–35.4 26.6 22.0–31.7 35.7 32.0–39.5 27.2 21.0–34.3 33.7 29.0–38.7
 Age (mean) n=315 44.1 42.7-45.7 45.4 44.0-46.8 45.6 44.1-47.1 45.4 44.0-46.8 45.6 44.1-47.1
 18-24 4.4 2.2-6.7 2.5 0.8-4.3 2.9 1.0-4.7 2.5 0.8-4.3 2.9 1.0-4.7
 25-29 7.6 4.7-10.6 6.7 3.9-9.4 6.7 3.9-9.4 6.7 3.9-9.4 6.7 3.9-9.4
 30-34 11.4 7.9-15.0 9.2 6.0-12.4 10.8 7.3-14.2 9.2 6.0-12.4 10.8 7.3-14.2
 35-39 12.7 9.0-16.4 15.2 11.2-19.2 14.9 11.0-18.9 15.2 11.2-19.2 14.9 11.0-18.9
 40-44 13.0 9.3-16.8 13.7 9.8-17.5 14.0 10.1-17.8 13.7 9.8-17.5 14.0 10.1-17.8
 45-50 15.6 11.5-19.6 16.5 12.4-20.6 15.2 11.2-19.2 16.5 12.4-20.6 15.2 11.2-19.2
 50+ 33.3 28.1-38.6 35.2 29.9-40.5 34.6 29.3-39.9 35.2 29.9-40.5 34.6 29.3-39.9
Current marital status
 Married/cohabiting 60.1 57.2–62.9 71.6 67.5–75.3 53.6 49.7–57.4 74.3 69.3–78.7 56.0 48.1–63.5
 Never married 4.6 3.6–5.9 3.5 2.4–4.9 5.2 3.8–7.2 3.2 2.0–5.3 5.2 3.2–8.5
 Divorced/separated 8.9 7.6–10.4 8.9 6.7–11.7 8.9 7.4–10.7 7.7 5.4–10.8 8.8 6.3–12.2
 Widowed 26.4 24.1–28.9 16.1 13.6–19.0 32.3 28.9–35.8 14.8 11.8–18.4 30.0 24.7–35.8
 Married/cohabiting (n = 665) 58.2 54.4-62.0 29.8 26.3-33.3 28.3 24.8-31.7 29.8 26.3-33.3 28.3 24.8-31.7
Page | 65 
 Never married (n = 665) 2.0 0.9-3.0 0.8 0.1-1.4 1.2 0.4-2.0 0.8 0.1-1.4 1.2 0.4-2.0
 Divorced/separated (n = 665) 10.0 7.8-12.4 5.1 3.4-6.8 5.0 3.3-6.6 5.1 3.4-6.8 5.0 3.3-6.6
 Widowed (n = 665) 29.6 26.1-33.1 12.9 10.4-15.5 16.7 13.9-19.5 12.9 10.4-15.5 16.7 13.9-19.5
Education
Years of schooling 
completed (mean)
5.9 5.6–6.2 5.7 5.4–5.9 6.0 5.6–6.4 5.7 5.4–6.0 6.0 5.3–6.7
Highest level completed
Never attended school 11.1 9.4–13.1 11.7 9.3–14.6 10.8 8.6–13.4 11.5 8.7–15.1 12.3 8.6–17.4
Some primary school 36.6 33.9–39.4 36.4 32.7–40.3 36.8 33.1–40.6 36.2 31.3–41.3 35.8 29.8–42.3
Completed primary 
school
24.8 23.2–26.5 26.8 23.6–30.2 23.6 21.9–25.5 28.4 24.3–32.7 20.5 17.3–24.2
Some secondary school 22.0 19.7–24.6 22.4 19.3–25.9 21.8 18.6–25.4 21.7 18.2–25.8 22.0 16.9–28.0
Completed secondary 
school
4.2 3.2–5.4 2.2 1.2–3.8 5.3 3.9–7.0 1.7 1.0–2.9 7.3 4.4–11.9
Higher than secondary 
school
1.3 0.8–2.0 0.5 0.2–1.3 1.7 1.0–2.9 0.5 0.2–1.5 2.1.0 1.0–4.2
Years of schooling 
completed (mean) n = 231
7.9 7.6-8.2 7.4 7.1-7.8 8.0 7.6-8.3 7.4 7.1-7.8 8.0 7.6-8.3
Highest level completed
Never attended school 
(n = 323)
11.1 7.7-14.6 11.8 8.2-15.3 9.3 6.1-12.5 11.8 8.2-15.3 9.3 6.1-12.5
Some primary school (n 
= 233)
44.2 37.8-50.6 56.2 49.8-62.6 43.8 37.4-50.2 56.2 49.8-62.6 43.8 37.4-50.2
Completed primary 
school (n = 231)
77.1 77.6-82.5 72.7 66.9-78.5 77.1 71.9-82.5 72.7 66.9-78.5 77.1 71.9-82.5
Some secondary school 
(n = 233)
53.6 47.2-60.1 41.2 34.8-47.6 54.5 48.1-60.9 41.2 34.8-47.6 54.5 48.1-60.9
Completed secondary 
school (n = 231)
9.5 5.7-13.3 7.4 4.0-10.8 11.7 7.5-15.9 7.4 4.0-10.8 11.7 7.5-15.9
Higher than secondary 
school (n = 233)
2.1 0.3-4.0 2.6 0.5-4.6 1.7 0.0-3.4 2.6 0.5-4.6 1.7 0.0-3.4
Ability to read sentence in preferred language
Cannot read at all 33.4 30.6–36.4 38.1 33.9–42.5 30.8 27.0–34.8 38.7 33.6–44.0 30.2 24.8–36.2
Read part 18.0 16.3–20.0 18.3 15.7–21.2 17.9 15.5–20.5 19.4 16.2–23.1 20.5 16.3–25.5
Read whole 48.5 45.4–51.6 43.6 40.3–46.9 51.4 46.9–55.8 41.9 38.1–45.9 49.3 44.1–54.4
Cannot read at all (n = 322) 14.0 10.2-17.8 16.5 12.4-20.5 15.8 11.8-19.8 16.5 12.4-20.5 15.8 11.8-19.8
Read part (n = 322) 26.1 21.3-30.9 33.2 28.1-38.4 27.0 22.1-31.9 33.2 28.1-38.4 27.0 22.1-31.9
Read whole (n = 322) 52.8 47.3-58.3 41.0 35.6-46.4 49.4 43.9-54.9 41.0 35.6-46.4 49.4 43.9-54.9
Page | 66 
Household
Floor
Unfinished 41.3 37.2–45.5 71.7 66.3–76.6 24.0 18.7–30.2 77.9 71.9–83.0 39.1 26.6–53.2
Finished 58.7 54.5–62.8 28.3 23.4–33.7 76.0 69.8–81.3 22.1 17.0–28.1 60.9 46.8–73.4
Unfinished (n = 323) 0 --- 0 --- 0 --- 0 --- 0 ---
Finished 100 --- 100 --- 100 --- 100 --- 100 ---
Roof
Unfinished 20.7 17.4–24.4 45.4 38.1–52.8 6.7 3.9–11.1 52.0 43.0–60.8 12.8 6.4–23.9
Finished 79.3 75.6–82.6 54.6 47.2–61.9 93.3 88.9–96.1 48.0 39.2–57.0 87.2 76.1–93.6
Unfinished (n = 318) 0.3 -0.3-0.9 0.3 -0.3-0.9 0.0 --- 0.3 -0.3-0.9 0.0 ---
Finished 99.7 99.1-100.3 99.7 99.1-100.3 100 --- 99.7 99.1-100.3 100 ---
Wall
Unfinished 30.9 26.8–35.4 54.0 46.3–61.6 17.8 13.2–23.5 59.9 49.3–69.7 24.5 15.5–36.4
Finished 69.1 64.6–73.2 46.0 38.4–53.7 82.2 76.5–86.8 40.1 30.3–50.7 75.5 63.6–84.5
Unfinished (n = 319) 0.0 --- 0.0 --- 0.0 --- 0.0 --- 0.0 ---
Finished 100 --- 100 --- 100 --- 100 --- 100 ---
Wealth (count of 19 items: 
mean)
4.9 4.6–5.2 3.9 3.7–4.2 5.5 5.1–5.9 3.8 3.5–4.1 4.9 4.3–5.6
Wealth (count of 19 items: 
mean) n = 323
4.2 2.7-5.7 2.2 0.6-3.8 13.8 10.1-17.7 2.2 0.6-3.8 13.8 10.1-17.7
Own livestock
No 52.5 48.1–56.8 19.2 13.9–26.0 71.4 65.2–76.9 15.8 10.8–22.5 56.9 42.4–70.3
Yes 47.5 43.2–51.9 80.8 74.0–86.1 28.6 23.1–34.8 84.2 77.5–89.2 43.1 29.7–57.6
No (n = 324) 56.8 51.4-62.2 30.9 25.8-35.9 66.7 61.5-71.8 30.9 25.8-35.9 66.7 61.5-71.8
Yes (n = 324) 50.7 46.9-54.5 69.1 64.1-74.2 33.3 28.2-38.5 69.1 64.1-74.2 33.3 28.2-38.5
Own agricultural land 
No 47.8 43.3–52.3 15.7 10.6–22.7 66.0 59.7–71.8 11.0 7.8–15.3 53.3 38.4–67.7
Yes 52.2 47.7–56.7 84.3 77.3–89.4 34.0 28.2–40.3 89.0 84.7–92.2 46.7 32.3–61.6
No (n = 297) 63.6 58.1-69.1 32.0 26.7-37.3 74.7 69.8-79.7 32.0 26.7-37.3 74.7 69.8-79.7
Yes (n = 297) 36.4 30.9-41.9 68.0 62.7-73.3 25.3 20.3-30.2 68.0 62.7-73.3 25.3 20.3-30.2
Source: MTE Field Survey 2019 and Mbizvo, et al. 2018
Page | 67 
Appendix 5: Knowledge, Practice and Attitude Among Adolescents and Youth aged 10 to 17 years on HIV/AIDs 
Total rural Total urban Total Female 
rural
Total Female 
urban
Total Male rural Total Male 
urban
Total
% CI % CI % CI % CI % CI % CI % CI
OVC 10 to 17 years
Child has heard of illness called AIDs 
No (n = 131) 7.5 -1.0-16 5.0 -2.1-12.1 13.0 -1.8-27.9 0 --- 0 --- 11.1 -5.0-27.2 5.3 1.4-9.2
Yes (n = 131) 92.5 84.0-101.0 95.0 87.9-102.1 87.0 72.1-101.8 100 --- 100 --- 88.9 72.8-105. 94.7 90.8-98.6
HIV+ Students treated unkindly by other students
 No (n = 98) 65.0 42.1-87.9 80.0 60.8-99.2 66.7 35.4-98.0 83.3 58.6-108 50.0 5.3-94.7 50.0 5.3-94.7 66.3 56.8-75.9
 Yes (n = 98) 35.0 12.1-57.9 20.0 0.8-39.2 33.3 2.0-64.6 16.7 -8.1-41.4 50.0 5.3-94.7 50.0 5.3-94.7 33.7 24.1-43.2
Child knows HIV status
 No (n = 89) 7.1 -8.3-22.6 7.1 -8.3-22.6 0 --- 0 --- 14.3 -20.7-49.2 0 --- 4.5 0.1-8.9
 Yes (n = 89) 92.9 77.4-108.3 92.9 77.4-108. 100 --- 100 --- 85.7 50.8-120. 100 --- 95.5 91.1-99.9
Child knows where people can test for HIV
 No (n = 124) 20.0 6.1-33.9 17.1 4.0-30.3 26.3 4.5-48.1 15.8 -2.3-33.8 12.5 -5.7-30.7 18.8 -2.7-40.2 15.3 8.9-21.8
 Yes (n = 124) 80.0 66.1-93.9 82.9 69.7-96.0 73.7 51.9-95.5 84.2 66.2-102. 87.5 69.3-105. 81.3 59.8-102 84.7 78.2-91.1
Child had sex in past 1 year
No (n = 122) 81.8 67.9-95.7 93.9 85.3-102 78.9 58.8-99.1 89.5 74.3-104 85.7 84.7-105 100 -- 93.4 89.0-97.9
Yes (n = 122) 18.2 4.3-32.1 6.1 -2.5-14.7 21.1 0.9-41.2 10.5 4.7-25.7 14.3 -6.7-35.3 0 -- 6.6 2.1-11.0
Page | 68 
Appendix 6: PEPFAR MER Essential Indicators for OVC programs by DAPP provinces, age group and residence 
FY18 
PEPFAR MER Essential Indicators for OVC programs by DAPP provinces, age group and residence FY18
0-4 5-9 10-14 15-17 Total
Rural
n=64
Urban
n=48
Rural
n=116
Urban
n=113
Rural
n=35
Urban
n=64
Rural
n=7
Urban
n=27
Rural
n=222
Urban
n=252
% CI % CI % CI % CI % CI % CI % CI % CI % CI % CI
OVC
Caregiver knows child’s HIV status (n=1,530)
 No 40.7 32.3-49.6 46.9 36.6-57.4 53.6 1-61.0 36.0 26.5-46.8 62.3 53.7-70.3 48.2 38.8-57.6 57.1 43.9-69.4 49.0 33.4-64.8 55.1 48.2-61.8 44.1 35.3-53.2
 Yes 59.3 50.4-67.7 53.1 42.6-63.4 46.4 39.0-53.9 64.0 53.2-73.5 37.7 29.7-46.3 51.8 42.4-61.2 42.9 30.6-56.1 51.0 35.2-66.6 44.9 38.2-51.8 55.9 46.8-64.7
No (n=211, 240) 2.4 0.3-4.4 1.2 -0.2-2.7 --- --- --- --- 10 -4.4-24.5 4.5 -1.9-11 0 --- 0 --- 3 0.8-5.2 1.6 0.2-3.1
Yes (n=211, 240) 98.6 95.6-99.7 98.8 97.3-100.2 --- --- --- --- 90.0 75.5-104.4 95.5 89.0-101.9 100 --- 100 --- 97.0 94.8-99.2 98.4 96.9-99.8
Undernourished
 No 96.5 89.8-98.9 95.7 90.1-98.2 --- --- --- --- --- --- --- --- --- --- --- --- 96.5 89.8-98.9 95.7 90.1-98.2
 Yes 3.5 1.1-10.2 4.3 1.8-9.9 --- --- --- --- --- --- --- --- --- --- --- --- 3.5 1.1-10.2 4.3 1.8-9.9
 No (n=38, 44) 65.8 50.0-81.6 81.8 70.0-93.7 --- --- --- --- --- --- --- --- --- --- --- --- 65.8 50.0-81.6 81.8 70.0-93.7
 Yes (n=38, 44) 34.2 18.4-50.0 18.2 6.3-30.0 --- --- --- --- --- --- --- --- --- --- --- --- 34.2 18.4-50.0 18.2 6.3-30.0
Too sick to participate in daily activities
 No 50.0 42.6-57.4 56.3 41.1-70.3 67.1 61.9-71.9 69.7 63.6-75.3 67.3 62.4-71.8 63.6 56.4-70.3 59.0 50.0-67.4 72.1 60.1-81.6 63.4 60.4-66.3 65.9 60.9-70.6
 Yes 50.0 42.6-57.4 43.8 29.7-58.9 32.9 28.1-38.1 30.3 24.7-36.4 32.7 28.2-37.6 36.4 29.7-43.6 41.0 32.6-50.0 27.9 18.4-39.9 36.6 33.7-39.6 34.1 29.4-39.1
 No 85.9 77.2-94.7 70.8 57.5-84.2 83.6 76.8-90.5 83.2 76.2-90.2 100 100 100 100 87.4 83.0-91.8 86.9 82.7-91.1
 Yes 14.1 5.3-22.8 29.2 15.8-42.5 16.4 9.5-23.2 16.8 9.8-23.8 0 0 0 0 12.6 8.2-17.0 13.1 8.9-17.3
Has a birth certificate
 No 70.7 58.2-80.6 86.5 62.5-96.1 86.9 79.0-92.1 90.8 84.5-94.6 94.2 90.1-96.7 97.1 94.6-98.4 98.7 91.1-99.8 100 --- 88.0 82.3-92.0 93.9 89.0-96.7
 Yes 29.3 19.4-41.8 13.5 39.0-37.5 13.1 7.9-21.0 9.2 5.4-15.5 58.0 3.3-9.9 2.9 1.6-5.4 1.3 0.2-8.9 0.0 --- 12.0 8.0-17.7 6.1 3.3-11.0
 No 78.1 67.7-88.5 68.7 55.1-82.4 72.4 64.2-80.7 79.6 72.1-87.2 78.8 64.1-93.5 84.8 76.0-93.7 85.7 50.8-79.3 77.8 61.0-94.5 75.3 65.681.1 78.7 73.7-83.8
 Yes 21.9 11.5-32.3 31.3 17.6-44.9 27.6 19.3-35.8 20.4 12.8-27.9 21.2 6.5-35.9 15.2 6.3-24.0 14.3 20.7-49.2 22.2 5.5-39.0 24.7 18.9-34.4 21.3 16.2-26.3
Regularly attends school
 No --- --- --- --- 74.4 67.7-80.1 69.7 60.9-77.3 62.4 54.9-69.4 55.5 47.5-63.2 60.3 45.8-73.2 61.5 47.5-73.9 67.1 62.0-71.9 62.1 54.3-69.2
 Yes --- --- --- --- 25.6 19.9-32.3 30.3 22.7-39.1 37.6 30.6-45.1 44.5 36.8-52.5 39.7 26.8-54.2 38.5 26.1-52.5 32.9 28.1-38.0 37.9 30.8-45.7
No (n=109,155) --- --- --- --- 86.1 78.3-93.9 77.3 67.6-87.0 62.5 41.6-83.4 84.2 74.4-94.0 66.7 12.5-79.1 78.3 60.0-96.5 79.8 72.2-87.5 80.0 73.6-86.4
Yes (n=109,155) --- --- --- --- 13.9 6.1-21.7 22.7 13.0-32.4 37.5 16.6-58.4 15.8 6.0-25.6 33.3 -20.9-87.5 21.7 3.5-40.0 20.2 12.5-27.8 20.0 13.6-26.4
Progressed in school during the last year (n=112)
 No --- --- --- --- 55.6 44.9-65.8 42.5 35.0-50.5 9.9 7.2-13.4 86 6.7-11.0 16.9 10.3-26.6 17.4 8.8-31.6 22.9 20.0-26.1 19.8 16.3-23.8
 Yes --- --- --- --- 44.4 34.2-55.1 57.5 49.5-65.0 90.1 86.6-92.8 91.4 89.0-93.3 83.1 73.5-89.7 82.6 68.4-91.2 77.1 73.9-80.0 80.2 76.2-83.7
 No --- --- --- --- 10.5 2.3-18.7 22 11.1-32.9 23.8 3.9-43.7 24.3 9.8-38.8 16.7 -26.2-59.5 12.5 -5.7-30.7 14.3 6.6-21.9 21.4 13.7-29.1
 Yes --- --- --- --- 89.5 81.3-97.7 78.0 67.1-88.9 76.2 56.3-96.1 75.7 61.2-90.2 83.3 40.5-126.2 87.5 69.3-105.7 85.7 78.1-93.4 78.6 70.9-86.3
Page | 69 
Children <5 years of age who recently engaged in stimulating activities with any household member over 15 years of age (n= 328) *
 No 8.1 3.8-16.5 7.9 2.9-19.8 --- --- --- --- --- --- --- --- --- --- --- --- 8.1 3.8-16.5 7.9 2.9-19.8
 Yes 91.9 83.5-96.2 92.1 80.2-97.1 --- --- --- --- --- --- --- --- --- --- --- --- 91.9 83.5-96.2 92.1 80.2-97.1
 No 4.8 -0.6-10.2 0 --- --- --- --- --- --- --- --- --- --- --- --- --- 4.8 -0.6-10.2 0 ---
 Yes 95.2 89.8-100.6 100 --- --- --- --- --- --- --- --- --- --- --- --- --- 95.2 89.8-100.6 100 ---
Household level indicators
Household able to access money to pay for unexpected household expenses (n= 340)
 No --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- 35.7 29.1-43.0 58.4 52.5-64.0
 Yes --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- 64.3 57.0-70.9 41.6 36.0-47.5
 No --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- 48.4 39.5-57.3 35.8 28.0-43.6
 Yes --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- 51.6 42.7-60.5 64.2 56.4-72.0
Caregiver agrees harsh punishment is appropriate discipline
 No --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- 55.2 49.4-60.8 63.0 56.8-68.7
 Yes --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- 44.8 39.2-50.6 37.0 31.3-43.2
 No --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- 69.2 64.1-74.2 66.4 61.3-71.4
 Yes --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- 30.8 25.8-35.9 33.6 28.6-38.7
*Stimulating activities = Read books to a child, tell stories to a child, sing songs to a child, take child outside home, play with the child and name things/count/draw things with a child 
Page | 70 
Appendix 7: PEFPAR MER Core Indicators, by DAPP provinces, age group and residence 
PEFPAR MER Core Indicators, by DAPP provinces, age group and residence
0-4
n = 417
5-9
n = 943
10-14
n =1,129 
15-17
n = 422
Total
n = 2911
Total rural
n = 1,123
Total urban
n = 1,788
Total female
n = 1,435
Total male
n = 1,476
% CI % CI % CI % CI % CI % CI % CI % CI % CI
OVC
CW.2 Diarrhoea in past 2 weeks 
 No 66.6 61.6–71.2 — — — — — — 66.6 61.6–71.2 67.1 60.1–73.4 66.2 59.1–72.6 66.7 60.1–72.7 66.5 58.7–73.5
 Yes 33.4 28.8–38.4 — — — — — — 33.4 28.8–38.4 32.9 26.6–39.9 33.8 27.4–40.9 33.3 27.3–39.9 33.5 26.5–41.3
 No (n = 48) 77.1 64.8-89.4 --- --- --- --- --- --- 85.3 81.5-89.1 83.3 72.4-94.3 75.0 62.3-87.7 81.3 69.8-92.7 77.1 64.8-89.4
 Yes (n = 48) 22.9 10.6-35.2 --- --- --- --- --- --- 14.7 10.9-18.5 16.7 5.7-27.6 25.0 12.3-37.7 18.8 7.3-30.2 22.9 10.6-35.2
CW.3 Fever in past 2 weeks
 No 56.8 50.9–62.5 — — — — — — 56.8 50.9–62.5 53.9 44.5–63.1 59.2 51.9–66.2 59.0 51.6–66.1 54.6 46.9–62.0
 Yes 43.2 37.5–49.1 — — — — — — 43.2 37.5–49.1 46.1 36.9–55.5 40.8 33.8–48.1 41.0 33.9–48.4 45.4 38.0–53.1
 No (n = 48) 64.6 50.5-78.6 --- --- --- --- --- --- 76.8 68.8-84.7 77.1 64.8-89.4 68.8 55.1-82.4 70.8 57.5-84.2 77.1 64.8-89.4
 Yes (n = 48) 35.4 21.4-49.5 --- --- --- --- --- --- 23.2 15.3-31.2 22.9 10.6-35.2 31.3 17.6-44.9 29.2 15.8-42.5 22.9 10.6-35.2
CW.5 Day without eating in last 4 weeks (Age 2 – 17, n = 2,819)
 No 76.5 70.5–81.6 68.7 64.5–72.5 75.4 71.8–78.7 74.4 69.9–78.5 73.1 70.3–75.8 77.2 72.7–81.1 70.9 67.2–74.4 75.4 72.0–78.5 70.9 67.7–74.0
 Yes 23.5 18.4–29.5 31.3 27.5–35.5 24.6 21.3–28.2 25.6 21.5–30.1 26.9 24.2–29.7 22.8 18.9–27.3 29.1 25.6–32.8 24.6 21.5–28.0 29.1 26.0–32.3
 No (n = 14) 92.9 77.4-108.3 71.4 44.4-98.5 85.7 64.7-106.7 78.6 54.-103.2 83.0 79.4-86.7 64.3 35.6-93.0 71.4 44.4-98.5 57.1 27.5-86.8 92.9 77.4-108.3
 Yes (n = 14) 7.1 -8.3-22.6 28.6 1.5-55.6 14.3 -6.7-35.3 21.4 -3.2-46.0 17.0 13.3-20.6 35.7 7.0-64.4 28.6 1.5-55.6 42.9 13.2-72.5 7.1 -8.3-22.6
CW.6 Fully immunized (Age 1 – 4, n = 390)
 No 47.0 42.3–51.7 — — — — — — 47.0 42.3–51.7 43.4 36.9–50.0 49.8 43.5–56.1 48.5 41.2–55.9 45.4 38.5–52.5
 Yes 53.0 48.3–57.7 — — — — — — 53.0 48.3–57.7 56.6 50.0–63.1 50.2 43.9–56.5 51.5 44.1–58.8 54.6 47.5–61.5
 No (n = 105) 0 --- --- --- --- --- --- --- 0 --- 0 --- 0 --- 0 --- 0 ---
 Yes (n = 105) 100 --- --- --- --- --- --- --- 100 --- 100 --- 100 --- 100 --- 100 ---
CW.7 Has basic shelter
 No — — — — — — — — 12.5 10.9–14.3 14.8 12.1–18.0 11.2 9.2–13.5 — — — —
 Yes — — — — — — — — 87.5 85.7–89.1 85.2 82.0–87.9 88.8 86.5–90.8 — — — —
 No (n = 321) --- --- --- --- --- --- --- --- 19.4 16.4-22.4 20.2 15.8-24.7 18.1 13.8-22.3 --- --- --- ---
 Yes (n = 321) --- --- --- --- --- --- --- --- 80.6 77.6-83.6 79.8 75.3-84.2 81.9 77.7-86.2 --- --- --- ---
CW.8 Child has basic support in 4 domains*
 No — — — — 56.1 52.4–59.8 64.1 59.7–68.2 58.3 55.1–61.5 58.9 52.7–64.8 58.1 54.4–61.7 60.3 56.2–64.1 56.5 51.9–60.9
Page | 71 
 Yes — — — — 43.9 40.2–47.6 35.9 31.8–40.3 41.7 38.5–44.9 41.1 35.2–47.3 41.9 38.3–45.6 39.7 35.9–43.8 43.5 39.1–48.1
 No (n = 83) --- --- --- --- 0 --- 0 --- 0 --- 0 --- 0 --- 0 --- 0 ---
 Yes (n = 83) --- --- --- --- 100 --- 100 --- 100 --- 100 --- 100 --- 100 --- 100 ---
CW.10 Currently enrolled in school
 No — — 34.4 30.3–38.9 11.4 9.2–14.1 24.6 21.0–28.7 22.3 19.8–25.1 21.8 18.0–26.0 22.6 19.4–26.2 21.3 18.5–24.4 23.3 20.1–26.9
 Yes — — 65.6 61.1–69.7 88.6 85.9–90.8 75.4 71.3–79.0 77.7 74.9–80.2 78.2 74.0–82.0 77.4 73.8–80.6 78.7 75.6–81.5 76.7 73.1–79.9
 No (n = 151) --- --- 6.0 2.1-9.8 0 --- 0 --- 3.4 1.2-5.7 2.8 -0.4-5.9 3.9 0.8-7.0 1.1 -1.1-3.2 5.4 0.7-10.2
 Yes (n = 151) --- --- 94.0 90.2-97.9 100 --- 100 --- 96.6 94.3-98.8 97.2 94.1-100.4 96.1 93.0-99.2 98.9 96.8-101.1 94.6 89.8-99.3
Household level indicators
HW.1 Caregiver has basic support in 4 domains*
 No — — — — — — — — 53.1 50.2–56.0 53.8 49.3–58.1 52.7 48.9–56.5 — — — —
 Yes — — — — — — — — 46.9 44.0–49.8 46.2 41.9–50.7 47.3 43.5–51.1 — — — —
 No (n = 311) --- --- --- --- --- --- --- --- 23.8 19.0-28.6 15.4 11.4-19.5 23.5 18.7-28.2 --- --- --- ---
 Yes (n = 311) --- --- --- --- --- --- --- --- 76.2 71.4-81.0 84.6 80.5-88.6 76.5 71.8-81.3 --- --- --- ---
HW.2 Household able to access money to pay for food related expenses (n = 1,812)
 No — — — — — — — — 57.1 52.2–61.8 47.6 39.7–55.6 62.1 55.8–68.0 — — — —
 Yes — — — — — — — — 42.9 38.2–47.8 52.4 44.4–60.3 37.9 32.0–44.2 — — — —
 No (n = 323) --- --- --- --- --- --- --- --- 7.7 4.8-10.7 6.2 3.5-8.8 5.0 2.6-7.3 --- --- --- ---
 Yes (n = 323) --- --- --- --- --- --- --- --- 92.3 89.3-95.2 93.8 91.2-96.5 95.0 92.7-97.4 --- --- --- ---
HW.2 Household able to access money to pay for school-related expenses (n=1,412)
 No — — — — — — — — 66.2 61.8–70.3 58.9 51.6–65.7 70.8 65.2–75.8 — — — —
 Yes — — — — — — — — 33.8 29.7–38.2 41.1 34.3–48.4 29.2 24.2–34.8 — — — —
 No (n = 199) --- --- --- --- --- --- --- --- 53.3 46.3-60.3 47.2 40.2-54.2 53.8 46.8-60.8 --- --- --- ---
 Yes (n = 199) --- --- --- --- --- --- --- --- 46.7 39.7-53.7 52.8 45.8-59.8 46.2 39.2-53.2 --- --- --- ---
HW.3 Household food insecure (ever no food in past 4 weeks)
 No — — — — — — — — 26.0 22.7–29.6 35.5 29.1–42.5 20.6 17.1–24.6 — — — —
 Yes — — — — — — — — 74.0 70.4–77.3 64.5 57.5–70.9 79.4 75.4–82.9 — — — —
 No (n = 320) --- --- --- --- --- --- --- --- 34.4 29.1-39.6 49.7 44.2-55.2 35.0 29.7-40.3 --- --- --- ---
 Yes (n = 320) --- --- --- --- --- --- --- --- 65.6 60.4-70.9 50.3 44.8-55.8 65.0 59.7-70.3 --- --- --- ---
*Domains of child development = Physical, social-emotional, cognitive, communicative-language and adaptive 
Page | 72 
Appendix 8: USAID Zambia OVC Results Framework 
Chart 1: USAID Zambia OVC Results Framework 
Development Hypothesis: Accessing social services and economic support contributes to HIV/AIDS epidemic control and mitigation for OVC and their households
Goal: Improved care and resilience of vulnerable populations, specifically targeting children and adolescents living with, affected by and/or vulnerable to HIV and their 
households.
FAMILIES SERVICES STRUCTURES LEARNING
Result 1: Resilience of households to 
care for children and adolescents 
living with, affected by and/or 
vulnerable to HIV measurably 
increased (30% effort)
Result 2: Child wellbeing status 
measurably improved due to provision 
and accessing of quality care and support 
services (40% effort)
Result 3: Capacity of government and community 
structures to care for and support children and 
adolescents living with, affected by and/or 
vulnerable to HIV measurably increased (20% 
effort)
Result 4: Strengthened shared 
learning and evidence base to 
improve programming and 
inform policy and program 
investment (10% effort)
• IR 1.1. Percentage of households 
caring for OVC demanding and 
accessing health and social services 
measurably increased. 
• IR 1.2. Household livelihood and 
asset base to meet basic needs of 
children and support self-reliance 
measurably improved. 
• IR 1.3. Capacity of households to 
provide positive parenting measurably 
strengthened.
• IR 2.1. Referral systems and case 
management functions measurably well￾functioning for OVC adolescents living 
with, affected by and/or vulnerable to 
HIV to access the range of health and 
social services from a range of providers 
within their geographic area.
• IR 2.2. System for regularly assessing 
the vulnerability status of children and 
adolescents measurably strengthened.
• IR 2.3. Sources of health and social 
services for children, adolescents and 
households adequately available and 
accessible.
• IR 3.1. Capacity of government and civil society 
structures to maintain a well-functioning 
coordination of care system measurably increased.
• IR 3.2. Capacity of government and civil society 
structures to implement a well-functioning 
continuum of care system for children and 
adolescents living with HIV measurably 
increased.
• IR 3.3. Capacity of district and ward government 
entities to implement supportive supervision and 
monitoring methods to improve quality and 
coordination of OVC supportive services 
measurably increased.
• IR 3.4. Ability of priority districts and scale-up 
sites to participate in data management that 
• IR 3.1. Objective evidence of 
results and impact developed 
from program experience.
• IR 3.2. Evidence of program 
results and impact utilized to 
inform programming and policy 
dialogue with stakeholders, 
especially government and civil 
society.
Page | 73 
consolidates and provides community-level data 
to regional databases for reporting up into a 
national monitoring system measurably improved.
Page | 74 
Appendix 9: USAID Zambia OVC Results Framework 
Chart 2: USAID Zambia OVC Results Framework 
Development Hypothesis: Accessing social services and economic support contributes to HIV/AIDS epidemic control and mitigation for OVC and their households
Goal: Improved care and resilience of vulnerable populations, specifically targeting children and adolescents living with, affected by and/or vulnerable to HIV and their 
households.
FAMILIES SERVICES STRUCTURES LEARNING
Result 1: Resilience of households to 
care for children and adolescents 
living with, affected by and/or 
vulnerable to HIV measurably 
increased (30% effort)
Result 2: Child wellbeing status 
measurably improved due to provision 
and accessing of quality care and support 
services (40% effort)
Result 3: Capacity of government and community 
structures to care for and support children and 
adolescents living with, affected by and/or 
vulnerable to HIV measurably increased (20% 
effort)
Result 4: Strengthened shared 
learning and evidence base to 
improve programming and 
inform policy and program 
investment (10% effort)
• IR 1.1. Percentage of households 
caring for OVC demanding and 
accessing health and social services 
measurably increased. 
• IR 1.2. Household livelihood and 
asset base to meet basic needs of 
children and support self-reliance 
measurably improved. 
• IR 1.3. Capacity of households to 
provide positive parenting measurably 
strengthened.
• IR 2.1. Referral systems and case 
management functions measurably well￾functioning for OVC adolescents living 
with, affected by and/or vulnerable to 
HIV to access the range of health and 
social services from a range of providers 
within their geographic area.
• IR 2.2. System for regularly assessing 
the vulnerability status of children and 
adolescents measurably strengthened.
• IR 2.3. Sources of health and social 
• IR 3.1. Capacity of government and civil society 
structures to maintain a well-functioning 
coordination of care system measurably increased.
• IR 3.2. Capacity of government and civil society 
structures to implement a well-functioning 
continuum of care system for children and 
adolescents living with HIV measurably 
increased.
• IR 3.3. Capacity of district and ward government 
entities to implement supportive supervision and 
monitoring methods to improve quality and 
• IR 3.1. Objective evidence of 
results and impact developed 
from program experience.
• IR 3.2. Evidence of program 
results and impact utilized to 
inform programming and policy 
dialogue with stakeholders, 
especially government and civil 
society.
Page | 75 
services for children, adolescents and 
households adequately available and 
accessible.
coordination of OVC supportive services 
measurably increased.
• IR 3.4. Ability of priority districts and scale-up 
sites to participate in data management that 
consolidates and provides community-level data 
to regional databases for reporting up into a 
national monitoring system measurably improved.
Page | 76 
Appendix 10: Summary Report on Key Informants and Focus Group
Discussions 
Key Informants Interviews were conducted with 65 Key Informants from key stakeholder 
organizations comprising DAPP, USAID, Creative Associates, NZP+, KAFHI, YWCA, 
Ministry of Health, Ministry of Community Development and Social Services and Population 
Council., In addition, FG Hs were convened with 19 Groups of 10 participants (190 participants). 
Tabulated below is a summary of FGDs and KIIs:
1. Relevance 
Major activities of the project included the following 
 Vegetables (cabbage, onion, rape, beans, pumpkins) growing as group, sales proceed sued 
to support OVC 
 Savings and Internal Lending Communities (SILC). In a group of 10 members, make cash 
savings and lend money to members at minimum interest. 
 Provision of “pass – ons” to VAG members and pass-on to other members of the group 
who are in the line of receiving. The pass – ons include livestock (chicken and goats) and 
legume crops (cowpeas, pigeon peas and soya beans 
 Community Health Workers (CHWs) and Children Care Volunteers (CCVs) are trained 
by the medical staff in health centres in HIV counselling, testing. treatment, care and 
support. These volunteers conduct outreach visits to households with OVC 
infected/affected by HIV and AIDS 
 Project leaders in conjunction with community mobilizers conducting training with VAG 
members in health, agriculture, HIV and AIDS, water, sanitation and hygiene. The 
trainings were conducted for VAG members, Youth and Kids Clubs using VAG training 
and Youth Training manuals respectively. 
 School Block grant to selected schools (desks, books and teaching materials). Selected 
OVC pupils have had their school fees waived. 
Responding to community needs 
 Able to grow vegetables and legumes which are sold. Some are retained for household 
consumption and surplus sold for cash. Sales proceeds are used to meet household 
expenses and pay school fees for children 
 Pass – ons (goats and chickens) given to VAG members (households) constituting liquid 
assets. Meat to be consumed in households and manure to be used in gardens 
 SILC: Able to save and borrow on affordable terms (2 – 5 % interest) By laws in place to 
govern defaulters. Loans used to invest in small businesses and proceed used to pay 
school fees 
Page | 77 
2. Effectiveness 
Individual service providers (CHW, CCVs) who are trained by medical experts and psychosocial 
counsellors in counselling and screening OVCs perform better (professionally, ethics, quality of 
service) because they had been prepared for service provision. 
In fact, according to Zambian Health Act, no one is allowed to conduct counselling and HIV 
testing without undergoing training and being certified by relevant body 
Uptake of social grants, health care and child protection services amongst OVCs and their 
households is high as long these services were readily available to the them (OVCs & households). 
The barriers were manifested in terms of procuring school block grants (desks & 
teaching/learning materials). 6 out of 9 schools had received the school block grant. For health 
care, few facilities which are far away from some villages beset with medicine stock outs and few 
medical staff and inadequate HIV testing kits. 
Trainings conducted by project leaders and community mobilisers who stay in the same project 
communities with targeted households and OVCs. Training manuals useful but could have been 
more helpful if translated into local languages 
Support to communities in setting up SILC groups 
Delays in disbursement of school block grant resulting in non- waiving of school fees which 
made some OVC pupils not attending school regularly 
Pass-ons “goats and chickens beset with problems of chickens dying as soon as there were give 
out to recipient households+ 
3. Exit and Sustainability 
Household Level 
Care givers received training in parenting (looking after OVCs and supporting them) the skills 
which they are using in keeping OVCs 
Skills acquired in gardening and entrepreneurship being used. Households will continue using 
them even after project end 
Pass-ons (goats, chickens & legumes) assets of households. Source of food and income 
Acquired WASHE knowledge and skills improved household sanitary and hygiene conditions 
OVC pupils enrolled and retained in schools. 
Support Groups, where they have been formed provide counselling and support to OVCs on 
ART 
Page | 78 
Community Level 
Weekly meetings and trainings improved relationships and unity in project communities 
Increased small business, distributed livestock and legumes, increased economic activities of 
project communities 
Through community dialogues – identify community problems and solutions to address. The 
community platform can be used to lobby for development from relevant authorities (community 
voice) 
OVC community structures 
NHC and CWAC (CHW) are existing structures which will continue. CHWs are attached to local 
health facilities 
Trained CCVs and CHWs will continue rendering services as they are linked to health facilities 
Youth and Kids Clubs are part of school structures and will continue functioning after project 
end 
Traditional and civic leaders and Parents Teachers Association have been sensitized on OVCs 
and project interventions to provide support and services to them 
DAPP ZAFAM Project Challenges 
- Delays in procurement of school block grant (desks, learning & teaching materials) 
- Long distances to health facilities, in some areas, where communities have to walk long 
distances. Referral system not working well 
- Support group not established in each project community: Some are far off 
ZAMFAM SC embedded in local structures 
- NHC, WASHE, CWACS, traditional and civic structures- strongly embedded in these 
structures 
- Schools: Youth and Kids Clubs 
- Community Support Group 
- Community Action Groups/Saving Groups 
-
Page | 79 
4. Cross Cutting Issues 
4.1 Gender 
-Parenting responsibilities tilt more towards women. Gender sensitization (trainings) 
being made. More women caregivers than men (Demographic statistics) 
- VAG/Saving Groups, more women than men. At project start, more women 
and men started joining them. Involvement of traditional and civic leaders and school 
teachers 
- Apparently, more men involved in goats and women in small livestock 
4.2 Environment 
- WASH training considered environmental challenges (diseases covered – bacterial & malaria) 
Caring services (use of mosquito net) 
- SMART agriculture training and practice 
- Youth & Kids Clubs: environmental protection 
5. Lessons learnt and recommendations 
Projects targeting urban areas should be differianted from rural areas 
- Wellbeing can be improved if empowered with knowledge and information e.g. SILC, 
entrepreneurship can reduce dependency on government and donor 
- Possible to reduce new infections based on ZAMFAM results – reduced indulgence in 
casual sex, usage of condoms 
- Targeting youth and parents, effective in reducing casual sex 
- School block grant enhances OVC pupils school attendance and progression in school 
- Improved quality of housing among participating households 
- Reduced cases of diarrhoea cases 
- Malnutrition, especially during lean period, continues to be challenge. Benchmark and 
MTE were done at different agricultural seasons (benchmark – May & July) and MTE 
(Dec/Jan). at lull period. 
Page | 80 
Appendix 11: List of Key Informants 
LIST OF KEY INFORMANTS 
S/N Full name Sex Position Organisation District Phone No.
1 David Mwale M District Coordinator DAPP Chibombo 096 0282862
2 Shambulo Kalengu M M & E Specialist DAPP Kabwe
3 Andrew Nkole M Project Leader DAPP Chibombo 0960282942
4 Idah K. Phiri F Senior School Teacher Syanalumba Primary 
School
Livingstone 0977 620314
5 Hurryness T. Lilanda F Deputy School Head Syanalumba Primary 
School
Livingstone 0977 670661
6 Festus Chisenga F Community Mobiliser DAPP Livingstone 096 8721 123
7 Mirriam Sinamuwi F Community Mobiliser DAPP Livingstone 096 8721 123
8 George Manyika M Community Mobiliser DAPP Livingstone 0960282779
9 Kalembi Luyako F Environmental Health 
Technician
Libuyu Health 
Centre
Livingstone 0977934845
10 Emma Muchela F Deputy Sister – in￾Charge
Libuyu Health 
Centre
Livingstone 0977653710
11 Kuliwa Makale F CWAC member Ministry of 
Community 
Development
Livingstone 0978172305
12 Juliet Zulu F NHC member Ministry of Health Livingstone 0979152686
13 Roy Kanganja M NHC Zonal Chairperson Ministry of Health Livingstone 0972064303
14 Munalula Yuwanga M Community Mobiliser DAPP Livingstone 0960282999
15 Mercy Nawa F Community Mobiliser DAPP Livingstone 0960283024
16 Martin Balengu M Community Mobiliser DAPP Livingstone 0960283010
17 Lisa Shantungwa F Project Leader DAPP Livingstone 0960282966
18 Blending Mendes F Project Leader DAPP Livingstone 0960282973
19 Melvis Zulu F Community Mobiliser DAPP Livingstone 09602822995
20 Caroline Kauseni F DAC Advisor District AIDS Task 
Force
Livingstone 097406779
21 Kalumba Melvin M Social Economic Planner City Council Livingstone 0977311927
22 Sekeleti Nanda M Environmental Planner City Council Livingstone 0966878842
23 Linda Chitanda F Volunteer Youth Alive Zambia Livingstone 0965862544
24 Austin Makembo F Community Mobilizer DAPP Mazabuka 0960282823
25 Able Chilundika M Project Leader DAPP Mazabuka 0960282927
26 Nchimunya Habwebe M Community Mobilizer DAPP Mazabuka 0969122093
27 Audrin Kasompola M Project Leader DAPP Mazabuka 0969182804
28 Joyce Mapulanga M Community Mobilizer DAPP Mazabuka 0960282801
29 Salome T. Simbule F Assistant Social Welfare 
Officer
Ministry of 
Community 
Development
Mazabuka 0973077766
30 Prudence Mulosa F Assistant Community 
Development Officer
Ministry of 
Community 
Development
Mazabuka 0979552403
31 Geoffrey Chisala M Senior Teacher /Clubs 
Coordinator
Mount Camel 
Primary Schoo
Kapiri Mposhi 0972756162
32 Petronella Chibesa F Community Mobiliser DAPP Kapiri Mposhi 0960282752
33 Milton Simwinga M VAG Coordinator DAPP Kapiri Mposhi 0965445392
34 Ellen Mambo F VAG Coordinator DAPP Kapiri Mposhi
35 Christopher Simfukwe M Deputy School Head Mushimbili 
Community School
Kapiri Mposhi 0979548113
36
Page | 81 
37 Alick Mwelwa M Community Mobilizer DAPP Kapiri Mposhi 0960282816
38 Nalwamba Prisca F Sister in Charge Mutaba Clinic Kapiri Mposhi 0966242704
39 Loveness Kabwe F Nurse Mutaba Clinic Kapiri Mposhi
40 Agness Matanda F Nurse Mutaba Clinic Kapiri Mposhi
41 Janet M. Kachenga F Children Care Giver DAPP Kapiri Mposhi 0976312091
42 Audrey Kaumba M Community Mobiliser DAPP Kapiri Mposhi 0969183081
43 Reuben Kamalondo M Village Head man Judan Village, Chief 
Chipepo
Kapiri Mposhi 09792213856
44 Milimo Munanyimbo M Data Entry Clerk DAPP Kapiri Mposhi 0960282764
45 Kunda Lubingu F Data Entry Clerk DAPP Kapiri Mposhi
46 Bonaventure K. 
Siatumbu
M Capacity Building 
Specialist/Team Leader
Creative Associates 
International
Kabwe
47 Eunice Mwenya F Programs Manager Kabwe Adventist 
Family Health 
Institute (KAFHI
Kabwe 0974567771
48 Angela Mkandawire F Programs Officer KAFHI Kabwe 0977737434
49 Josephine K. Siame F Regional Coordinator YWCA Kabwe 0978564004
50 Eurny Ngoma M Programme Officer YWCA Kabwe
51 Joseph Siwabamundi M Finance Director DAPP Kabwe
52 Wilson Chipulu M Community Mobiliser DAPP Kabwe 0960282772
53 Solomon Mumisa M District Coordinator NZP+ Kabwe
54 Stellious Muyeye M Finance & 
Administrative Officer
NZP+ Kabwe 0976981091
55 Mick Mwanabunga M Youth Coordinator NZP+ Kabwe 0971781705
56 Alice Lungu F Programme Assistant NZP+ Kabwe 0979443137
57 Nkomba Kayeyi M ZAMFAM Unit Head Population Council Lusaka
58 Justin D. Kalenga M Village Headman Chiwaya Village, 
Chief Liteta
Chibombo 0968449422
59 George Mweene M CHW/Village Headman Hamabwe Village, 
Chief Liteta
Chibombo 0967238319
60 Royce Bbenkele F Sister – in- Charge Malombe Health 
Centre
Chibombo 0977379279
61 Mwitila Audrey F Teacher/Club 
Coordinator
Malombe Primary 
School
Chibombo 0962081847
62 Matthews Muzingwa M VAG Coordinator DAPP Chibombo 0965403246
63 Eunice Phiri F Community Mobilizer DAPP/Chazanga Chibombo 0978600746
64 Cynthia Shafuluma F Deputy School Head Chinshanshi 
Community School
Chibombo 0973583312
65 Tickley Chilinga M School Head Muleke Community 
School
Mumbwa 09792729916
66 Faustin Musanje F Deputy School Head Muleke Community 
School
Mumbwa 0978930825
67 Bornwell Shambwalu M Senior Village Head Chimoto Village, 
Chief Mumba
Mumbwa 0953765658
68 Phinia Mooya M School Head Mumba Scheme 
Primary School
Mumbwa 0966468721
69 Killian Mweemba M Deputy School Head Muleke Community 
School
Mumbwa 0961998376
70 Given Mwansa F Teacher/Clubs 
Coordinator
Muleke Community 
School
Mumbwa 0966805154
71 Patrick Hangumbulu M CHW/Counsellor Maimwene Health 
Post
Mumbwa 0977386059
72 Charity Juma F Nurse Maimwene Health 
Post
Mumbwa 097607368
73 Peter Banda M Community Mobilizer DAPP Mumbwa 0960282776
Page | 82 
Appendix 12: List of Focus Group Discussion participants 
LIST OF FOCUS GROUP DISCUSSION PARTICIPANTS 
District Planned FGD Actual FGD Number of Participants
Livingstone 2 4 40
Mazabuka 2 3 30
Kabwe 2 3 30
Kapiri Mposhi 2 3 30
Chibombo 2 3 30
Mumbwa 2 3 30
Total 12 19 190
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Appendix 13: Terms of Reference 
 
 
Terms of Reference (ToR) 
Mid-Term Evaluation of Development Aid from People to People (DAPP) 
Zambia Family (ZAMFAM SC), a United States for AID International 
Development (USAID) funded Project November 2016–March 2018 
ZAMFAM SC Project Monitoring and Evaluation Unit 
8/5/2018 
Version 2.0 
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LIST OF ACRONYMS ....................................................................................................................................... 3
1. INTRODUCTION...................................................................................................................................... 4
1.1 ABOUT DAPP ................................................................................................................................................ 4
1.2 ABOUT THE PROJECT........................................................................................................................................ 4
2. RATIONALE, EVALUATION USERS AND STAKEHOLDERS ......................................................................... 5
2.1 RATIONALE.................................................................................................................................................... 5
2.2 EVALUATION USERS ........................................................................................................................................ 5
2.3 STAKEHOLDERS............................................................................................................................................... 5
3. EVALUATION PURPOSE, OBJECTIVES AND SCOPE ..................................................................................... 5
3.1 PURPOSE....................................................................................................................................................... 5
3.2 SPECIFIC OBJECTIVES........................................................................................................................................ 6
3.3 SCOPE .......................................................................................................................................................... 6
4. EVALUATION APPROACH........................................................................................................................... 6
4.1 EVALUATION CRITERIA AND QUESTIONS .............................................................................................................. 6
5. APPROACH AND METHODOLOGY .......................................................................................................... 7
6. EXPECTED DELIVERABLES AND TIMELINE .............................................................................................. 8
7. MANAGEMENT AND IMPLEMENTATION RESPONSIBILITIES ................................................. 9
8. QUALITY ASSURANCE ..........................................................................................................................10
9. BUDGET...............................................................................................................................................11
APPENDICES ................................................................................................................................................12
A. MTE REPORT STRUCTURE ............................................................................................................................ 12
TABLE 1: CRITERIA AND EVALUATION QUESTIONS............................................................................................................. 7
3 | D A P P Z A M F A M S C P r o j e c t M T E T O R , A u g u s t , 2 0 1 8
List of Acronyms 
AIDS Acquired Immune Deficiency Syndrome 
DAPP Development Aid from People to People 
ERG Evaluation Reference Group 
ET Evaluation team 
EoI Expression of Interest 
HIV Human Immune-deficiency Virus 
HTS HIV Testing Services 
KAFHI Kabwe Adventist Family Health Institute 
KAP Knowledge, Attitude and Practice 
M&E Monitoring and Evaluation 
MTE Mid-Term Evaluation 
NGOs Non-Governmental Organizations 
NZP+ Network of Zambian People Living with HIV 
OVC Orphans and Vulnerable Children 
PEPFAR President’s Emergency Plan for AIDS Relief 
USAID United States Agency for International Development 
ToR Terms of Reference 
ZAMFAM SC Zambia Family South Central Project 
ZMK Zambian Kwacha 
4 | D A P P Z A M F A M S C P r o j e c t M T E T O R , A u g u s t , 2 0 1 8
1. Introduction 
1.1 About DAPP 
DAPP-Zambia is a local Non-Governmental Organization (NGO) whose goal is to reduce 
poverty by enabling marginal groups in communities to make sustainable improvements to 
their wellbeing through participatory development models. DAPP is registered as a Zambian 
welfare organization and has a track record of successful grass-roots development in 
Zambia. 
1.2 About the project 
USAID is supporting DAPP to implement the Zambia Family South-Central (ZAMFAM SC) 
project. ZAMFAM SC is a five-Year project (November 2015-November 2020) working 
collaboratively with Creative Associates International, Kabwe Adventist Family Health 
Institute (KAFHI) and the Network of Zambian People Living with HIV and AIDS (NZP+) to 
strengthen comprehensive, integrated, service delivery and support to children living with, 
affected by, or vulnerable to HIV and AIDS. The goal of the project is to improve the care
and resilience of Orphans and Vulnerable Children (OVC) and their households in the two 
targeted provinces of Zambia: Southern and Central. ZAMFAM SC is providing child and 
family focused services, including community-based child welfare support and sustainable 
delivery of a full range of services needed for the families. The specific objectives which 
ZAMFAM SC is actively pursuing include: 
 Increasing resilience of households to care for children and adolescents living with, 
affected by and/or vulnerable to HIV; 
 Improving child wellbeing status due to provision and accessing of quality care and 
support services; 
 Increasing capacity of government and community structures to care for and support 
children and adolescents living with, affected by and/or vulnerable to HIV; and 
 Strengthening shared learning and evidence base to improve programming and 
inform policy and program investment. 
ZAMFAM SC is implementing activities in ten districts namely: Chibombo, Kabwe, Kapiri, 
Mubwa in the central part of Zambia, and Livingstone, Mazabuka, Monze, Namwala, 
Sinazongwe in the southern part of Zambia. The project maintains services to 72,219
households and 125, 000 OVC each year. 
As the ZAMFAM SC Project has now reached the half-way point, an MTE is being 
commissioned in accordance with a cooperative agreement as indicated in the Monitoring 
and Evaluation (M&E) Plan to assess the progress towards achieving the project objectives 
thus far. 
5 | D A P P Z A M F A M S C P r o j e c t M T E T O R , A u g u s t , 2 0 1 8
2. Rationale, Evaluation users and Stakeholders 
2.1 Rationale 
The MTE is being commissioned for the following reasons: 
 The ZAMFAM SC Project conducted a baseline study before the start of the project 
that provided a situational analysis. This allowed ZAMFAM SC to establish indicator 
baseline information and to verify the targets established in the project agreement. 
This MTE will allow ZAMFAM SC to follow up on the progress of the indicators 
established based on the results of the baseline study. 
 Project improvement - using MTE results as feedback to ZAMFAM project to make 
the project function more effectively and efficiently. 
 Project accountability and transparency – to allow stakeholders and funder to be 
aware of the progress of the project. 
 Provide strategic and concrete evidence on the relevance, results, processes, and 
resource utilization for the project. 
2.2 Evaluation Users 
The expected users of this MTE will be, primarily, the ZAMFAM SC Project team, DAPP 
Partnership Office, Government of the Republic of Zambia (GRZ), USAID, and the partners 
that are involved in project implementation. 
2.3 Stakeholders 
A number of stakeholders both inside and outside of the ZAMFAM SC Project have interests 
in the results of the evaluation and some of these will be asked to play a role in the evaluation 
process. The Evaluation team (ET) will provide a deep stakeholder analysis as part of the 
Inception phase. 
Accountability to affected populations is tied to DAPP’s commitments to include beneficiaries 
as key stakeholders in DAPP’s work. DAPP is committed to ensuring gender equality and 
women’s empowerment in the evaluation process, with participation and consultation in the 
evaluation with women, men, boys and girls from different beneficiary groups. 
3. Evaluation Purpose, Objectives and Scope 
3.1 Purpose 
The purpose of the MTE is to assess progress so far towards achieving project objectives 
and outcomes and draw out lessons for how ZAMFAM SC Project can be improved during 
the rest of its implementation for a more positive impact. 
6 | D A P P Z A M F A M S C P r o j e c t M T E T O R , A u g u s t , 2 0 1 8
3.2 Specific objectives 
In particular, the MTE will aim to: 
 Assess the relevance of the strategies and the approach used in the implementation 
of ZAMFAM Project; 
 Assess the effectiveness and efficiency in the implementation of ZAMFAM Project at 
province, district, and sub-district levels; 
 Assess the results achieved in ZAMFAM Project and the extent to which sustainability 
considerations have been built-in; 
 Compare baseline data with the current evaluation data and provide insights into 
progress against the targets of the project; 
 Assess the extent to which issues of gender equality, social inclusion and equity, and 
environment have been taken into consideration; 
 Assess the extent of coordination with partners and other actors in the area of 
OVC/HIV with a view to strengthen partnerships; and 
 Identify lessons and good practices from the implementation of ZAMFAM SC, and 
opportunities to improve current planning, project implementation, and feed into the 
project improvement plan for the remaining two and half years. 
3.3 Scope 
The evaluation will cover ZAMFAM SC Project interventions during the period November, 
2016- June, 2018. The evaluation will be forward-looking and will provide lessons and 
actionable recommendations to improve on the future performance of ZAMFAM SC Project 
for the remaining period. 
The geographical scope will include all two provinces in the ZAMFAM project six districts of 
operation where the project interventions are being undertaken: Chibombo, Kabwe, Kapiri, 
Livingstone, Mazabuka and Mumbwa. 
4. Evaluation Approach 
4.1 Evaluation Criteria and Questions 
 Evaluation Criteria: The evaluation will apply the international evaluation criteria of 
Relevance, Effectiveness, Efficiency, Impact and Sustainability. 
 Evaluation Questions: Allied to the evaluation criteria, the evaluation will address 
the following key questions, which will be further developed by the Evaluation team 
during the inception phase. Collectively, the questions aim at highlighting the key 
lessons and performance of the ZAMFAM project, which could inform future strategic 
and operational decisions moving forward in the remaining two and half years 
implementation. Below is a table with relevant criteria and evaluation questions. 
7 | D A P P Z A M F A M S C P r o j e c t M T E T O R , A u g u s t , 2 0 1 8
TABLE 1: CRITERIA AND EVALUATION QUESTIONS
Criteria Evaluation Questions
Relevance  To what extent were the operations and objectives of the ZAMFAM SC 
Project consistent with beneficiaries’ needs, and GRZ and donors’ 
policies? 
 Were approaches and strategies used relevant to achieve the intended 
changes in the baseline values?
Effectiveness
 What best practices can be documented with regard to service delivery 
and implementation?
 What is the level of knowledge and awareness of OVC around HIV/AIDS?
 What is the change in Knowledge, Practice and Attitude on HIV and AIDS 
among adolescents and youth? 
 How have rates of graduation of OVC due to decreased vulnerability 
changed over the course of implementation
Efficiency  To what extent have the resources of the project been efficiently utilized?
Exit and 
sustainability  What will the household likely going to continue beyond the life of the 
project?
 What supportive mechanism have been put in place for the household?
Cross-cutting Issues
Coordination, 
Gender, and 
Environment.
 What has been the environmental concerns and what has been the 
mitigations this far?
 To what extent has the project implementation mainstreamed gender 
issues?
5. Approach and methodology 
The evaluation approach will be both process and outcome based. 
The project implements a routine monitoring system based on a Log Frame developed at the 
beginning of the project and corresponding data collection plan to collect data against key 
output and outcome indicators. The evaluation methodology is expected to review this data 
and, as far as possible, allow comparability taking into account any issues around data 
collection for the first half of the project. 
The consultant is expected to employ a variety of data collection and analysis techniques for 
both quantitative and qualitative data to ensure a comprehensive evaluation exercise. This 
will likely include, at a minimum: 
 Document and systems review: Review of existing documentation, including; 
project reports, project log frame and monitoring and evaluation data. 
 Surveys: Application of structured survey questionnaires with a representative, 
random sample of target population to quantitatively assess outcomes. This will be in 
greater in scope, breadth and depth compared to standard routine project monitoring. 
 Focus Group Discussions: With target groups and other stakeholders to assess 
implementation experiences and effectiveness, document successes, challenges and 
lessons learned, and develop recommendations for improvement. 
8 | D A P P Z A M F A M S C P r o j e c t M T E T O R , A u g u s t , 2 0 1 8
 Key Informant Interviews: Consultations with key project stakeholders, including 
field staff and partners. Guidance on appropriate stakeholders will be provided by 
ERG. 
The consultant will be expected to: 
 Review relevant project documents, including but not limited to: project reports, 
project log frame, household survey reports and data and baseline surveys. 
 Collect and review relevant guideline document and relevant secondary data etc. 
 With the guidance of ERG develop, test and apply survey questionnaires. A 
representative random sample of the target population should be interviewed to 
assess outcomes and establish prospect impact of the project interventions in line 
with log frame indicators. The project is putting a strong emphasis on the need to 
collect information’s on outcome indicators. 
 Design and conduct focus group discussions with relevant community members, both 
male and female, to assess implementation experiences and effectiveness, 
document successes, challenges and lessons learned, and develop 
recommendations for improvement. 
 Carry out key informant interviews i.e. consultations with key project stakeholders, 
including field staff and partners. Guidance on appropriate stakeholders will be 
provided by ERG. 
 Collate and analyses data. 
 Present findings to ZAMFAM key stakeholders and staff and invite comments at a 
one-day workshop. 
 Draft report and submit to ZAMFAM for comments. 
 Incorporate comments and produce final report. 
6. Expected Deliverables and Timeline 
All written documentation is to be submitted in English using Microsoft Word in both soft and 
hard copy. The main body of all reports should be written in simple, non-technical language 
(i.e. plain English), with any technical material to be presented in annexes. All primary data 
collected and analysis conducted for the purpose of the evaluation will remain the property 
of ZAMFAM SC and must be submitted electronically and in a clear and comprehensible 
format in Excel. 
The evaluation should begin no later than between the 20th August 2018, with the evaluator(s) 
expected to take a total of 40 days from the day of contracting to complete the assignment. 
The consultant will provide the following deliverables to ZAMFAM SC within the timeframe 
stated: 
1. Inception Report: within 5 working days of evaluation launch, a detailed report on the 
evaluator’s proposed approach to the evaluation will be submitted for approval. This will 
provide preliminary findings/understandings based on document review, rationale and a 
detailed description of the methodology and tools, research questions, analytical 
methods, budget with a breakdown of costs and detailed work plan for the entire exercise. 
Any draft questionnaires or interview forms will also be submitted for review at this stage. 
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2. Data collection: testing questionnaires, refining data collection tools, and administer 
data collection within 7 working days of the evaluation launch. 
3. Data analysis and reporting: Preliminary Report and Presentation: within 30 
working days of evaluation launch, the consultant will present the preliminary findings 
for discussion at a stakeholders’ workshop. This should include a draft set of 
recommendations and lessons learnt. At the end of the workshop, a report incorporating 
comments by stakeholders should be produced. 
4. Final Report: within 50 days of evaluation launch, a detailed report of the overall findings 
of the MTE will be submitted to the Managing Director and Chief of Party for approval. 
The report structure is annexed to this ToR. 
5. A Power point presentation outlining key findings and implications, and recommendation 
for future implementation to be presented at a Stakeholders’ Workshop in November 
2018.
7. Management and Implementation Responsibilities 
The consultant will report directly to the Chief of Party and ERG Coordinator. However, s/he 
will also be expected to work closely with the field staff. Any proposed changes to the 
personnel listed in the application must be explained in the inception report and approved by 
ERG. 
DAPP ZAMFAM project will provide: 
 Relevant project documents; 
 Guidance and technical support as required throughout the evaluation; 
 Logistical arrangements for all field travel; 
 Copies of all key background resources identified; 
 ERG time up to a maximum of 3 person to assist with data collection; 
 Introductory meetings with key government staff; 
 Comments and feedback on, and approval of, all deliverables within agreed timeline 
The consultant will be responsible for: 
 Review documents and submit inception report; 
 Developing the detailed evaluation methodology; 
 Conducting all data collection; 
 Analysis of data and reporting in a clear and accessible format; 
 Regular progress reporting to the evaluation manager, including responding to any 
comments or technical inputs wherever reasonable; 
 Production of deliverables within agreed timeline and in accordance with quality 
requirements of evaluation manager; 
 Seeking comments and feedback from ERG regularly, through ERG Coordinator, in 
sufficient time to discuss and incorporate these into the final report. 
 Production of the final evaluation report containing data against all indicators in the 
project log frame, evidence-based responses to the key evaluation questions, 
summary of lessons learnt and recommendations for future implementation. 
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Qualification and Desirable Competencies: Applications from individuals or teams are 
welcome and will be assessed on their ability to demonstrate the following qualifications and 
competencies: 
Essential requirements: 
 A minimum of 5 years’ experience in carrying out impact evaluations, demonstrable 
academic and practical experience in qualitative and quantitative research 
methodology, evaluation design and implementation. 
 Experiences in public health, preferably including HIV programs 
 Experiences in community engagement and economic strengthening programs 
 Good knowledge of gender issues 
 Strong analytical and communication skills, evaluation experience and familiarity with 
Zambia OVC landscape 
 Familiarity with the approaches, rules, regulations of the donors, particularly that of 
USAID/PEPFAR 
8. Quality Assurance 
The first level of quality assurance of all evaluation deliverables will be conducted by the EET 
prior to submitting the deliverables to the ERG. 
The ERG recommends the evaluation quality assessment checklist (see below) is used as 
an element of the proposed quality assurance system for the draft and final versions of the 
thematic evaluation report. The main aim of the checklist is to ensure that the thematic 
evaluation complies with evaluation professional standards. 
Evaluation quality assessment checklist: 
Components Explanation
1. Structure and Clarity of 
the Report
To ensure report is user-friendly, comprehensive, logically 
structured and drafted in accordance with international standards.
2. Executive Summary To provide an overview of the evaluation, written as a stand-alone 
section including key elements of the evaluation, such as 
objectives, methodology and conclusions and recommendations.
3. Design and Methodology To provide a clear explanation of the methods and tools used 
including the rationale for the methodological choice justified. To 
ensure constraints and limitations are made explicit (including 
limitations applying to interpretations and extrapolations; 
robustness of data sources, etc.)
4. Reliability of Data To ensure sources of data are clearly stated for both primary and 
secondary data. To provide explanation on the credibility of 
primary (e.g. interviews and focus groups) and secondary (e.g. 
reports) data established and limitations made explicit.
5. Findings and Analysis To ensure sound analysis and credible evidence-based findings. 
To ensure interpretations are based on carefully described 
assumptions; contextual factors are identified; cause and effect 
links between an intervention and its end results (including 
unintended results) are explained.
6. Validity of conclusions To ensure conclusions are based on credible findings and convey 
evaluators’ unbiased judgment of the intervention. Ensure 
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conclusions are prioritized and clustered and include: summary; 
origin (which evaluation question(s) the conclusion is based on); 
detailed conclusion.
7. Usefulness and clarity of 
recommendations
To ensure recommendations flow logically from conclusions; are 
targeted, realistic and operationally-feasible; and are presented in 
priority order. Recommendations include: Summary; Priority level 
(very high/high/medium); Target (administrative unit(s) to which 
the recommendation is addressed); Origin (which conclusion(s) 
the recommendation is based on); Operational implications.
The second level quality assurance will be conducted by ZAMFAM internal ERG who will 
comment on the evaluation deliverables as well as the draft and final evaluation reports, 
notably to verify accuracy of facts presented and validity of interpretations of evidence. 
The Managing Director of DAPP Office maintains an oversight and quality assurance role in 
terms of the final evaluation report. 
9. Budget 
For the purpose of this evaluation, the evaluators will be identified through a tender process, 
in which case the budget (with detailed breakdown) will be proposed by the applicant. The 
budget to be proposed should include all costs including local transportation, field work, and 
consultancy fees. 
 Payment Modalities 
The payment modalities will be as follow: 
Professional Fees: 
 50% of total Professional Fees upon acceptance of the Draft Inception Report 
 50% upon production of acceptable final MTE report. 
Interested evaluators or firms are requested to submit: 
1. An Expression of Interest detailing their interpretation of the TOR, proposed methodology 
including sampling framework, work schedule and proposed budget for Two Hundred and 
Fifty Thousand Zambian Kwacha (K250, 000), equivalent to 20,833 USD.
 2. A capability statement demonstrating how you meet the required qualifications and 
competencies; 
3. Copies of all relevant Curriculum Vitae (CVs). Only CVs for the specific individuals that will 
form the proposed Evaluation team should be included; 
 4. A sample of an evaluation report for a similar project completed within the last 24 months 
(this will be treated as confidential and only used for the purposes of quality assurance); 
5. Two references (including one from your last client/employer). 
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All documents must be submitted by email to the Chief of Party: munene.v@dappzambia.org 
copied to the Evaluation Reference Group Coordinator Andrew andrewtandeo@hotmail.com 
and to Info@dappzambia.org. by close of business Wednesday 22nd August, 2018. 
APPENDICES 
A. MTE report structure 
A. MTE rep ort structure 
# Components Content 
1 Cover and Title pages  Title of evaluation
 Date of release of report 
 Name of evaluators
2 Executive Summary  No more than 3 pages containing 
evaluation purpose, evaluation questions, 
brief description of the project, data 
collection methods, analytic methods, 
evaluation findings, limitations, 
conclusions and recommendations
3 Project Background  Brief description of the project including 
dates of project implementation, total cost, 
geographical location, and objectives, 
targeted beneficiaries and stakeholders
4 Evaluation purpose, objectives 
and scope 
 Evaluation purpose statement, specific 
objectives and scope of work
7 Evaluation questions  Evaluation criteria and questions the 
evaluation will answer 
8 Evaluation Design, Methods, and 
Limitations 
 Overall evaluation design 
 Type of evaluation (process, outcome, and 
prospect impact)
 Sampling strategy
 Data collection methods and rationale as 
aligned to evaluation questions
 Sources of data analytic methods and 
rationale
 Ethical considerations and assurances 
(e.g., non- research determination and/or 
approval with dates; application of 
informed consent, if appropriate; 
procedures to ensure human rights 
protection)
 Deviations and adjustments (if any) from 
the approved Scope of Work/protocol
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 Procedures used to ensure that the data 
are of the highest achievable quality
 Data analysis plan
 Limitations of the design and analytic 
methods
9 Findings and Conclusions  Key findings in relations to the evaluation 
questions
 Key findings for the project improvement in 
relations to the evaluation questions 
 Unexpected findings 
 Lessons learnt 
 Conclusions 
 Graphical representation of results and 
quotes where relevant
10 Recommendations  Actionable, feasible, and specific 
recommendations aligned to key findings
11 Dissemination  Dissemination procedures/plan
12 References  Reports or publications cited in the body of 
the report
13 Appendices  Approved ToRs
 Data collection instruments/tools
 Informed Consent, where relevant
 Abridged bios of the Evaluation team
members including qualifications, 
experience, role on the team, and Ethical 
certifications (if applicable)
 Conflict of interest statement
 Evaluation costs
 Project Results Framework or Logical 
Framework