ZAMBIA NATIONAL HEALTH STRATEGIC PLAN …

1 ZAMBIA NATIONAL HEALTH STRATEGIC plan 2017 2021 i .Contents Acronyms .. vii 1. Executive Summary .. 1 Introduction .. 1 HEALTH Sector Performance .. 1 HEALTH Service Delivery .. 1 Human Resources for Heath .. 1 Infrastructure Development .. 2 Drugs and Medical Supplies .. 2 HEALTH Care Financing .. 2 HEALTH Information .. 2 STRATEGIC Direction .. 2 STRATEGIC Framework .. 3 Implementation Framework .. 3 Monitoring and Evaluation (M&E) .. 3 Required Financial Resources .. 4 2. Introduction .. 5 Country Background .. 5 Achievements and Challenges of the HEALTH Sector STRATEGIC plan .. 5 Disease Burden .. 7 HEALTH Sector STRATEGIC Programmed Approach.

2 8 Socio-economic Determinants of HEALTH .. 9 The NATIONAL HEALTH System .. 10 3. Vision, Mission, Overall Goal, Principles and Priorities .. 13 4. HEALTH Service Delivery System .. 15 Primary HEALTH Care and Community HEALTH .. 15 Reproductive, Maternal, Child, and Adolescent HEALTH and Nutrition .. 19 Reproductive and Maternal HEALTH .. 19 Child HEALTH .. 22 Nutrition .. 24 Adolescent HEALTH .. 27 Communicable Diseases .. 28 General Introduction .. 28 Malaria .. 28 HIV/AIDS .. 31 Sexually Transmitted Infections .. 33 34 Viral Hepatitis .. 36 Neglected Tropical Diseases .. 36 Public HEALTH Surveillance and Disease Intelligence .. 38 Epidemic Preparedness and Response, and Emerging Issues.

3 40 Non-Communicable Diseases .. 42 Hospital Services .. 44 ii Surgical, Obstetric, and Anesthesia Services .. 46 Eye HEALTH Services .. 47 Paediatric Services .. 48 Renal HEALTH Services .. 49 Emergency and Mobile HEALTH Services .. 50 Diagnostic Services .. 51 Imaging Services .. 54 Blood Transfusion Services .. 56 Ear, Nose, and Throat (ENT) Services .. 58 Nursing and Midwifery Services .. 59 Pharmaceuticals and Medical Supplies .. 61 5. Integrated HEALTH Service Support 65 Leadership and Governance .. 65 HRH .. 71 HEALTH Care Financing .. 75 HEALTH Information Technology and Research .. 79 Infrastructure, Equipment and Transport .. 80 Implementation, Monitoring and 82 Legal, Policy and Regulatory Framework.

4 82 Institutional Framework .. 83 Key Sector Partners .. 84 Planning, budgeting, and capacity building .. 85 6. Costing of the NHSP .. 87 Overview .. 87 Total NHPS Costs by Major HEALTH Systems Input Components .. 90 7. Key Performance Indicators .. 93 Reproductive, Maternal, Neo-natal, Child HEALTH , Nutrition, and Adolescent HEALTH .. 93 Malaria .. 97 HIV/AIDS .. 98 Tuberculosis .. 100 Neglected Tropical Diseases .. 101 Public HEALTH Surveillance .. 102 Epidemic Preparedness and Response and Emerging Issues .. 103 Non-Communicable Diseases .. 104 Hospital Services .. 106 Eye HEALTH .. 107 Emergency and Mobile HEALTH Services .. 107 Imaging Services.

5 108 Blood Transfusion Services .. 108 Laboratory Services .. 109 Environmental HEALTH , Food Safety, and Occupational HEALTH .. 111 Human 112 HEALTH Care Financing Strategy .. 112 HEALTH Information Technology and Research .. 113 HEALTH Infrastructure .. 113 iii Foreword Despite progress made in reducing maternal and child mortality rates, ZAMBIA remains a country with a high disease burden which is under significant pressure to improve the HEALTH status of the people. This plan identifies strategies to significantly reduce the disease burden and accelerate the attainment of the Sustainable Development Goals. The plan is a major departure from the past STRATEGIC plans.

6 While the plan recognizes that all HEALTH care interventions are important and should continue to receive support; it also recognizes that interventions must be prioritized 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. This NATIONAL HEALTH STRATEGIC plan (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.

7 As a government, we are committed to sustaining the gains made in the past five years, and to expanding the coverage and improving the quality of HEALTH services provided to our people. This plan identifies strategies and programs which will ensure that people of ZAMBIA are healthy and able to contribute to economic development as articulated in the NATIONAL Vision 2030 and the Seventh NATIONAL Development plan which prioritize HEALTH as a key economic investment that will drive our socio-economic development agenda. The NATIONAL HEALTH STRATEGIC plan 2017 -2021 has a transformative agenda which focuses on building robust and resilient HEALTH systems. The plan focuses on delivering quality HEALTH services across the continuum of care which includes promotive, preventive, curative, rehabilitative and palliative care.

8 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 and 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 other key HEALTH outcomes. We acknowledge 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 this document emphasizes strong multi-sectoral collaboration to address all the social determinants of HEALTH .

9 It is my considered view that with appropriate levels of commitment and support from the Government, Cooperating Partners, HEALTH workers and other key stakeholders this plan will significantly improve the HEALTH status of Zambians and significantly contribute to NATIONAL development. I therefore, urge all the people involved in the implementation of this plan to fully dedicate themselves to this important NATIONAL assignment. My Ministry is committed to ensuring the successful implementation of this plan . Honorable Dr. Chitalu Chilufya, MP MINISTER OF HEALTH v Acknowledgments I would like to acknowledge the all-inclusive and widespread consultative processes that have facilitated the development of this NATIONAL HEALTH STRATEGIC plan 2017 2021.

10 The consultative process entailed engaging with varied stakeholders at the various levels of the HEALTH and support system in order to ensure that the outcome reflected the wishes and aspirations of all. The stakeholders committed material, financial, and technical expertise to the process, which is highly commended. First and foremost, I wish to express my sincere gratitude to the late Mr. John Moyo, Permanent Secretary-Administration, who until his untimely death had dedicated himself to the completion of this document; May His Soul Rest in Peace. My gratitude also goes to our various partners and colleagues who encouraged and supported the development of this STRATEGIC plan through their various forms of support.