Zambian Experience, Issues and Constraints Directorate of Policy and Planning Ministry of Health Zambia UK Health Workers Alliance Seminar

Presentation Layout  Health Reforms  SWAps  Basket Funding Mechanism  MoU  Background  Benefits  Constraints  Next Steps  Concluding remarks

Health Sector Reforms  The Health Sector in Zambia has been instrumental in embracing Sector Wide Approach.  During the late 80’s and early 90’s Zambia’s health sector was characterized by several fragmented donor projects  Need to integrate all the vertical programmes into a sectoral framework that would meet common national goals and objectives.  An MoU was developed between MoH and CPs and was signed November 1999 and June 2006 respectively which was based on agreed SWAp coordinating mechanisms for adherence. 3

Health Sector Reforms  Four (4) main SWAp Co-ordinating meetings are held every year (ACM, SAG, Policy and TWG)  The SWAp increased the fiscal space in terms of commitment from Cooperating partners initially, and eventually Government also increased its contribution to the sector. 4

Background to ZUHWA Many Zambian health and health-related academic institutions have “small scale” partnerships (‘health links’) with individuals, departments, organisations or NGOs in Europe or North-America. Some Zambian institutions such as the University Teaching Hospital, Chainama College of Health Partnerships and St Francis have multiple partnerships. 5

Background to ZUHWA Although such partnerships are designed to bring development benefits and learning to Zambian institutions and to their European and North American partners, they can also involve high transaction costs to both Zambian and the overseas partners. Health partnerships come from a strong desire to help by the European or North-American partner. They are often based on individual initiatives and, in most cases, personal relationships. Some partnerships are based on the acceptance of any help offered rather than on a careful analysis of the health needs, benefits, costs and value for money. Partnerships can often be donor driven and not always aligned to the strategic priorities of the Zambian Ministry of Health 6

Background to ZUHWA In 2007 the Ministry of Health in collaboration with the Tropical Health and Education Trust, a UK based NGO, commissioned a mapping report to find out the number, type and impact of international partnerships across Zambia. The report found out that –The majority of international health partnerships are concentrated in Lusaka. (UTH over 24 and Chainama reported 14. Outside Lusaka St Francis Hospital in Katete, had 25 links. –Provincial Health Offices reported not links. –3 Central Hospitals, namely UTH, Chainama Hospital and Arthur Davidson Children’s Hospital in Ndola had partnerships. (Ndola and Arthur Davidson now had partnerships. Kitwe does not have partnerships) –17 out of 74 district and 19 provincial hospitals had established links of various kinds. –9 out of 21 health training institutions had links –Statutory boards also had links. –The work of these partnerships in only a few occasions supported the needs of hard to reach rural areas 7

Benefits –Potential for exchanges involving staff at all levels. Good for knowledge and skills transfer –Support for training and education plans: teaching, curriculum development, scholarships –Development of distant learning facilities 8

Constraints –Lack of awareness and coordination among different partnerships, at the institutional, regional and national levels. This leads to fragmentation and duplication. –Limited alignment with national health plans

Next Steps  Need to develop a framework for the promotion, management, coordination and evaluation of such partnerships  Request support from countries/collaborating partners to help identify and engage with partnerships between Zambian organisations and their respective countries. An example is the Zambia UK Health Workforce Alliance, through which we can reach Zambian and UK organisations working together to support health initiatives in Zambia. At the moment there over 45 organisations registered. Being part of the Alliance allow them work with each other. For example, a recent programme of work requires collaboration and coordination between 8 organisations. 10

Concluding remarks There is need to ensure that existing and future links are more accountable and contribute to the NHSP. Ministry has embarked on a Resource Mapping exercise and the ZUHWA seminar will provide some vital inputs. 11

Thank You 12