[By Stanslous Ngosa]
The successful attainment of Zambia’s goal of being a prosperous, middle-income country by 2030 as stipulated in the country’s Vision 2030 begins with transforming the country into a nation of healthy and productive people.
Therefore, the government, through the Ministry of Health, has continued to prioritise health service provision as a pathway to achieving this. The focus of the Ministry of Health is the provision of a continuum of care with particular emphasis placed on strengthening health systems and services using the primary health care (PHC) approach.
The Ministry’s 2017-2021 National Health Sector Strategic Plan (NHSP) provides guidance on all health interventions in the health sector.
The plan details the direction the health sector will take, the achievements and outcomes that will be attained as well as the interventions that will be undertaken to make sure these targets are met.
The plan also specifies the roles and responsibilities that all actors involved in the health sector will have to perform, the implementation challenges that have to be overcome, the monitoring and evaluation required, and the financial resources needed to enable the plan to be successfully implemented.
The approach taken in the 2017-2021 plan is a major departure from the past strategic plans. While the plan recognises that all health care interventions are important and should continue to receive support, it also recognises that interventions must be prioritised due to the constraints on available resources and capabilities.
The plan therefore focuses on primary health care as the main vehicle of service delivery, resolving the human resource crisis, addressing public health problems and ensuring that priority systems and services receive the necessary support.
The NHSP 2017-2021’s vision is to have ‘A Nation of Healthy and Productive People’, while the mission is ‘To provide equitable access to cost effective, quality health services as close to the family as possible’.
The NHSP supports the national Vision 2030 which expresses the Zambian people’s aspiration “to become a prosperous middle-income nation by 2030.” This plan envisions a prosperous country where all Zambians have access to quality health services. The NHSP focuses on delivering quality health services across the continuum of care which includes promotive, preventive, curative, rehabilitative and palliative care provided as close to the family settings as possible.
The attainment of the universal health coverage will be made possible through primary health care with a focus on community health. Through the integrated community primary health care approach, the country is expected to achieve a reduction in maternal and child mortality rates, elimination of malaria and to reduce the incidence of HIV and Aids. The Ministry of Health acknowledges that good health is a function of not only health care services, but also other socioeconomic factors which include education, agriculture, housing, water and sanitation.
A multi sectorial approach advocated in the Seventh National Development Plan (7NDP) where strategic interventions will be implemented in clusters is a positive move in tackling various determinants of health such as health nutrition practices, safe water and sanitation, better housing and improved literacy which need collaborative efforts. These determinants of health need other ministries to play a key role in addressing them, thereby ensuring that government improves the health status of communities. Therefore, the ministry emphasises strong multi-sectorial collaboration to address all the social and economic determinants of health.
With appropriate levels of commitment and support exhibited by His Excellency, Edgar Chagwa Lungu, President of the Republic of Zambia, cooperating partners, health workers and stakeholders, the plan will significantly improve the health status of Zambians and meaningfully contribute to national development by the end of 2021.
Additionally, in line with other key international and national initiatives and policies on health which includes the Sustainable Development Goals (SDGs), Abuja Declaration and the National Health Policy, the strategic plan’s outcomes and targets are consistent with the targets and goals contained in these policies. This, is in pursuance of the strategic plan’s overall goal of ‘improving the health status of people in Zambia in order to contribute to increased productivity and socio-economic development’.
In addition, the strategic plan was developed in line with the nation’s transformative agenda which recognises the importance of the health sector in improving national productivity. The embedded health service model within the strategic plan, therefore, has been be re-engineered with emphasis on the following: health promotion, disease prevention and curative and rehabilitative services in close-to-client settings.
The strategic plan includes the following ten (10) legacy goals which the Ministry of Health believes will transform the health sector. These are: reduction in maternal and child mortality; elimination of malaria; recruitment of 30, 000 health care workers; introduction of health care insurance to increase coverage from 4 per cent to 100 per cent; and the introduction of alcohol and drug abuse policy and programme.
Others are the achievement of HIV epidemic control; to reduce HIV new infections from 48, 000 to less than 5, 000; construction of six new specialised hospitals and 500 health facilities in the next five years; train 500 specialists by 2021; to halt and reduce non-communicable diseases, and to reduce TB incidences towards elimination.
The implementation of this plan will require harmonised and integrated actions by the Ministry of Health and other line ministries, local government, provinces, districts, cooperating partners, and local communities. The Ministry will provide leadership in implementing the plan, but will do so based on the principles of partnership and collaboration embodied in the sector wide approach.
The NHSP 2017-2021 will be implemented through national annual work plans developed jointly by the Ministry of Health and all cooperating partners within the structure of the medium-term expenditure framework. At a decentralised level, district health offices will produce annual action plans.
The NHSP interventions which are aimed at reaching desired outcomes and targets will be measured using a set of annual and periodic indicators that have been developed through consultations with all stakeholders. The priority areas of the NHSP are human resources for health, infrastructure, pharmaceuticals and supply chain management, HIV/AIDS and malaria.
With the prevailing funding levels to the health sector of about K6.8 billion per year, it is imperative that more resources for the sector are raised through other available channels if the Ministry of Health is to achieve its desired goals.
The author is head of media relations at the Ministry of Health.