Zambia

The objectives of this study include documenting the role of the private for-profit sector in voluntary counseling and testing (VCT) service delivery; establishing whether there are significant differences in the quality of VCT services, particularly in counseling and referral practices, between public, private for-profit, NGO, and mission providers; measuring key VCT service statistics at facilities within each sector; and identify best practices from each sector. [adapted from introduction]

This commentary paper highlights changing patterns of outward migration of Zambian nurses. The aim is to discuss these pattern changes in the light of policy developments in Zambia and in receiving countries. [from abstract]

The objective of this study was to analyse in what way HRH recruitment, deployment and retention at the district level are influenced by external funding; and to what extent this is in line with national and district policies and strategies. [from abstract]

We conducted a survey among nurses and midwives working at district level in Sudan and Zambia to determine their roles and functions in polio eradication and measles elimination programs. [from abstract]

Well-documented shortages of health care workers in sub-Saharan Africa are exacerbated by the increased human resource demands of rapidly expanding HIV care and treatment programmes. The successful continuation of existing programmes is threatened by health care worker burnout and HIV-related illness. This article details the results of a study conducted among health providers in the Lusaka public health sector. [adapted from abstract]

The Zambia Prevention, Care and Treatment Partnership began training and placing community volunteers as lay counsellors in order to complement the efforts of the health care workers in providing HIV counselling and testing services. These volunteers are trained using the standard national counselling and testing curriculum. This study was conducted to review the effectiveness of lay counsellors in addressing staff shortages and the provision of HIV counselling and testing services. [from abstract]

This report describes field experiences with task shifting in Lusaka, Zambia, where a large public-sector ART program has enrolled over 71,000 HIV-infected adults and children across 19 program sites. It advocates a comprehensive, three-pronged approach to task-shifting that comprises training, on-site clinical mentoring, and continuous quality assurance. A structured approach is important so that clinical care is not compromised when clinical duties are initially shifted to less specialized health professionals. [from introduction]

Zambia, like many of the countries heavily affected by HIV and AIDS in southern Africa, also faces a shortage of human resources for health. The country receives significant amounts of funding from GHIs for the large-scale provision of antiretroviral treatment through the public and private sector. This paper examines the impact of GHIs on human resources for ART roll-out in Zambia, at national level, in one province and two districts. [from abstract]

This paper examines the impact of Global Health Initiatives on human resources for antiretroviral treatment roll-out in Zambia at a national level, in one province and two districts. [adapted from abstract]

There has been little research on HIV incidence or prevalence among hospital staff worldwide, and even less on modes of transmission among those infected. Recent evidence from South Africa suggests that HIV prevalence among health care personnel may not differ greatly from the general population. This evaluation study describes the significant effect of HIV morbidity and mortality among the workers in Zambia’s health care system. [adapted from introduction]

In what areas do the HIV/AIDS donor programs interact with key operational parts of health systems? To answer it, and to better inform the ongoing discussion of AIDS and health systems, the report investigates and compares the donors’ interactions in three countries (Mozambique, Uganda, and Zambia) with three components of health systems: the health information system, the supply chain system for essential medicines, and human resources for health. [from summary] Chapter 4 is dedicated to the HRH aspects of this issue.

This article is an overview of the major HRH issues facing the health system in Zambia, including out-migration, an outdated medical-training infrastructure, faulty government management, and the effects of HIV/AIDS.

This presentation was given at the First Forum on Human Resources for Health in Kampala. It discusses the Zambia Health Workers Retention Scheme, an incentive program targeting key health worker cadres primarily in rural district to decrease attrition rates of critical service providers. [adapted from author]

This paper examines recent experiences in Zambia, and Ethiopia that illustrate why policy matters for developing the private health sector and underscoring the need for rational regulatory policies and practices. [author’s description]

This paper reports the findings of the PET/QSDS pertaining to human resources for health in Zambia. The Public Expenditure Tracking and Quality of Service Delivery survey (PET/QSDS) was undertaken in mid-2006 to provide quantitative assessment of the state of health service delivery in the country. One component of the survey focused on the management of health personnel, including staff availability, vacancy, absenteeism, and tardiness; staff turnover; staff workload, use of time, and morale; and staff salary and benefits. [from introduction]

In order to resolve the crisis and address the key issues the Ministry of Health has developed a Human Resources for Health Strategic Plan, in consultation with key stakeholders. The strategies and activities outlined in the Plan attempt to address the concerns of all the stakeholders consulted and to provide a framework to guide and direct interventions, investments and decision making in the planning, management and development of human resources for health. [from foreword]

This presentation was given as part of the Christian Health Association’s Conference: CHAs at a Crossroad Towards Achieving Health Millennium Development Goals. It discusses church health institutions and the HR crisis, including staffing levels and attrition; the national response, and details the many efforts of the CHAZ response such as the CHAZ Health Workers’ Retention Scheme.

This study evaluates an intervention to raise healthcare provider morale and retention. Two different incentives-cash and a trophy, awarded to facilities rather than individuals-were tested in two districts. The program was implemented district-wide. Health centers and other small health facilities competed for the awards and were scored on the basis of management system indicators. Interviews with staff in both districts measured the effect of the awards on staff motivation and satisfaction. [publisher’s description]

This study documents the contribution made by religion and religious entities to the struggle for health and wellbeing in Zambia and Lesotho, in a context dominated by poverty, stressed public health systems and the HIV/AIDS pandemic. By mapping and understanding these Religious Health Assets (RHAs), the study calls for a greater appreciation of the potential they have for the struggle against HIV/AIDS and for universal access and offers recommendations for action by both public health and religious leaders at all levels. Through respectful engagement these assets have the potential to increase in strength and value and become more effective in the long-term sustainability, recovery and resilience of individuals, families and communities. [publisher’s description]

This presentation was part of the ECSA 38th Regional Health Ministers’ Conference. It gives the background of the health care issues and indicators and discusses the programs and HRH interventions Zambia has used to address them

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The purpose of this technical effort by the Partnerships for Health Reform was to assess various issues, problems, and opportunities facing the University Teaching Hospital (UTH) in Zambia. This review serves to catalyze and provide input for the development of an effective strategic plan for the UTH and Zambia’s health services in general. Findings from this review provide a basis for recommendations on how to effectively address these issues in order to improve management and, ultimately, positively affect efficiency, quality, equity, and sustainability of services. [from abstract]

To tackle problems of staff shortage and maldistribution, in 2003 the Government of the Republic of Zambia in partnership with the Royal Netherlands Government embarked on a Pilot Zambian Health Workers Retention Scheme (ZHWRS) for health professionals. The scheme had as first objective to replace the Dutch doctors, working under the bilateral agreement between Zambia and the Netherlands. A regular review process was included as part of the scheme. This report is from the Midterm review that took place in January 2005. [from introduction]

The objectives of this presentation are to: describe the context of HIV/AIDS in Zambia, describe key findings from a study to evaluate nurses’ and midwives’ knowledge of HIV/AIDS, review the study’s implications for action, and propose steps to advance workplace programs.

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The Quality Assurance Project investigated how job aids could increase compliance with guidelines for the Integrated Management of Childhood Illness (IMCI) in cooperation with the Zambia Central Board of Health beginning in 1999. One of the first countries to introduce IMCI, Zambia had a large number of IMCI-trained providers, and several IMCI job aids were already in use: a chartbook, recording form, poster, and mother card. The study proceeded in three stages: an initial assessment of job aid usage in 1999, the design and introduction of a new IMCI job aid (called “new outpatient department book” or “NOPD book”) that also served as the patient record, and a second assessment of job aid usage in 2000 after introduction of the NOPD book.

This paper is a desk study which looks at experiences of integrating vertical health programmes into national delivery systems where government and donors have adopted a sector wide approach (SWAp) to supporting health sector reform. It was commissioned to facilitate decision making in SDC regarding future possible integration of the Tanzania Tuberculosis and Leprosy Programme into national delivery systems and the SWAp process.[author’s description]

This document, published by the Central Board of Health of Zambia, describes the implementation of the country’s health management information system (HMIS) during 1995 to 2003, and considers the system’s achievements and the challenges facing it. The new HMIS was a response to weaknesses of the previous system, which was highly fragmented but with centralised data management. The aim was to establish a self sustaining monitoring and evaluation system that would improve decision making at all levels of the health care system with timely, valid and appropriate information.

This presentation was part of the Health in Foreign Policy Forum 2006. It covers the face of the human resource for health crisis in Zambia, the migration of health professionals, the impact on health service delivery, current initiatives, country-level solutions, challenges to implementing the HRH strategic plan and options to mitigate the HR crisis in developing countries and the global level. [adapted from author]

The shortage of trained health professionals is among the main obstacles to strengthening low-income countries health systems and to scaling up HIV/AIDS control efforts. Traditional health practitioners are increasingly depicted as key resources to HIV/AIDS prevention and care. An appropriate and effective response to the HIV/AIDS crisis requires reconsideration of the collaboration between traditional and biomedical health providers (THPs and BHPs). The aim of this paper is to explore biomedical and traditional health practitioners experiences of and attitudes towards collaboration and to identify obstacles and potential opportunities for them to collaborate regarding care for patients with sexually transmitted infections (STIs) and HIV/AIDS. [author’s description]

This study aims to examine the range of impacts the [HIV/AIDS] pandemic has had on selected NGO partners of Oxfam operating in South Africa, Zambia, and Zimbabwe, and to make recommendations useful to NGOs, including Oxfam, donors, and policy-makers based on its results. [author’s description]

Horizons, in collaboration with CARE International and Family Health Trust, conducted a quasiexperimental intervention study to determine which care and support needs of people living with HIV and AIDS and their families could be met by trained youth, and to establish whether youth engaged in formalized care and support activities would increase their adoption of protective behaviors or reduce the stigma faced by members of AIDS-affected households.

The study was conducted in semi-urban and rural communities in two provinces of northern Zambia located 700 to 1,000 kilometers from Lusaka.