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MAIN REPORT Mapping of Health Links in the Zambian

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MAIN REPORT Mapping of Health Links in the Zambian Tropical Health and Education Trust Ministry of Health UNITED KINGDOM ZAMBIA MAIN REPORT Mapping of Health Links in the Zambian Health Services and Associated Academic Institutions under the Ministry of Health Submitted to: The Executive Director Tropical Health and Education Trust (THET) 210 Euston Road, London NW1 2BE UNITED KINGDOM and The Permanent Secretary Ministry of Health Ndeke House, Haile Selassie Avenue PO Box 30205, Lusaka ZAMBIA August 2007 CAN Investments Limited 26 Wusakili Crescent, Northmead PO Box 39485, Lusaka, Zambia Tel/Fax: 260-1-230418, E-mail: [email protected] MAIN REPORT The Tropical Health and Education Trust Mapping of Health Links in the Zambian Health In conjunction with Services and Associated Academic Institutions The Ministry of Health of Zambia under the Ministry of Health CONTENTS PAGE ACRONYMS USED...................................................................................................................................III FOREWORD AND ACKNOWLEDGEMENTS.......................................................................................V 1 EXECUTIVE SUMMARY..................................................................................................................1 1.1 INTRODUCTION..............................................................................................................................1 1.2 METHODOLOGY AND APPROACH ..................................................................................................1 1.3 EXISTING HEALTH LINKS ..............................................................................................................1 1.4 POTENTIAL AREAS FOR FUTURE LINKS .........................................................................................2 1.5 PROPOSED PROCESS FOR IDENTIFYING FUTURE LINKS..................................................................3 1.6 CONCLUSION.................................................................................................................................3 2 CONTEXT............................................................................................................................................4 3 BACKGROUND ..................................................................................................................................5 3.1 INTRODUCTION..............................................................................................................................5 3.2 DEFINITION OF LINKS....................................................................................................................6 3.3 THE TROPICAL HEALTH AND EDUCATION TRUST .........................................................................6 3.4 METHODOLOGY AND APPROACH ..................................................................................................7 3.5 PROBLEMS ENCOUNTERED............................................................................................................9 4 THE HEALTH DELIVERY SYSTEMS IN ZAMBIA...................................................................10 4.1 DEMOGRAPHIC AND SOCIAL-ECONOMIC CONTEXT.....................................................................10 4.2 ORGANISATION AND MANAGEMENT ...........................................................................................11 4.3 MAIN PROBLEMS AND CONSTRAINTS..........................................................................................16 4.4 THE HUMAN RESOURCE CRISIS...................................................................................................17 4.5 SECTOR STRATEGY AND PRIORITIES ...........................................................................................20 4.6 SECTOR PERFORMANCE ..............................................................................................................21 5 EXISTING HEALTH LINKS...........................................................................................................23 5.1 OVERVIEW ..................................................................................................................................23 5.2 PROVINCIAL HEALTH OFFICES AND DISTRICT HEALTH MANAGEMENT TEAMS ..........................23 5.3 CENTRAL HOSPITALS (“3RD LEVEL HOSPITALS”).........................................................................24 5.4 PROVINCIAL AND DISTRICT HOSPITALS (1ST AND 2ND LEVEL HOSPITALS) ...................................32 5.5 HEALTH CENTRES AND HEALTH POSTS.......................................................................................39 5.6 HEALTH TRAINING INSTITUTIONS ...............................................................................................39 5.7 STATUTORY BOARDS AND OTHER UNITS ....................................................................................40 6 POTENTIAL AREAS FOR FUTURE HEALTH LINKS..............................................................45 6.1 OVERVIEW ..................................................................................................................................45 6.2 GENERIC POTENTIAL AREAS FOR FUTURE LINKS........................................................................45 6.3 PROVINCIAL AND DISTRICT HEALTH MANAGEMENT LEVEL .......................................................46 6.4 HOSPITALS AT ALL LEVELS .........................................................................................................46 6.5 HEALTH CENTRES AND HEALTH POSTS.......................................................................................48 6.6 HEALTH TRAINING INSTITUTIONS ...............................................................................................48 6.7 STATUTORY BOARDS ..................................................................................................................49 7 PROPOSED PROCESS FOR IDENTIFICATION OF FUTURE LINKS...................................52 August 2007 i CAN Investments Limited Lusaka, Zambia MAIN REPORT The Tropical Health and Education Trust Mapping of Health Links in the Zambian Health In conjunction with Services and Associated Academic Institutions The Ministry of Health of Zambia under the Ministry of Health 8 APPENDICES....................................................................................................................................53 APPENDIX I: TERMS OF REFERENCE ........................................................................................................1 APPENDIX II: TRENDS FOR TOP 10 MAJOR DISEASES IN ZAMBIA, 2000-2006 ..........................................1 APPENDIX III: STAFFING LEVELS AND WORKLOADS.................................................................................3 APPENDIX IV: DISTRIBUTION OF CORE HEALTH WORKERS BY PROVINCE ...............................................5 APPENDIX V: CONSOLIDATED LIST OF EXISTING LINKS..........................................................................1 APPENDIX VI: LIST OF INSTITUTIONS AND PERSONS INTERVIEWED .........................................................1 APPENDIX VII: LIST OF DOCUMENTS/LITERATURE CONSULTED ...............................................................1 APPENDIX VIII: REPORTS/FEEDBACK FROM LINK PARTNERS....................................................................3 August 2007 ii CAN Investments Limited Lusaka, Zambia MAIN REPORT The Tropical Health and Education Trust Mapping of Health Links in the Zambian Health In conjunction with Services and Associated Academic Institutions The Ministry of Health of Zambia under the Ministry of Health ACRONYMS USED Acronym used Definition AU African Union The Consultant CAN Investments Limited CBOH Central Board of Health Chainama Chainama Hills Hospital and College for Health Sciences CHAZ Churches Health Association of Zambia COMESA Common Market for East and Southern Africa CPs Cooperating Partners DRC Democratic Republic of Congo DTSS Director of Technical Support Services DHMT District Health Management Board DHMBs District Health Management Boards DHMTs District Health Management Teams FNDP Fifth National Development Plan FNDP Fifth National Development Plan GNCZ General Nursing Council of Zambia Global Fund Global Fund against HIV/AIDS, TB and Malaria HCs Health Centres HMIS Health Management Information System HPs Health Posts HSSP Health Services Support Program HIPC Highly Indebted Poor Countries HIPC Highly Indebted Poor Countries HMBs Hospital Management Boards HMTs Hospital Management Teams HIV/AIDS Human Immuno-Deficiency Virus/Acquired Immunity Deficiency Syndrome HR Human Resources HR Plan Human Resources for Health Strategic Plan CPs International Cooperating Partners JLI Joint Learning Initiative on Human Resources for Health and Development Links Long-term International Health Links MMR Maternal Mortality Ratio MCZ Medical Council of Zambia MTEF Medium Term Expenditure Framework MDGs Millennium Development Goals MOH or the Ministry Ministry of Health M & E Monitoring and Evaluation NDP National Development Plan NHSP National Health Strategic Plan NHSP 2006/10 National Health Strategic Plan 2006/10 August 2007 iii CAN Investments Limited Lusaka, Zambia MAIN REPORT The Tropical Health and Education Trust Mapping of Health Links in the Zambian Health In conjunction with Services and Associated Academic Institutions The Ministry of Health of Zambia under the Ministry of Health NHSP National Health Strategic Plan 2006-10 PRA Pharmaceutical Regulatory Authority PRSP Poverty Reduction Strategy Paper PRSP Poverty Reduction
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