Analysis: STANSLOUS NGOSA
THE successful attainment of Zambia’s goal of being a prosperous, middle-income country by 2030 as stipulated in its Vision 2030 begins with transforming the country into a nation of healthy and productive people.
Therefore, Government, through the Ministry of Health (MoH), has continued to prioritise health service provision as a pathway to achieving this.
The MoH’s focus 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 2017-2021 National Health Sector Strategic Plan (NHSP) covering five-years 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, and the interventions that will be undertaken to make sure these targets are met.
It 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 plan is a major departure from the past strategic plans. While the plan recognises that all health care interventions are import, 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 supports the National Vision 2030, which expresses the Zambian people’s aspiration “to become a prosperous middle-income nation by 20 by 20 by 30.” This plan envisions a prosperous country where all Zambians have access to quality health services.
The plan 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 will achieve reduction in maternal and child mortality rates, malaria elimination and reduction in the incidence of HIV among key health outcomes.
The ministry 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.
Therefore, the plan emphasises strong multi-sectoral collaboration to address all the social and economic determinants of health.
With appropriate levels of commitment and support exhibited by President Edgar Lungu, cooperating partners, health workers and stakeholders, the plan will significantly improve the health status of Zambians and meaningfully contribute to national development.
Additionally, in line with other key international and national initiatives and policies on health which include 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.
The NHSP 2017-2021 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’.
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, in this particular order: health promotion, disease prevention and curative and rehabilitative services in close-to-client settings.
The first rung on the ladder of the health services is community-based prevention health services rather than curative services.
The strategic plan includes the following ten (10) Legacy Goals which the MoH believes will transform the health sector and these are:
1. Reduction in Maternal and Child Mortality
2. Elimination of Malaria
3. Recruitment of 30,000 health care workers
4. Introduction of Health Care Insurance to increase coverage from 4 percent to 100 percent
5. Introduction of Alcohol and Drug Abuse Policy and Programme
6. Achieve HIV Epidemic Control, Reduce HIV new Infection from 48,000
to less than 5,000
7. Construction of 6 new specialised hospitals and 500 health facilities in the next 5 years
8. Train 500 specialist by 2021
9. Halt and reduce Non- Communicable Diseases
10. Reduce TB incidence towards Elimination
The implementation of this plan will require harmonised and integrated actions by the MoH 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 MoH and all cooperating partners within the structure of the Medium Term Expenditure Framework. At the decentralised level, district health offices will produce annual, costed, 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.
These indicators, which are important for measuring the sector’s performance, are consistent with 7NDP indicators and have been informed by the country’s long-term vision and strategic direction (Vision 2030 and SDGs). These indicators will also form the basis of monitoring and evaluation of the NHSP 2017-2021.
The priority areas of the NHSP are Human Resources for Health (HRH), 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 as per budget allocation this year, imperative that we raise more resources to the sector through other available channels if we are to achieve our desired goals as indicated.
A multi-sectoral approach advocated in the 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 and thereby ensuring that we improve the health status of our communities. Ultimately, with this new approach, the Ministry is confident of attaining Vision 2030.
The author is Head – Media Relations in the Ministry of Health.