[{"bbox": [97, 152, 1134, 234], "category": "Text", "text": "access to electricity, water) especially in remote and rural areas has a negative impact on provision of ECE.\nMoreover, disabilities exclusion in school are not being fully addressed, and socio-emotional skills and provision\nof psychosocial support in schools are not part of the curriculum at any level of education."}, {"bbox": [97, 258, 708, 287], "category": "Section-header", "text": "Priority Area 2 – Education/Technical and Vocational training"}, {"bbox": [96, 312, 1136, 685], "category": "Text", "text": "In the secondary schools, the Technical and Vocational Training (TVET) pathway has been provided in parallel to the academic path, however its application has been slow and challenging. Beside the irrelevant and outdated curricula, lack of or inadequate infrastructure, equipment and technology as well as lack of qualified staff affect negatively the performance of TVET and skills development sector both at secondary and tertiary levels. TVET centres lack child-care support allowing young mothers to go through vocational training. Zambia is experiencing a major demographic shift with a growing population at 3.4%¹³ per year and a total fertility rate of 4.7%. It is a country of young people, with the majority of the population under the age of 35 (83%), out of which 46% are children (0-14 years) and 37% youth (15-35 years). The estimated median age is 17.6 years (2022)¹⁴, which is one of the lowest in the region and globally. Rapid population growth is placing enormous pressure on the supply of quality education and skills development services while straining the capacity of the labour market to absorb new workers. An increasing number of youth is looking for access to social services and employment while the situation is currently constrained. Youth unemployment stands at 17.4%¹⁵, with a higher prevalence for women (21.2%), driven to a great extent by a persisting mismatch between job, relevant skills and training and employment opportunities."}, {"bbox": [97, 709, 477, 737], "category": "Section-header", "text": "Priority area 3 – Health and sanitation"}, {"bbox": [96, 762, 1135, 1001], "category": "Text", "text": "Access to quality and affordable health services continues to be a challenge overall, particularly in rural areas. As a consequence, many related indicators nationwide remain alarming: limited access to basic maternal care, high levels of maternal mortality (252/100,000 live births), under-five and neonatal mortality (respectively 64/1,000 live births and 42% of all under-5 deaths), as well as malnutrition indicators (see below)¹⁶. The very high prevalence of early and unintended pregnancies among adolescent girls and young women (29% of 15-19 years old) is mainly caused by lack of access to health-related information, very poor Comprehensive Sexual Education (CSE)¹⁷ and by the socio-economic context including traditional harmful practices promoting sexual debut from puberty, high prevalence of SGBV, and barriers to access Adolescent Sexual And Reproductive Health and Rights (ASRHR)."}, {"bbox": [96, 1026, 1135, 1346], "category": "Text", "text": "The situation related to early pregnancies is not only one of the main causes of gender inequality (see Priority Area 4), but also of serious health consequences (e.g. high HIV prevalence) and cause of premature deaths and disabilities¹⁸ both for mothers and children. It also contributes to the very high prevalence of malnutrition in the country, translated for instance in the number of stunting children with cognitive problems and perpetuating the intergenerational cycle of malnutrition and poverty. In addition, 47.2% of child bearing develop fistula and other complications on first pregnancy¹⁹. According to a study conducted in 2015, 63% of obstetric fistula patients were abandoned by their partners/ spouses²⁰, increasing so the risk of impoverishment and malnutrition for them and their children. Termination of Pregnancy Act of 1972 settles de conditions and requirements and the 2005 amendment allows abortion for girls below 16 years. Despite the legal framework, very few facilities provide abortion and the existence of this service is often inversely proportional to the prevalence of early pregnancy and maternal mortality. As a consequence, induced terminations of pregnancy in girls 18 years old and younger account for 25% of maternal deaths²¹."}, {"bbox": [87, 1404, 582, 1430], "category": "Footnote", "text": "¹³ 2022 Census of Population and Housing, Preliminary Report - ZamStat"}, {"bbox": [87, 1429, 141, 1450], "category": "Footnote", "text": "¹⁴ Idem"}, {"bbox": [87, 1452, 757, 1478], "category": "Footnote", "text": "¹⁵ https://www.zamstats.gov.zm/wp-content/uploads/2023/05/2021-Labour-Force-Survey-NHPP.pdf"}, {"bbox": [87, 1478, 765, 1503], "category": "Footnote", "text": "¹⁶ Zambia Demographic and Health Survey 2018 https://dhsprogram.com/pubs/pdf/FR361/FR361.pdf"}, {"bbox": [87, 1502, 1143, 1546], "category": "Footnote", "text": "¹⁷ Zulu et al. International Journal for Equity in Health,2019.” Why teach sexuality education in school? Teacher discretion in implementing comprehensive sexuality education in rural Zambia."}, {"bbox": [87, 1546, 925, 1570], "category": "Footnote", "text": "¹⁸ UNESCO/UNFPA 2023, Preventing Early and Unitended Pregnancy among In-School Girls and Young Women in Zambia"}, {"bbox": [87, 1569, 642, 1588], "category": "Footnote", "text": "¹⁹ Obstetric fistula strategic plan 2022-2023, MoH, UNFPA and Fistula Foundation."}, {"bbox": [87, 1588, 490, 1608], "category": "Footnote", "text": "20 Zambia MoH Obstetrical Fistula Tracking Study of 2015."}, {"bbox": [87, 1607, 1143, 1645], "category": "Footnote", "text": "²¹ Deep Dive on improving maternal and newborn health and survival and reducing stillbirth in Zambia, Dr Apurva Chaturvedi, Health Specialist (RMNCH), UNICEF Zambia Mai 2023."}, {"bbox": [1038, 1682, 1145, 1706], "category": "Page-footer", "text": "Page 7 of 34"}]