DOCSLIB.ORG

Zambia “SAFE” Strategy Implementation Framework 2013 - 2017

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text

Load more

Ministry of Health Zambia “SAFE” Strategy Implementation Framework 2013 - 2017 Developed and Compiled By the Directorate of Clinical Care and Diagnostic Services National Eye Health Coordination FEBRUARY, 2013 i TABLE OF CONTENTS Statement by the Honourable Minister of Health ..................................................... iv Foreword by the Permanent Secretary ................................................................... vi Message on Trachoma by the Directorate of Clinical Care and Diagnostic Services ... viii Abbreviations and Acronyms ............................................................................... xii PART ONE: ZAMBIA BACKGROUND 1 1.1.0 Country Profile ............................................................................................. 1 1.1.1 Zambian Provinces and Districts .......................................................... 2 1.2.0 Zambia Health System Goals and Priorities ..................................................... 3 1.3.0 Eye Health Services in Zambia ...................................................................... 6 1.4.0 Aims of the “SAFE” strategy implementation framework .................................. 7 PART TWO: TRACHOMA IN ZAMBIA 8 2.1.0 Introduction ............................................................................................... 8 2.2.0 Trachoma Disease Burden in Zambia ............................................................ 9 2.3.0 National Trachoma Survey Results .............................................................. 9 2.4.0 Case for Action ........................................................................................... 12 2.4.1 Impact of trachoma control ............................................................... 13 2.4.2 “SAFE” Strategy ............................................................................... 15 PART THREE: STRATEGIC AND OPERATIONAL FRAMEWORK 17 3.1.0 Stakeholder engagement /roles and responsibilities ....................................... 17 3.1.2 Implementation Structure ............................................................................ 24 PART FOUR: FACTORS FOR SUCCESS 28 4.1.0 Mass Drug Administration (MDA) .................................................................. 32 ii PART FIVE: STRATEGIES AND LOGICAL FRAMEWORK OF “SAFE” STRATEGY IMPLEMENTATION 35 5.1.0 Surgery ...................................................................................................... 35 5.2.0 Antibiotics ................................................................................................... 36 5.3.0 Face and hand washing ............................................................................... 41 5.4.0 Environment .............................................................................................. 43 PART SIX: NATIONAL BUDGET PROJECTIONS FOR FULL “SAFE” STRATEGY SCALE UP 46 6.1.0 Cost estimate for each “SAFE” strategy components ..................................... 46 6.1.1 Surgery Cost Estimate........................................................................ 46 6.1.2 Antibiotics cost estimate......................................................................48 6.1.3 Face and hand washing...................................................................... 50 6.1.4 Environment.......................................................................................52 PART SEVEN: FUNDING FOR THE “SAFE” STRATEGY IMPLEMENTATION 57 7.1.0 Sources of funding ........................................................................... 58 PART EIGHT: GANTT CHART 59 PART NINE: REFERENCES 60 PART TEN: APPENDICES 61 10.1.0 Appendix 1: Schools and surrounding communities visited during ITM survey. 61 10.2.0 Appendix 2: Areas visited during trachoma mapping in fifteen districts using the WHO classical method .......................................................................................... 87 iii Statement by the Honourable Minister of Health Zambia needs a healthy population in order to develop and thrive. The Zambian people are the largest and greatest asset the country has. As a country we still hold to the affirmation and promise to work towards elimination and eradication of all Neglected Tropical Diseases including trachoma. We keep this aspiration and momentum through our mission statement of, “Providing Quality Health Services as close to the family as possible.” This document focuses on the trachoma situation in the country and re-affirms my government's commitment to work with all cooperating partners, civil society, the corporate sector and line Ministries in our pursuit to control, manage and eliminate trachoma in Zambia. It comprehensively highlights the goals, objectives and strategies toward control and elimination of trachoma in Zambia by the year 2020. It also provides an impetus in the reduction of the burden of other infectious diseases like cholera, typhoid, dysentery and other NTDs whose root cause is also related to poor sanitation and hygiene through the “SAFE” strategy components. The challenge in the control of trachoma disease in Zambia has been inadequate resources towards prevention, control and case management coupled with the absence of the institutional framework to fight against trachoma. The inadequate data on the extent of the disease has now been addressed. The prevalence of this disease can be used as an indicator of poverty levels in the country as it mostly affects the poor and marginalized communities. The chronicity of the disease disables and deprives people of their dignity and self esteem. Our priority is to improve the standards of sanitation and hygiene as well as safe water supply as we contribute to the country’s effective response to trachoma. iv I take sincere pleasure in thanking all our “It comprehensively highlights partners and the members of staff at the the goals, objectives and Ministry of Health for their hard work in strategies toward control and bringing to light this major public health elimination of trachoma in challenge in our country. It is my sincere Zambia by the year 2020. It will hope that this partnership will strengthen also provide an impetus in the and that ultimately we can achieve the goal reduction of the burden of other of eliminating trachoma by the year 2020. poor sanitation and hygiene Ministry of Health will endeavour to related infectious diseases such collaborate with other line Ministries in the as cholera, typhoid, dysentery fight against trachoma. and other NTDs through the “SAFE” strategy components.” We welcome any guidance, advice and support from our partners, civil society, line Ministries and all other stakeholders in the fight against trachoma and other Neglected Tropical Diseases. My Government shall remain committed to ensuring that our country achieves the goal of eliminating trachoma by the year 2020. v Foreword by the Permanent Secretary The trachoma survey conducted by MoH and cooperating partners revealed that trachoma is endemic in all provinces of Zambia, with highest prevalence rates found in Southern, Copperbelt, Northern and Muchinga Provinces. Areas affected by trachoma are characterized by perennial water shortages, inadequate sanitation, poor hygiene and poverty. In its trachoma control programme, Zambia has benefitted from various stakeholders. These stakeholders include Ministry of Health, other line Ministries and the eye health co-operating partners such as CBM, Centre for Disease Control (CDC), Colin Glassco Foundation, Geneva Global (GG), International Trachoma Initiative (ITI), Lions Aid Norway (LAN), Operation Eyesight Universal (OEU) and Sightsavers (SS). All 72 districts (as at 2011) were surveyed for trachoma. In fourty six “The WHO “SAFE” strategy is certainly the way to go in (46) districts trachoma was identified responding to the trachoma burden as a Public Health Problem which in the country. This strategy places emphasis on serious structural require the full implementation of the transformation in our delivery of “SAFE” strategy. This translates into water and sanitation services. This certainly provides yet another 70% of the districts being endemic avenue for attainment of the with active trachoma with an average MDGs.” prevalence of 15%. The above findings call for a complete shift in mindset at the community and national levels and change of priorities, especially at the Local Government level. There is need to have a more comprehensive strategy if trachoma is to be eliminated. The WHO “SAFE” strategy is certainly the way to go in responding to the trachoma burden in the country. This strategy places emphasis on serious structural transformation in our delivery of safe water and sanitation services. This certainly provides yet another avenue for attainment of the MDGs. vi The “SAFE” Strategy has been instrumental in developing a framework that will provide a guide in the planning, delivery, and management of “Clean, Caring, Competent and Confidential eye health services at Community, District, Provincial and National levels” in trachoma elimination. The “SAFE” strategy also provides the Ministry of Health with yet another opportunity of synergizing resources in combating all the diseases arising due to poor sanitation and hygiene and lack of safe water. The Ministry of Health and its partners in the trachoma response have found it prudent to apply the most appropriate strategies in the implementation of all activities and programmes pertaining to the “SAFE” strategy in the elimination of trachoma. Accompanying
Recommended publications
  • The Iccf Group Brochure Ed

    The Iccf Group Brochure Ed

    THE ICCF GROUP BROCHURE ED. 2021-2022 INTERNATIONALCONSERVATION.ORG TABLE OF CONTENTS WHO WE ARE AND WHAT WE DO ................................................................ 4 WORKING WITH LEGISLATURES ..................................................................... 8 • Caucuses We Support ................................. 10 • ICCF in the United States ................................ 12 • The ICCF Group in the United Kingdom ......................................................................................................... 31 • The ICCF Group in Latin America & the Caribbean ...................................................................................... 39 • The ICCF Group in Africa ............................ 63 • The ICCF Group in Southeast Asia ................ 93 WORKING WITH MINISTRIES ....................................................................... 103 MISSION THE MOST ADVANCED WE WORK HOW TO ADVANCE SOLUTION IN CONSERVATION CONSERVATION GOVERNANCE GOVERNANCE BY BUILDING 1. WE BUILD POLITICAL WILL POLITICAL WILL, The ICCF Group advances leadership in conservation by building political will among parliamentary PROVIDING and congressional leaders, and by supporting ministries in the management of protected areas. ON-THE-GROUND SOLUTIONS 2. CATALYZING CHANGE WITH KNOWLEDGE & EXPERTISE We support political will to conserve natural resources by catalyzing strategic partnerships and knowledge sharing between policymakers and our extensive network. VISION 3. TO PRESERVE THE WORLD'S MOST CRITICAL LANDSCAPES
  • Chililabombwe District Investment Profile

    Chililabombwe District Investment Profile

    CHILILABOMBWE DISTRICT INVESTMENT PROFILE WELCOME TO CHILILABOMBWE HOME OF THE CROAKING FROG This profile give you an insight of Chililabombwe District. It demonstrates the investment poetical of the District and the comparative advantages with other Districts in the Province. Chililabombwe is predominantly a mining town. However, the District offers a lot of other economic activities that have high potential for growth. Apart from mining, Chililabombwe has a conducive climate and suitable land for agriculture, fish farming, beekeeping and other agricultural related activities. The District also has potential for Tourism, Small-scale Mining, Infrastructure development, Trade and many others. Therefore, investing in Chililabombwe is one of the wisest business decisions you will make due to the high demand for goods and services in Chililabombwe and Congo DR. Phone: +260977316767 E-mail: [email protected] Facebook: Chililabombwe Municipal Council Sincerely, Christabel M. Mulala Chililabombwe Mayor PO Box 210023 President Avenue Chililabombwe Page | 1 Table of Contents WELCOME TO CHILILABOMBWE ................................................................................................... 1 LIST OF TABLES .................................................................................................................................. 4 LIST OF FIGURES ................................................................................................................................ 4 ABBREVIATIONS ...............................................................................................................................
  • Environmental Project Brief

    Environmental Project Brief

    Public Disclosure Authorized IMPROVED RURAL CONNECTIVITY Public Disclosure Authorized PROJECT (IRCP) REHABILITATION OF PRIMARY FEEDER ROADS IN EASTERN PROVINCE Public Disclosure Authorized ENVIRONMENTAL PROJECT BRIEF September 2020 SUBMITTED BY EASTCONSULT/DASAN CONSULT - JV Public Disclosure Authorized Improved Rural Connectivity Project Environmental Project Brief for the Rehabilitation of Primary Feeder Roads in Eastern Province Improved Rural Connectivity Project (IRCP) Rehabilitation of Primary Feeder Roads in Eastern Province EXECUTIVE SUMMARY The Government of the Republic Zambia (GRZ) is seeking to increase efficiency and effectiveness of the management and maintenance of the of the Primary Feeder Roads (PFR) network. This is further motivated by the recognition that the road network constitutes the single largest asset owned by the Government, and a less than optimal system of the management and maintenance of that asset generally results in huge losses for the national economy. In order to ensure management and maintenance of the PFR, the government is introducing the OPRC concept. The OPRC is a concept is a contracting approach in which the service provider is paid not for ‘inputs’ but rather for the results of the work executed under the contract i.e. the service provider’s performance under the contract. The initial phase of the project, supported by the World Bank will be implementing the Improved Rural Connectivity Project (IRCP) in some selected districts of Central, Eastern, Northern, Luapula, Southern and Muchinga Provinces. The project will be implemented in Eastern Province for a period of five (5) years from 2020 to 2025 using the Output and Performance Road Contract (OPRC) approach. GRZ thus intends to roll out the OPRC on the PFR Network covering a total of 14,333Kms country-wide.
  • Report20 Uniting to End Malaria 501(C)3

    Report20 Uniting to End Malaria 501(C)3

    PHOTO BY PAUL ISHII ANNUAL REPORT20 Uniting to End Malaria 501(c)3. EIN: 46-1380419 No one can foresee the duration or severity of COVID’s human and economic toll. But the malaria global health community agrees it will be disastrous to neglect or underinvest in malaria during this period, and thereby squander a decade of hard won progress. By some estimates, halting malaria intervention efforts could trigger a return to one million malaria deaths per year, a devastating mortality rate unseen since 2004. To that end many of our efforts last year were to strategically advocate for continued global malaria funding, as well as supporting COVID adjustments to ensure malaria projects were not delayed. Last year we supplied Personal Protection Equipment (PPE) to over 700 Rotary-funded community health workers (CHWs) in Uganda and Zambia; altered CHW The training to incorporate appropriate social distancing; conducted several webinars specifically focused on maintaining malaria financial support despite COVID; and we provided $50,000 to the Alliance for Malaria Prevention used for COVID/malaria public education in Africa. Jeff Pritchard Board Chair While our near-term work must accommodate pandemic restrictions, we are still firmly committed to our mission, “to generate a broad international Rotary campaign for the global elimination of malaria.” During the coming twelve months we intend to: • Implement a blueprint developed in 2020 for a large long-term Road malaria program with Rotary, the Bill & Melinda Gates Foundation, and World Vision, in the most underserved regions of Zambia’s Central and Muchinga Provinces, positively impacting nearly 1.4 million residents.
  • Zambia Page 1 of 8

    Zambia Page 1 of 8

    Zambia Page 1 of 8 Zambia Country Reports on Human Rights Practices - 2003 Released by the Bureau of Democracy, Human Rights, and Labor February 25, 2004 Zambia is a republic governed by a president and a unicameral national assembly. Since 1991, multiparty elections have resulted in the victory of the Movement for Multi-Party Democracy (MMD). MMD candidate Levy Mwanawasa was elected President in 2001, and the MMD won 69 out of 150 elected seats in the National Assembly. Domestic and international observer groups noted general transparency during the voting; however, they criticized several irregularities. Opposition parties challenged the election results in court, and court proceedings were ongoing at year's end. The anti-corruption campaign launched in 2002 continued during the year and resulted in the removal of Vice President Kavindele and the arrest of former President Chiluba and many of his supporters. The Constitution mandates an independent judiciary, and the Government generally respected this provision; however, the judicial system was hampered by lack of resources, inefficiency, and reports of possible corruption. The police, divided into regular and paramilitary units under the Ministry of Home Affairs, have primary responsibility for maintaining law and order. The Zambia Security and Intelligence Service (ZSIS), under the Office of the President, is responsible for intelligence and internal security. Civilian authorities maintained effective control of the security forces. Members of the security forces committed numerous serious human rights abuses. Approximately 60 percent of the labor force worked in agriculture, although agriculture contributed only 15 percent to the gross domestic product. Economic growth increased to 4 percent for the year.
  • Winrock Report Template

    Winrock Report Template

    <name of> Project | Month Year Photo: EMPOWER participants from Chimtende Hub, Katete District (Winrock International) EMPOWER Case Study UNDERSTANDING VARIATION IN REAL COURSE ATTENDANCE AND ACHIEVEMENT Date: October 30, 2020 Author: Alex Hardin, Winrock International EMPOWER Case Study UNDERSTANDING VARIATION IN REAL COURSE ATTENDANCE AND ACHIEVEMENT Date: October 30, 2020 PROJECT NAME: EMPOWER: Increasing Economic and Social Empowerment for Adolescent Girls and Vulnerable Women in Zambia COOPERATIVE AGREEMENT NUMBER: IL-29964-16-75-K- AUTHOR: Alex Hardin, Winrock International FUNDER: United States Department of Labor Funding is provided by the United States Department of Labor under cooperative agreement number IL-29964-16-75-K-. One hundred percent of the total costs of the project are financed with federal funds, for a total of $5,000,000. This material does not necessarily reflect the views or policies of the United States Department of Labor, nor does mention of trade names, commercial products, or organizations imply endorsement by the United States Government. CONTACT: 2101 Riverfront Drive 2451 Crystal Drive, Suite 700 Little Rock, AR 72202 Arlington, VA 22202 501-280-3000 701-302-6500 winrock.org Acknowledgements The case study researcher would like to thank everyone who offered their time and energy toward the development of this report. Special thanks go to the Chasefu and Petauke District Coordinators, Dennis and Sombo, without whom the vast majority of the research would have been impossible, and to Diana, Mutale, Doug,
  • Zambia Page 1 of 16

    Zambia Page 1 of 16

    Zambia Page 1 of 16 Zambia Country Reports on Human Rights Practices - 2002 Released by the Bureau of Democracy, Human Rights, and Labor March 31, 2003 Zambia is a republic governed by a president and a unicameral national assembly. Since 1991 generally free and fair multiparty elections have resulted in the victory of the Movement for Multi -Party Democracy (MMD). In December 2001, Levy Mwanawasa of the MMD was elected president, and his party won 69 out of 150 elected seats in the National Assembly. The MMD's use of government resources during the campaign raised questions over the fairness of the elections. Although noting general transparency during the voting, domestic and international observer groups cited irregularities in the registration process and problems in the tabulation of the election results. Opposition parties challenged the election result in court, and court proceedings remained ongoing at year's end. The Constitution mandates an independent judiciary, and the Government generally respected this provision; however, the judicial system was hampered by lack of resources, inefficiency, and reports of possible corruption. The police, divided into regular and paramilitary units operated under the Ministry of Home Affairs, had primary responsibility for maintaining law and order. The Zambia Security and Intelligence Service (ZSIS), under the Office of the President, was responsible for intelligence and internal security. Members of the security forces committed numerous, and at times serious, human rights abuses. Approximately 60 percent of the labor force worked in agriculture, although agriculture contributed only 22 percent to the gross domestic product. Economic growth slowed to 3 percent for the year, partly as a result of drought in some agricultural areas.
  • Full Text Document (Pdf)

    Full Text Document (Pdf)

    Kent Academic Repository Full text document (pdf) Citation for published version Macola, Giacomo (2006) “It Means as If We Are Excluded from the Good Freedom”: Thwarted Expectations of Independence in the Luapula Province of Zambia, 1964-1967. Journal of African History, 47 (1). pp. 43-56. ISSN 0021-8537. DOI https://doi.org/10.1017/S0021853705000848 Link to record in KAR https://kar.kent.ac.uk/7559/ Document Version UNSPECIFIED Copyright & reuse Content in the Kent Academic Repository is made available for research purposes. Unless otherwise stated all content is protected by copyright and in the absence of an open licence (eg Creative Commons), permissions for further reuse of content should be sought from the publisher, author or other copyright holder. Versions of research The version in the Kent Academic Repository may differ from the final published version. Users are advised to check http://kar.kent.ac.uk for the status of the paper. Users should always cite the published version of record. Enquiries For any further enquiries regarding the licence status of this document, please contact: [email protected] If you believe this document infringes copyright then please contact the KAR admin team with the take-down information provided at http://kar.kent.ac.uk/contact.html ‘IT MEANS AS IF WE ARE EXCLUDED FROM THE GOOD FREEDOM’: THWARTED EXPECTATIONS OF INDEPENDENCE IN THE LUAPULA PROVINCE OF ZAMBIA, 1964-1966* BY GIACOMO MACOLA Centre of African Studies, University of Cambridge ABSTRACT: Based on a close reading of new archival material, this article makes a case for the adoption of an empirical, ‘sub-systemic’ approach to the study of nationalist and post- colonial politics in Zambia.
  • 1 Elections and Peacebuilding in Zambia Assessment Final Report

    1 Elections and Peacebuilding in Zambia Assessment Final Report

    Elections and Peacebuilding in Zambia Assessment Final Report Contents Executive Summary ............................................................................................................ 3 Introduction ......................................................................................................................... 8 I. Structural Vulnerabilities ................................................................................................. 9 A. Political Factors.............................................................................................................. 9 B. Social Factors ............................................................................................................... 11 Table 1 .............................................................................................................................. 14 Composition of Members of Parliament by Gender since 1994 ....................................... 14 C. Economic Factors ......................................................................................................... 14 D. Security Factors............................................................................................................ 14 II. Vulnerabilities Specific to the 2011 Election ............................................................... 15 A. Electoral Administration .............................................................................................. 15 B. Parallel Vote Tabulation (PVT) ..................................................................................
  • Country Profile: Zambia

    Country Profile: Zambia

    TECHNICAL MARKET REVIEW Country Profile: Zambia CTCN Report No.: REPORT NO, Rev. Draft Date: 2018-06-06 1 IMPORTANT NOTICE AND DISCLAIMER 1. This document is intended for the sole use of the Customer as detailed on the front page of this document to whom the document is addressed and who has entered into a written agreement with the DNV GL entity issuing this document (“DNV GL”). To the extent permitted by law, neither DNV GL nor any group company (the "Group") assumes any responsibility whether in contract, tort including without limitation negligence, or otherwise howsoever, to third parties (being persons other than the Customer), and no company in the Group other than DNV GL shall be liable for any loss or damage whatsoever suffered by virtue of any act, omission or default (whether arising by negligence or otherwise) by DNV GL, the Group or any of its or their servants, subcontractors or agents. This document must be read in its entirety and is subject to any assumptions and qualifications expressed therein as well as in any other relevant communications in connection with it. This document may contain detailed technical data which is intended for use only by persons possessing requisite expertise in its subject matter. 2. This document is protected by copyright and may only be reproduced and circulated in accordance with the Document Classification and associated conditions stipulated or referred to in this document and/or in DNV GL’s written agreement with the Customer. No part of this document may be disclosed in any public offering memorandum, prospectus or stock exchange listing, circular or announcement without the express and prior written consent of DNV GL.
  • Corporate Affairs and Business Development

    Corporate Affairs and Business Development

    CORPORATE AFFAIRS AND BUSINESS DEVELOPMENT ENVIRONMENTAL IMPACT ASSESSMENT THE PROPOSED CONNECTION OF NORTH WESTERN PROVINCE TO THE NATIONAL GRID AT 132kV PREPARED BY THE ENVIRONMENT AND SOCIAL AFFAIRS UNIT 2011 EXECUTIVE SUMMARY In the Northwestern Province (NWP) ZESCO Limited supplies electricity to five districts namely Mwinilunga, Mufumbwe, Kabompo, Zambezi and Chavuma from isolated Diesel Generation Stations located in each district. The older districts (Mwinilunga, Kabompo, and Zambezi) have been on diesel power supply for over forty years now. Solwezi and Kasempa are the only two districts in the province that are supplied from the national hydro power grid. Power supply from the diesel power stations is characterized by high operational costs, inadequate capacity, very low reliability and high emissions. ZESCO Limited has therefore long sought to replace diesel generated power supply with reliable and cost effective power from the national grid by connecting all the diesel power stations to the grid. By the year 2000, ZESCO Limited was operating ten diesel stations country wide, but by 2007, four such stations had been replaced by grid supply while two new stations were installed in two newly designated districts. Despite having great potential for mining and agricultural development, NWP generally remains underdeveloped due to insufficient and unreliable power supply. It is against this background that the Government of the Republic of Zambia through ZESCO Limited, intends to connect the 5 NWP Districts still on diesel, to the National Grid at 132 kilo Volts (kV) through a transmission line network from Kasempa T-Off (Nselauke) to Chavuma and linking Mwinilunga to Lumwana. The main objective of the project is to replace the diesel generated electricity with hydro electricity by constructing a 132kV transmission line network which would be linked to the main national power grid.
  • COMMITTEE on HEALTH, JUNE 2019.Pdf

    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.