.
Inclusive education is increasingly recognized not only as an access strategy but also as a pedagogical approach capable of improving learner behaviour and social outcomes. While global research has focused on participation and equity, limited empirical studies in Sub-Saharan Africa examine behavioral outcomes associated with inclusive pedagogy. This study investigates the relationship between inclusive teaching practices and positive learner behaviour in Zambian schools. The study adopts a qualitative-dominant mixed methods design involving 90 participants including learners, teachers, administrators, teacher trainees and community stakeholders. Data were collected through interviews, focus group discussions, classroom observations and questionnaires. Data are analysed using thematic analysis and descriptive statistics. Findings show that inclusive practices such as differentiated instruction, cooperative learning, peer mentoring and positive reinforcement contribute to improved learner empathy, cooperation, confidence and self-regulation. Results further indicate that inclusive classroom environments promote belonging, reduce behavioral conflict and strengthen peer relationships. The study concludes that inclusive pedagogy functions not only as an instructional strategy but also as a behavioral development mechanism. The findings suggest the need to strengthen teacher training in inclusive pedagogy and behaviour support strategies. Policy frameworks should incorporate behavioral indicators alongside academic outcomes. The study contributes empirical African evidence linking inclusive pedagogy to behavioral development and supports the view that inclusive education contributes to social cohesion and holistic learner development.
ABSTRACT Background and Aims Hypertension is a leading cause of cardiovascular complications (CVCs), yet the contribution of socioeconomic and behavioral risk factors to CVC development in Zambia is poorly understood. This study aimed to assess the association between socioeconomic status (SES), lifestyle behaviors, and CVCs among hypertensive patients at the University Teaching Hospital (UTH) in Lusaka, Zambia. Methods A hospital‐based cross‐sectional study was conducted using secondary data from 384 medical records of hypertensive adults aged ≥ 18 years at UTH. Data on sociodemographic characteristics, SES, behavioral factors (salt intake, smoking, alcohol use, physical activity), and presence of CVCs (e.g., heart failure, left ventricular hypertrophy) were extracted. Multivariable logistic regression analysis was performed, and due to evidence of quasi‐complete separation, Firth's penalized logistic regression was applied to improve estimate stability. Results Increasing age was significantly associated with higher odds of CVCs (aOR = 1.097, p < 0.001). Male sex was not significantly associated with CVCs after adjustment (aOR = 1.76, p = 0.24). Low SES was associated with higher odds of CVCs (aOR = 4.09, p = 0.05), although this was borderline significant. Smoking (aOR = 3.09, p = 0.04) and alcohol intake (aOR = 1.13, p = 0.002) were significantly associated with increased odds, while physical activity was strongly protective (aOR = 0.08, p < 0.001). Conclusion Socioeconomic and behavioral factors were associated with the manifestation of CVCs in hypertensive patients. Older age was associated with increased odds of CVCs. Smoking and alcohol use were significant behavioral risk factors, while low SES showed a borderline association. Higher education and physical activity were protective. Public health interventions must integrate targeted lifestyle modification and address socioeconomic disparities to mitigate cardiovascular risk.
BackgroundAntifungal resistance (AFR) is a growing global health threat, particularly in low- and middle-income countries such as Zambia, where antifungals are often accessed without prescription. Antifungal stewardship (AFS) programs aim to optimise antifungal use, yet limited data exist on pharmacy students' knowledge, attitudes, and practices (KAP) toward AFR and AFS. This study evaluated pharmacy students' knowledge, attitudes, and practices (KAP) toward AFR and AFS in Zambia.MethodsA descriptive cross-sectional survey was conducted among 288 randomly selected pharmacy students between August and September 2024 using a structured questionnaire. Descriptive statistics summarised demographics and KAP responses. Associations were analysed using Chi-square and Fisher's Exact Tests, while multivariable logistic regression identified predictors of good KAP (p < 0.05).ResultsAmong respondents (55.2% female; 76.7% aged 18–25 years), most students (94.1%) knew how to define AFR, and 90.3% recognized antifungal misuse as a factor driving resistance. Nevertheless, only 18.1% showed good knowledge, 67.7% held positive attitudes (especially among fourth-year students, p < 0.001), and merely 2.4% practiced appropriately. Multivariable analysis found that being a fourth-year student increased the likelihood of a good attitude (aOR = 5.10, 95% CI: 2.28–11.43). Married students were more likely to demonstrate good practices (aOR = 2.75, 95% CI: 1.13–6.68) towards AFR and antifungal stewardship (AFS) compared to unmarried ones. Additionally, age above 33 years was not significantly associated with better knowledge (aOR = 1.29, 95% CI: 0.32–5.18).ConclusionPharmacy students in Zambia demonstrated positive attitudes towards AFR and AFS, but significant gaps in knowledge and practice remain. Strengthening AFR and AFS-related content and experiential training within the pharmacy curriculum is urgently needed to improve preparedness for clinical practice.
BACKGROUND AND AIMS:Diabetic ketoacidosis (DKA) at type 1 diabetes diagnosis is common in low-resource settings and associated with prolonged hospitalisation. We aimed to identify determinants of time to discharge among children with new-onset DKA in Zambia. METHODS:We conducted a retrospective cohort study of children aged 0-16 years with newly diagnosed T1DM and DKA at the University Teaching Hospital, Lusaka (2018-2023). The primary outcome was time to discharge (days). We used Kaplan-Meier with log-rank tests and Cox regression. To address proportional hazards (PH) violation, we fitted a stratified Cox model (stratified by HbA1c, vomiting and DKA severity) for PH validation and a granulated Cox model with DKA severity (mild, moderate, severe) to estimate independent effects. PH was verified using Schoenfeld residuals. RESULTS:Among 353 children (mean age 8.3 years, SD 4.6), median stay was 5 days (IQR 4-8). Log-rank tests showed significant differences in discharge probability by DKA severity (χ2 = 70.32, p < 0.001) and vomiting (χ2 = 30.35, p < 0.001). In the granulated model, DKA severity was the strongest predictor of delayed discharge (moderate: HR = 0.01, p < 0.001; severe: HR = 0.01, p < 0.001), while infection was associated with faster discharge (HR = 1.51, p < 0.001). Ketonuria lost significance after DKA adjustment (HR = 0.90, p = 0.770), indicating a marker not an independent predictor. The stratified model confirmed PH satisfaction (global test χ2 = 5.62, df = 7, p = 0.584). Age, sex, polyuria, family history and residence were not significant. CONCLUSIONS:DKA severity is the strongest independent predictor of prolonged hospital stay in children with new-onset DKA. Ketonuria is a useful bedside marker but lacks independent effect beyond severity. Infection independently predicts faster discharge. These findings could inform risk stratification and resource allocation in similar settings.
