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COMMITTEE on HEALTH, JUNE 2019.Pdf REPUBLIC OF ZAMBIA REPORT OF THE COMMITTEE ON HEALTH, COMMUNITY DEVELOPMENT AND SOCIAL SERVICES FOR THE THIRD SESSION OF THE TWELFTH NATIONAL ASSEMBLY Printed by the National Assembly of Zambia REPORT OF THE COMMITTEE ON HEALTH, COMMUNITY DEVELOPMENT AND SOCIAL SERVICES FOR THE THIRD SESSION OF THE TWELFTH NATIONAL ASSEMBLY TABLE OF CONTENTS Item Page 1.0. Membership of the Committee 3 2.0. Functions of the Committee 3 3.0. Meetings of the Committee 4 4.0. Committee’s Programme of Work 4 5.0. Arrangement of the Report 4 6.0. Procedure adopted by the Committee 4 PART I CONSIDERATION OF THE TOPICAL ISSUES Topic One - Service Delivery in Public Health Institutions in Zambia 7.0. Background 5 7.1. Consolidated summary of submissions by Stakeholders 6 7.1.1. Defining Service Delivery 6 7.1.2. The Provision of Health Care Services in Zambia 6 7.1.3. The Delivery of Health Care Services in Zambia 7 7.1.4. Financing of the Public Health Services 7 7.1.5. Adequacy of the Policy and Legal Framework Governing Service Delivery in Zambia 7 7.1.6. Strategies that Government has put in place to improve Health Service Delivery 8 7.1.7. The Role of Non-state Actors in Complimenting the Government’s Efforts in Providing Quality Service Delivery in Health Institutions 11 7.1.8. Challenges Facing Public Health Institutions in Providing Quality Service Delivery 11 8.0. Other Concerns Raised by Stakeholders 15 9.0. Local Tour of Lusaka and Luapula Provinces 19 9.1. Committee’s Findings 19 9.1.1. University Teaching Hospitals 19 9.1.2. Chipata Level One Hospital 23 9.1.3. Tours of Mutwewankonko Rural Health Centre; Mansa Central Urban Health Clinic; Kapata East 1 Rural Health Centre and Kasoma-Bangweulu Rural Health Post in Luapula Province 24 9.1.4 Other Concerns Raised during the Public Hearing 26 9.1.5. Tour of Medical Stores Limited 26 9.1.6. Care for Business 28 10.0. Committee’s Observations and Recommendations 29 i Topic Two - The Welfare of the Older Persons in Zambia 11.0 Background 34 11.1 Consolidated Summary of Submissions by Stakeholders 34 11.1.1. Definition of Older Persons 34 11.1.2. The Policy and Legal Framework Governing the Aged in Zambia 35 11.1.3. Legal Framework 35 11.1.4. Policy Framework 36 11.1.5. Programmes Put in Place by the Government to Uplift the Welfare Of Older Persons in the Country 37 11.1.6. The Role of Non-State Actors in complementing the Government’s Efforts to Uplift the Welfare of Older Persons in the Country 38 11.1.7. Challenges Faced in Caring for Older Persons 38 11.1.8. Tour of Matero After Care Centre 39 11.1.9. Committee’s Findings 40 11.1.10. Other Concerns Raised 40 11.1.11. Committee’s Observations and Recommendations 41 PART II 12.0. Consideration of the Action – Taken Report on the Report of the Committee for the Second Session of the Twelfth National Assembly 43 12.1. Zambia’s Response Towards Non-Communicable Diseases 43 12.2. Progress and Update on the Social Cash Transfer Programme in Zambia 52 13.0. Consideration of the Action – Taken Report on the Report of the Committee for the First Session of the Twelfth National Assembly 56 13.1. Zambia’s Preparedness for the Implementation of the Sustainable Development Goal on Health with Special Focus on Sexual Reproductive Health Rights 56 14.0. Consideration of the Action – Taken Report on the Report of the Committee for the Fifth Session of the Eleventh National Assembly 63 15.0. Consideration of the Action – Taken Report on the Report of the Committee for the Fourth Session of the Eleventh National Assembly 64 16.0. Conclusion 65 Appendix I – Officials of the National Assembly 66 Appendix II – The Witnesses 67 ii REPORT OF THE COMMITTEE ON HEALTH, COMMUNITY DEVELOPMENT AND SOCIAL SERVICES FOR THE THIRD SESSION OF THE TWELFTH NATIONAL ASSEMBLY 1.0 MEMBERSHIP OF THE COMMITTEE The Committee consisted of Dr C Kalila, MP (Chairperson); Ms P Kasune, MP (Vice Chairperson); Dr C Kambwili, MP; Dr J K Chanda, MP; Mr L N Tembo, MP; Mr J Kabamba, MP; Ms A M Chisangano, MP; Mr L Kintu, MP; Mr M Ndalamei, MP; and Mr A Mandumbwa, MP. Dr C Kambwili, MP, ceased to be a Member of the Committee following the declaration of the Roan Parliamentary Constituency seat vacant. The Honourable Mr Speaker National Assembly Parliament Buildings LUSAKA Sir, Your Committee has the honour to present its Report for the Third Session of the Twelfth National Assembly. 2.0 FUNCTIONS OF THE COMMITTEE The functions of the Committee, set out in the National Assembly Standing Orders, are to: i) study, report and make appropriate recommendations to the Government, through the House, on the mandate, management and operations of the Government ministries, departments and agencies under their portfolio; ii) carry out detailed scrutiny of certain activities being undertaken by the Government ministries, departments and agencies under their portfolio and make appropriate recommendations to the House for ultimate consideration by the Government; iii) make, if considered necessary, recommendations to the Government on the need to review certain policies and certain existing legislation; iv) examine annual reports of Government ministries and departments under their portfolios in the context of the autonomy and efficiency of Government ministries and departments and determine whether the affairs of the said bodies are being managed according to relevant Acts of Parliament, established regulations, rules and general orders; v) consider any Bills that may be referred to it by the House; 3 vi) consider international agreements and treaties in accordance with Article 63 of the Constitution; vii) consider special audit reports referred to it by the Speaker or an Order of the House; viii) where appropriate, hold public hearings on a matter under its consideration; and ix) consider any matter referred to it by the Speaker or an Order of the House. 3.0 MEETINGS OF THE COMMITTEE The Committee held fifteen meetings to consider submissions on the topical issues during the period under review. 4.0 COMMITTEE’S PROGRAMME OF WORK At the commencement of the Third Session of the Twelfth National Assembly, the Committee considered and adopted the following programme of work: a) Consideration of the Action-Taken Report on the Report of the Committee for the Second Session of the Twelfth National Assembly; b) Consideration of the following topical issues; i) Service Delivery in Public Health Institutions in Zambia; ii) The Welfare of Older Persons in Zambia; c) Consideration and adoption of the Committee’s draft report. 5.0 ARRANGEMENT OF THE REPORT The Committee’s Report is in two parts. Part I highlights the findings of the Committee on the two topical issues, namely: Service Delivery in Public Health Institutions in Zambia and the Welfare of Older Persons in Zambia. Part II reviews the Action-Taken Report on the Report of the Committee for the Second Session of the Twelfth National Assembly. 6.0 PROCEDURE ADOPTED BY THE COMMITTEE The Committee sought both written and oral submissions from the relevant Government ministries and institutions, non-governmental organisations, civil society organisations, the World Health Organisation (WHO) and interested individuals. 4 PART I CONSIDERATION OF TOPICAL ISSUES SERVICE DELIVERY IN PUBLIC HEALTH INSTITUTIONS IN ZAMBIA 7.0 BACKGROUND Various stakeholders expressed concern over the quality of health service delivery in public health institutions. While noting that the Government had initiated health reforms as espoused in the Zambia National Health Strategic Plan 2017-2021 and the Seventh National Development Plan, the quality of health care by health providers had allegedly been affected by irregular and erratic funding to health facilities, inadequate infrastructure, outdated broken down or lack of modern equipment, inadequate ambulance services, negative attitudes towards clients, long waiting times, drug stock outs and inadequate human resource in many instances, among other things, much to the dissatisfaction of the general public. For this reason, the Committee resolved to undertake a study to examine the quality of health service delivery in public health institutions. In order to gain insight into the topic, the Committee invited the following witnesses to make oral and written submissions: a) The University of Zambia (UNZA) – School of Medicine; b) The University Teaching Hospitals (UTH); c) Levy Mwanawasa Hospital; d) World Health Organisation (WHO); e) Health Professionals Council of Zambia (HPCZ); f) Zambia Union of Nurses Organisation (ZUNO); g) Zambia Medicines Regulatory Authority (ZAMRA); h) Churches Health Association of Zambia (CHAZ); i) Medical Stores Limited (MSL); j) African Medical Research Foundation( AMREF); k) Pharmaceutical Society of Zambia; l) Care For Business (CFB); m) Matero First Level Hospital; n) Network of Zambian People Living with HIV; o) Neighbourhood Health Committee, Mandevu Health Centre; p) Ministry of Higher Education; q) Common Grounds Network; and r) Ministry of Health. 5 7.1 CONSOLIDATED SUMMARY OF SUBMISSIONS BY STAKEHOLDERS 7.1.1. Defining Service Delivery The Committee was informed that the World Health Organisation (WHO) Handbook on Monitoring the six Building Blocks of Health Systems, defined service delivery as an immediate output of the inputs into the health system, such as financing, the health workforce, procurement and supplies. Increased inputs, therefore, led to improved service delivery and enhanced access to services. The Committee was informed that ensuring the availability of health services that met a minimum quality standard and securing access to them were key functions of a health system. To monitor progress in strengthening health service delivery, it was also necessary to determine the dimensions along which progress would be measured.
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