Theses and Dissertations

A profile of community based acute poisoning and its associated mortality at the university teaching hospital in Lusaka in 2015

2017-01-01T00:00:00Z

A profile of community based acute poisoning and its associated mortality at the university teaching hospital in Lusaka in 2015 Mwanza, Boris ABSTRACT Background: Acute poisoning remains a common method employed for suicide worldwide. World Health Organization (WHO) estimates that about 0.3 million people die every year worldwide due to various poisoning agents. Methodology: The study was a cross-sectional descriptive study. A retrospective survey of acute poisoning cases presenting at U.T.H medical emergency department was undertaken. This was conducted by identifying and reviewing all acute poisoning cases that presented at this department during the period 1st January, 2015 to 31th December, 2015 (a period of 12 months). A total of 131 patients’ medical records and charts on poisoning were reviewed. The data was thereafter analyzed by using statistical package of social science (SPSS). All statistical tests were at 5% significance level. Results: Of the 131 acute poisoning cases reviewed, 51.1% were female. Most patients (53.4%) were single and 47.3% were unemployed. Acute poisoning cases occurred more in the age-group of 20-39 years (49.6%). Most of poisoning cases (58.8%) occurred in areas associated with poor socio-economic status. Organophosphate poisoning accounted for (38.2%) of all the poisoning cases. Other common agents/drugs used were paracetamol tablets (7.6%), antibiotics (6.1%), antiretroviral (ARVs) (3.1%) and household chemicals (11.5%). Thirty four patients (26%) took more than one drug/ agent. Out of 109 patients who had the reason for their poisoning stated, 57 patients had relationship disharmony (32 married, 25 unmarried). Fourteen patients had family issues which mainly resulted from conflicts with parents and grandparents. The psychosocial problems of the 16 patients were not specified and accidental poisoning was seen in 5 patients. Majority of the patients (85.5%) were discharged without any complications and the mortality rate was observed at 4.6%. Low GCS (< 8) and hypothermia were common clinical features amongst patients that got admitted. The association between mortality and poisoning associated with alcohol was found to be statistically significant (p=0.04). Conclusion: Acute poisoning is still a common phenomenon, majorly amongst females in the age group of 20 – 39 years, with poor quality of life. Relationship disharmony is the most common reason for poisoning. Organophosphate poisoning accounted for most of the poisoning cases. Drug/agent used can only be curtailed to a minimal extent. Prevention through early detection of vulnerable patients and early psychological management should be our goal.

Epidemiology of ectopic pregnancy at the university teaching hospital,Lusaka

2016-01-01T00:00:00Z

Epidemiology of ectopic pregnancy at the university teaching hospital,Lusaka Chisha, Percival Sume Background: Ectopic pregnancy is defined as a pregnancy outside the uterine cavity and is a life-threatening emergency in the field of obstetrics and gynaecology. It is a most common cause of maternal morbidity and mortality in the first trimester of pregnancy. In resource-constrained settings, where trained specialists are limited in number and geographic location, outcomes are worse. Diagnosis is frequently missed, partly because the patient may not be aware that she is pregnant. However, timely diagnosis accompanied by appropriate management of ectopic pregnancy can alter the clinical course from death to life. The study aims to determine the epidemiology of ectopic pregnancies at University Teaching Hospital (UTH). Methods: A cross sectional study conducted between May, 2014 to November, 2014 in the Department of Obstetrics and Gynaecology at the University Teaching Hospital, Lusaka, Zambia. Women treated for ectopic pregnancies were recruited from the gynaecology ward, interviewed by research assistants and data abstracted from their medical files. Results: A total of 90 women with ectopic pregnancies were enrolled representing 0.5% of early and late pregnancy admissions (total 19,600 pregnant women reviewed between May 2014 –November, 2014). Over 70% were from high residential areas, 52% had at least secondary education, and 81.1% were married or co-habiting. Although 27.8% were HIV positive, 37.8% did not have a known status. Almost half (46.6%) were in their first or second pregnancy. Though 10% were in the second trimester (13-19weeks) gestation, most (67.8%) were below 12 weeks and in 22% the gestation was not known. The commonest risk factors were: more than one sexual partner ever (55.6%) with 10% ever treated for a sexually transmitted disease. The commonest symptoms were lower abdominal pain (97.8%) and amaenorrhea (83.3%). Dizziness was reported in 48.9%. About a quarter (24.4%) were considered in shock on admission and most had abdominal tenderness (86.7%). Where an ultrasound was done (n=57, 63.3%) this was helpful in 86% of cases (n=49). Haemoperitnem was reported in 59.6%. In 65 cases (72.2%) either paracentesis or culdocentesis was done and was positive for blood in 49 (75.4%) of cases. Apart from only one case treated with methotrexate, all other had a laparotomy and 70% were found ruptured. The commonest sites for the ectopic were infundibulum (33.3%) and ampulla (28.9%). Salpingectomy was the commonest procedure (84.4%). Over half (54.3%) had blood loss greater than 500mls. And 44 (48.9%) were transfused. In 34 cases of those transfused, one or two units were transfused. Four patients (4.4%) were recovered in a high dependency unit – the rest in an ordinary ward. One patient died (case fatality of 1.1%). Conclusion: The series at UTH showed that ectopic pregnancy had a low prevalence and had a risk factor profile and clinical presentation like that described elsewhere in the region. Most cases presented with a ruptured ectopic requiring blood transfusion. Earlier presentation can provide an opportunity for more conservative treatment with less morbidity.

Neonatal apgar score outcomes in spinal versus general anaesthesia at the university teaching hosipital (UTH) lusaka

2016-01-01T00:00:00Z

Neonatal apgar score outcomes in spinal versus general anaesthesia at the university teaching hosipital (UTH) lusaka Muloshi, Carol Musonda Background: The knowledge gap was from the fact that the type of anaesthetic drug administered during caesarean section can have effects on neonatal outcome like low Apgar score with most hospitals in developed countries now using more modern inhalational anaesthetic agents with fewer or no cardio-depressant effects e.g. Isoflurane or Sevoflurane. However at UTH, halothane is still being used for maintenance of general anaesthesia despite well documented cardio-respiratory depressant effects with very limited research done on its effects on neonatal Apgar score. The Apgar score is a means of rapid evaluation of the physical condition of infants shortly after birth. Thus this study investigated the effects of general anaesthesia with halothane versus spinal anaesthesia on neonatal Apgar score. Objective: The purpose of the study was to determine the effects of general anaesthesia with halothane versus spinal anaesthesia on neonatal Apgar score. Methods: This was a prospective observational cohort study conducted at the University Teaching Hospital (UTH) in Lusaka, Zambia. A questionnaire was used for data collection. This study involved 70 neonates. Of these, 54 were born from mothers that had undergone caesarean section under spinal anaesthesia and 16 from mothers that had undergone general anaesthesia. The data was analysed using SPSS version 16.0. Inferential analysis was conducted using logistic regression. Results: 20 neonates out of 54 (37%) in the spinal anaesthetic group had an Apgar score less than 8 at 1 minute. Out of the 16 neonates in the general anaesthesia group, 14 (87.5%) had Apgar score less than 8 at 1 minute. One (2%) neonate had an Apgar score less than 8 at 5 minutes in the spinal anaesthesia group while 53 neonates. At 5 minutes, 4 (25%) neonates had Apgar score less than 8 in the GA group. vi The linear logistic regression at 1 minute Shows that it’s over 11 times more likely to get a low Apgar with a general anaesthetic as compared to a spinal anaesthetic (OR 11.9). The Apgar score at 1 minute in the Spinal anaesthesia group was statistically significantly higher than the general anaesthesia group (p=0.002). The linear logistic regression at 5 minutes Shows that it’s over 17 times more likely to get a low Apgar with a general anaesthetic as compared to a spinal anaesthetic (OR 17.7). Further, the 5 minutes Apgar score in the spinal anaesthesia group was statistically significantly higher than the general anaesthesia group (p=0.014). Conclusion: With the results pointing to the fact that there is significant difference in neonatal Apgar score outcomes in spinal versus general anaesthesia, the researcher therefore rejected the null hypothesis. It is therefore inferred that spinal anaesthesia method has better neonatal outcomes by Apgar score measure than general anaesthesia method.

A study on the common hydrotheraphy practices and the prevalence of burn wound bacterial colonisation at the university teaching hosipital in lusaka zambia

2016-01-01T00:00:00Z

A study on the common hydrotheraphy practices and the prevalence of burn wound bacterial colonisation at the university teaching hosipital in lusaka zambia Ziwa, Mudaniso BACKGROUND Hydrotherapy plays an important role in the management of surgical patients, and especially so in those that have sustained burns to their skin. Different centers practice hydrotherapy differently. At the University Teaching Hospital in Lusaka, Zambia, patients with burns in surgical wards use a common bathtub for cleaning their wounds. This breaches patient isolation and increases risk of cross-infection. Audit records from the department of surgery show that burn wound colonization and infection is an important source of morbidity and mortality. However, there is no evidence yet that the hydrotherapy as practiced at our institution does lead to cross infection among patients with burns. OBJECTIVE The general objective was to determine if the hydrotherapy practice plays a role in cross-infection. We also wanted to characterize these organisms being spread by cross-infection. METHODS This was a prospective analytical study. Patients meeting the admission criteria were recruited. Swabs from the burn wounds were collected on admission (day 0), day 4 and day 7. Weekly swabs of the bathtub were also collected, after the tub had been cleaned and declared ready for the next patient. Weekly water samples were also collected. Selected results, for Staphylococcus aureus and Klebsiella pneumoniae, were subjected to further analysis and PCR. Results were analyzed using statistics software, SPSS version 23. RESULTS In this study, there were 96 participants of which 51 (53.1%) were males and 45 (46.9%) were females. Age distribution ranged from 5months old to 91 years old. The modal age range was 1 to 2 years old. The modal burn percentage was 6% to 10%, followed by 11 to 15%. Hot water was the cause of burns in 65.6%. Staphylococcus aureus and Klebsiella pneumoniae were the commonest organisms isolated. These came from wounds that looked clinically clean. Others were enteric organisms. In terms of readily available antibiotics, there was more sensitivity to Amikacin and Chloramphenicol than Ciprofloxacin (our commonly used antibiotic). The bathtub also had Staphylococcus aureus and Klebsiella pneumoniae, besides enteric organisms. Sixty five point four percent (65.4%) of the Klebsiella were ESBL v producers. The tub had samples that were both ESBL producers as well as widely resistant Klebsiella by other means. Of the ESBLs, 29.4% had the SHV gene, 23.5% had the TEM gene and 47.1% had both SHV and TEM. There was no CTX gene identified. MRSA accounted for 30.6% of all the Staphylococcus in this study. The PVL gene was detected in 11.8%, SPA gene in 35.3%, while 5.9% of the Staphylococcus had both PVL and SPA genes. No growth was obtained from the water samples. Seventy-two point nine percent (72.9%) of the patients were discharged, 19.8% died, while 7.3% left against medical advice. CONCLUSION Hydrotherapy as currently practiced at the University Teaching Hospital does contribute significantly to cross-infection among burns patients. The organisms transmitted are widely resistant to available antibiotics and this is posing a serious threat to treatment of infections.

Common bacteria causes of neonatal sepsis and antimicrobial susceptibility at the university teaching hospital, Lusaka, Zambia?

2014-01-01T00:00:00Z

Common bacteria causes of neonatal sepsis and antimicrobial susceptibility at the university teaching hospital, Lusaka, Zambia? Msiska, Taonga Sophia Background: Prescribing effective preventative antibiotics and treating infections in mothers, providing a clean birth environment, and delivering the baby within 24 hours of rupture of membranes, where possible, can all help lower the chance of neonatal sepsis. However, neonatal sepsis remains one of the leading causes of morbidity and mortality among neonates, responsible for 30- 50% of the total neonatal deaths in low-and middle-income countries. The incidence and mortality of neonatal sepsis in Zambia is quite high. In 2007, the neonatal mortality rate in Zambia was 38/1,000 live births. The present study sought to identify the common bacterial causes of neonatal sepsis and antimicrobial susceptibility at the University Teaching Hospital in Lusaka, Zambia. Methods: This was a descriptive cross sectional study with convenience sampling for a period of three months of 142 neonates at the University Teaching Hospital (UTH) Paediatric Department. Data was obtained from mothers with neonates clinically diagnosed with sepsis at the UTH from October 2013 to January, 2014. Data was collected by reviewing obstetric and neonatal files while laboratory studies done were HIV rapid test (for HIV exposure), random blood sugar, and full blood count and blood culture to establish common blood pathogens. All tests were done after consent from the mothers or a guardian for blood to be collected from neonates was obtained. There was a questionnaire administered for each patient for a more detailed antenatal and delivery history of the neonate. Results: Positive blood culture results were at 30% and most common bacteria isolated causing neonatal sepsis in A-block, UTH were gram positive staphylococcus aureus and coagulase negative staphylococcus, which together accounted to 85% of the positive blood culture tests. Staphylococcus aureus and coagulase negative staphylococcus were highly susceptible to Ciprofloxacin (100%), Chloramphenicol (84%), Cefotaxime (70%), Oxacillin (69%) and Gentamycin (70.6%). Penicillin (65%) showed high resistance to staphylococcus aureus and coagulase negative staphylococcus. The most common clinical presenting features were fever, irritability and poor feeding. Neonates born from the UTH had on average 4.5 increased odds for early onset sepsis compared to neonates born from other health centers (OR: 4.48, CI: 1.85 - 10.85, p < 0.01). v Conclusions: Gram positive staphylococcus aureus is the common cause neonatal sepsis in A-block UTH. The first line Penicillin treatment is highly resistance and careful consideration should be made by UTH management to introduce third generation cepholosporins and macrolides as first line to effectively improve treatment and prevent morbidity. Infection prevention in delivery and nursery wards should be held as highest priority to prevent loss of life. Key words: Neonate, early onset sepsis, late onset sepsis, University Teaching Hospital (UTH)

Factors Affecting Access To and Utilisation of Reproductive Health Services Among Adolescents in Lusaka District: Case Study of Kamanga CompoundBarbara Nkonde-Bwalya

2016-01-01T00:00:00Z

Factors Affecting Access To and Utilisation of Reproductive Health Services Among Adolescents in Lusaka District: Case Study of Kamanga CompoundBarbara Nkonde-Bwalya Nkonde-Bwalya, Barbara Sexual and reproductive health is part of physical and emotional well-being of all human beings. Adolescents globally have unique sexual and reproductive health needs and accompanying vulnerabilities. Many adolescents face sexual health risks of early sexual debut, sexually transmitted infections including HIV/AIDS, unplanned pregnancies and illegal abortions. The general objective of the study was to identify factors affecting access to and utilisation of reproductive health services among adolescents in Lusaka District. Specific objectives were: 1. To assess gender variations in adolescents’ knowledge and utilisation of reproductive health services. 2. To find out factors affecting access to and utilisation of reproductive health services. 3. To identify measures to improve access to and utilisation of reproductive health services among adolescents. The study sample comprised 200 respondents. Data collection was done by carrying out structured face-to-face interviews with 180 adolescents, interview guides were used to collect data from 3 focus group discussions comprising 6 adolescents each and 2 key informants (health service providers). Quantifiable data were coded and analysed using SPSS to generate frequency tables and percentages, whereas qualitative data were analysed using thematic analysis. This study has established that there are gender gaps in knowledge and utilisation of RHS among the adolescents in Kamanga Compound. For instance, the study discovered that more girls than boys were aware of specific types of RHS including family planning methods. It was discovered that more (23.9%) male than female (21.7%) had utilised family planning methods. The findings further revealed that more (26.4%) female than male, (25.3%) adolescents had received RHS. At the same time, the study noted that dispite the gender gaps, the level of access and utilisation of RHS among adolescents was low for both sexes. Reasons for low utilisation of RHS included shortage of health services providers, and lack of adolescent-friendly services, adolescents’ preference for service providers of the same sex, age difference between adolescents and the service providers, distance to the health facility and lack of transport; lack of specific consulting rooms for adolescents and non-confidential condom outlets, lack of services like lifebuoy soap at v Chelstone Clinic for male adolescents undergoing male circumcision, and judgmental attitude among health providers. Drawing from the lifespan theoretical concepts, the study concluded that there existed a service gap in provision of adolescent RHS. Adolescents continued to be socially excluded from accessing and utilising RHS. The study therefore, recommended for scaling up of adolescentfriendly services; use of brochures and youth magazines to increase awareness of available services for adolescents and sensitisation of health providers, parents/ guardians, communities and key stakeholders about RHS for adolescents; Use mobile service provision within the Community by the Ministry of Health in order to address the problem of distance faced by adolescents, regular training and in-servicing of health providers to effectively serve adolescents with emphasis on adolescents’ rights to confidential and comprehensive RHS. This study further recommended for a study on a similar topic to be carried out on a larger scale so that the results could be generalised to the rest of the country.

Epidemiology of Cryptosporidiosis in dogs in Lusaka district, Zambia

2016-01-01T00:00:00Z

Epidemiology of Cryptosporidiosis in dogs in Lusaka district, Zambia Mugala, Lamson Cryptosporidium is an intracellular zoonotic protozoan parasite that causes cryptosporidiosis, a diarrhoeal disease of humans and domestic animals. The parasite has been reported in a variety of domestic animals including dogs. Several species of Cryptosporidium infecting animals have also been reported in humans highlighting the zoonotic nature of the disease. This study was aimed at determining the prevalence and associated risk factors of Cryptosporidium infection in domestic dogs in Lusaka district of Zambia. It was a prospective cross-sectional descriptive study carried out from October, 2015 to May, 2016 in three Veterinary Clinics as well as Kalingalinga and Kabanana residential areas within Lusaka District. A total of 390 dog faecal samples were collected and analyzed at the University of Zambia, School of Veterinary Medicine laboratory and at the parasitology laboratory at the University Teaching Hospital. The modified Ziehl Neelsen and fluorochrome (Auramine) staining techniques were used to identify positive samples. A sample was considered positive if at least one oocyst was identified under the microscope. Proportions were compared using chi-square, fisher’s exact test and logistic regression, where appropriate. Overall, 390 dogs ranging from 2 months to 13 years were examined for the presence of Cryptosporidium. Out of these, 280 (71.8%) were of mixed breed while 110 (28.2%) were pure breeds; and 75.6% (295/390) were vaccinated while 24.4% (95/390) were not. Majority of the dogs (62.3%; 243/390) were males compared to only 37.7% (147/390) females. Most of the dogs (89. 2%; 348/390) were fed leftovers while the rest were fed pet food (5.9%; 23/390), sawdust (2.1%; 8/390) or both leftovers and pet food (2.8%; 11/390). The overall prevalence of Cryptosporidium infection in the dogs was 5.9% (23/390). Of the 23 positive dogs, 21 (5.4%) were detected by both Ziehl Neelsen and fluorochrome methods, while the other two were detected by fluorochrome method only, giving a prevalence of 5.9% (23/390) for the latter. The prevalence of Cryptosporidium in males was 5.3% (13/243) while that for females was 6.8% (10/147) but the difference was not significant (P= 0.658). There was a statistically significant difference in Cryptosporidium infection between mixed breed and pure breed dogs (P=0.012), with prevalence being higher in the mixed breed type. Water source was another variable found to be significantly associated with Cryptosporidium infection (P=0.041). Other factors investigated were not associated with Cryptosporidium infection. There was no statistically significant difference in the detection of Cryptosporidium using Auramine and Modified Ziehl Neelsen as the results obtained from the two methods were found to be in almost perfect agreement (Kappa=0.95). The study detected Cryptosporidium oocysts in dogs with most of them being asymptomatic. Most of the factors investigated apart from breed and water source were not associated with the Cryptosporidium infection. The two compared techniques, namely; Modified Ziehl Neelsen and Auramine can be adopted for routine examination of Cryptosporidium oocysts since both showed similar analytical results.

Land conflict resolution mechanisms in Kalikiliki Settlement,Lusaka

2016-01-01T00:00:00Z

Land conflict resolution mechanisms in Kalikiliki Settlement,Lusaka Mbilikita, Chilombo The high density of people living per unit area in Kalikiliki, which is an informal settlement, has created land use conflicts. The prevalence of these unresolved land use conflicts presents a challenge for settlement upgrading. Without resolving land use conflicts, settlement upgrading will be a challenge. The first objective of the study was to identify the nature and causes of land use conflicts in Kalikiliki. The second objective looked at assessing the mechanisms for land conflict resolution in Kalikiliki while the third objective sought to assess the parameters that could be used to promote sustainable land use conflict resolution in settlement upgrading. The data was collected using snowball sampling for the community residents and the key informants were selected using purposive sampling. The information collected was analyzed using descriptive analysis with tables and frequencies, and thematic analysis. The findings revealed that the main land use conflicts prevalent in Kalikiliki were land encroachments, conflicts of public interest, double land allocations, improper siting of pit latrines and indiscriminate dumping of solid waste. These land conflicts were caused by corruption within the community leadership structure, lack of a land register, limited accessibility networks, lack of conflict documentation, absence of a solid waste management system, limited land rights provided in the occupancy license and undefined plot boundaries. The mechanisms used in the resolution of the identified land use conflicts were own negotiations between the two parties in conflict. Other mechanisms available to the Kalikiliki residents were negotiation with the help of local community institutions such as the Lusaka City Council, Ward Development Committee and the Zambia Police. The parameters for sustainable land use conflict resolution include: a transparent and efficient Ward Development Committee to handle land use related conflict and local community conflict resolution institutions to employ a conflict resolution tool that promotes equity and agreement by both parties. Other parameters include documentation of land use conflict and their resolution, and enhancing security of tenure by increasing the land rights provided for in the occupancy license from only the building to the land surrounding the building. The overall conclusion of the study was that the mechanisms of land use conflict resolution in Kalikiliki settlement are predominately negotiations, between individuals or through the leadership structures within the community. Therefore, in order to reduce land use conflicts in settlement upgrading, these community structures need to be enhanced with conflict resolution skills in order to deal with land use conflicts in a cooperative manner in order to generate mutually beneficial options for the parties involved in the conflict. Key Words: Conflict resolution, negotiation, settlement upgrading,

Greenhouse solar drying and thin layer drying of fresh Kapenta(Stolothrissa Tanganicae)

2016-01-01T00:00:00Z

Greenhouse solar drying and thin layer drying of fresh Kapenta(Stolothrissa Tanganicae) Aduke, Ngira Rhoda The aim of this study was to carry out an experimental investigation on drying fresh Kapenta (Stolothrissa tanganicae), in a Greenhouse Solar Dryer and to evaluate a suitable thin-layer drying model for fresh Kapenta. The nutritional constituents and quality of dried Kapenta produced from a Greenhouse Solar Dryer and that dried in the open sun were also analysed. The Greenhouse Solar Dryer design; Kainji Solar Tent Dryer described by Olokor and Omojowo (2009) was adopted and constructed for this study. The length, width and height of the dryer were 1.5 metres by 1 metre by 1 metre, respectively. A rectangular wooden frame was fabricated and 20 mm diameter plastic pipes clamped on opposite ends to form the Greenhouse frame. Pieces of rock were spread within the base of the wooden frame and covered with black polythene. The Greenhouse plastic was fitted onto the entire Greenhouse framework. Kapenta was placed in a thin layer on a drying rack inside the Greenhouse Solar Dryer from 9.00 am and was dried until a constant weight of the samples was reached. Another set of two samples were placed on a drying rack in the open sun as control samples. The Kapenta in the Greenhouse Solar Dryer dried to a much lower moisture content compared to the Kapenta dried in the open sun. In order to develop a thin-layer drying model, fresh Kapenta was dried by convection in a hot air dryer at different air temperatures. The influence of the drying temperature (35, 45 and 55°C) on the moisture ratio and drying rate has been studied in this research. The experimental drying data obtained for Kapenta under varying temperatures was fitted commonly used thin-layer drying models by using non-linear least squares regression analysis. All the models were compared according to three statistical parameters, i.e. coefficient of correlation ( 2R ), the reduced chi-square ( 2 x ) and the root mean square error (RMSE). It was found that the coefficient of correlation values of Page were higher (0.9804-0.9970), and the corresponding reduced chi-square (0.0002-0.0012) and the root mean square error (0.0081-0.0328) values were lower as compared to the other models, indicating that the Page model is the best to describe drying curves of Kapenta among all the models. Based on Student’s t-test, the Kapenta dried in the Greenhouse Solar Dryer had higher nutritional values of protein fat and carbohydrates that differed significantly at 95% level of significance from the Kapenta dried in the open sun.

Intergrated risk management in the supply chain of essential medicines in Zambia

2015-01-01T00:00:00Z

Intergrated risk management in the supply chain of essential medicines in Zambia Musonda, Mario M.J. Access to health care is a human right, which includes having timely access to affordable and quality essential medicines at the right place and in sufficient quantity. However, inefficient public sector supply chain management contributes to constant shortages of essential medicines at health facilities. Literature review involved a desktop study of published research studies and reports on risk management, supply chain management of essential medicines and their integration to increase the efficiency of the latter. The research was conducted on a sample population of offices under Ministry of Health Headquarters, Lusaka Provincial and District Offices, selected health facilities in Lusaka, Medical Stores Limited, Zambia Medicines Regulatory Authority and Cooperating Partners. Individuals involved in study were selected judgmentally by their functions under selection and quantification, regulation, procurement, storage, distribution, quality assurance and dispensing of essential medicines. Structured interviews and discussions were held with selected experts and self-administered questionnaires were distributed. The highest prioritised risks were; inadequate and inconsistent fund disbursements, weak information management systems, weak quality management systems and insufficient resources (HR and infrastructure) among others. Analysis of the supply chain of essential medicines and the risks that were identified, assessed and ranked helped in designing and proposing the Organisation Risk Management Model. The results for this research can be used to increase the efficiency of the public sector supply chain of essential medicines and other pharmaceuticals. The results of the study also showed that there is need to implement effective risk management systems by participating institutions and organisations to increase the efficiency of the entire supply chain in order to avoid and/or reduce shortages of essential medicines at health facilities.