NAME : JANEMUGALA

COMPUTER # :220200295

LECTURE : MRS E.M.C SINKALA

PROGRAM : BSC. PUBLIC HEALTH

COURSE : HEALTH SYSTEM AND DELIVERY (HSD 501)

Date Due : 17TH ,APRIL 2024

Question: Critically analyse the goals of healthcare systems and delivery in Zambia in
relation to Sustainable Developmental Goals (SDG’s)
Introduction

Human kind faces many challenges to ensure that all people have the same development
and wellbeing opportunities. The Sustainable Development Goals (SDGs) were established in
2015 to succeed the Millennium Development Goals. They serve as a universal call to action
to end poverty and protect the planet. The SDGs are a broad framework for human
development. They aspire to achieve a number of targets across many sectors. 193
countries, including Zambia, adopted these goals and committed to the 2030 agenda by the
United Nations which were the Sustainable Developmental Goals (SDG’s). In order to achieve
these goals Zambia’s health care and delivery systems formulated goals that required the
collaboration of civil society, the public and private sectors. Zambia’s health sector has since
been implementing reforms aimed at improving service delivery in order to meet the
Sustainable Developmental Goals. In this essay we shall critically analyse the goals of health
care systems and delivery in Zambia in relation to Sustainable Developmental Goals

Reduction of Maternal and Child Mortality

This goal primarily targets SDG 3 which aims at good health and wellbeing for all. Studies
have suggested child mortality rate of 182 per 1000 live births. Pursuant to this vast gulf
between numbers of births and survival rates of children, these specific mortality rates have
been significantly reduced by increasing the proportion of deliveries attended by skilled
medical personnel. This has ensured that in the case of a complication during birth (which is
in most cases where mortality occurs), it can be managed sufficiently with reduced chance
of fatality due to inadequate emergency obstetric care. Health systems and infrastructure
will also be strongly linked to this. This has initiated a regionalized approach to care for
mothers and babies and be more cost-effective in preventing mortality of the two highest
risk groups identified in the country. The training and adequate staffing of the right
personnel will also be pivotal in reducing maternal and child mortality.

Prevention and Control of Communicable Diseases

Zambian has aimed at achieving a reduction in morbidities and premature deaths caused by
communicable diseases and maternal and child health conditions. This is being achieved
through increasing the access and use of preventive, promotive, and curative health
services. It recognized the principle of equity, by giving priority to the rural, underserved,
and the poor, and it sought active participation by communities in their own health. Key
strategies included the implementation of DOTS therapy for TB, infant and under-five clinics,
the prevention and treatment of STIs, and relatively effective immunization coverage. This
plan was a comprehensive attempt to tackle Zambia's huge burden of communicable
disease, and if fully implemented, would have made significant inroads into achieving some
of SDG 3's targets.

Strengthening Health Systems and Infrastructure

Purpose is to construct a good health delivery system. This goal is strongly linked to SDG 9,
which aims at industry innovation and infrastructure. This in itself requires an investment by
the country to increase the amount of educated and well-trained professionals that are
available, as well as increasing the skill level of those who are already practicing. This has
not been t isolated to the health sector, as the government employs a wide range of
professionals (e.g. engineers, accountants, and teachers) that are crucial in providing the
managerial and technical support for health interventions to be carried out effectively. This
has in turn, led to an increase in quality health infrastructure. At all levels, various
interventions have been carried out in an environment that not only allows patient access
but also a reasonable standard of care. An effective infrastructure will enable health systems
to be more sustainable, adaptable, and able to deal with current and future health
challenges.

Improving Health Workforce Capacity

Strategies to achieve this has contributed to significant changes to workforce policy and
planning. This goal is related to SDG 8, which supports decent work and economic growth.
The development of a critical mass of competent and motivated health workers from
peasant and working backgrounds for rural areas is not a task that has been realized to
prevent workforce shortfalls. A long-term vision and commitment to a set of strategies that
are flexible and responsive to internal and external context is important, and a starting point
would be a comprehensive workforce plan that is linked to the broader health system plan.
This has involved consultation with a wide range of stakeholders, situation analysis,
forecasting of health worker needs and resources, and the development of policies and
implementation of reforms monitored by appropriate information systems.

Enhancing Health Financing Mechanisms

Sufficient health financing is one of the key building blocks for a successful health system. It
explains that a well-functioning health financing system ensures that people are able to use
health services and are protected from financial catastrophe or impoverishment associated
with having to pay for them. An increment of healthcare financing through the
establishment of a specific fund, such as a healthcare tax or earmarking of resources from
the general tax, and abolishing the system of user fee charges is crucial in order to combat
this. Earmarking of resources has provided a clear transparent path for the public to
understand how much, and where the resources are coming from. This would ensure that
no one is excluded from the health system due to inability to pay cost at point of use, or
high cost of living as it would be replaced by a predetermined contribution. User fees have
been shown to deter people, particularly the poor, from seeking medical treatment and
preventive services.

Improving Healthcare Infrastructure

Infrastructure development is part of the Poverty Reduction Strategy which encompasses

improving health and nutrition. In one rural program where interviews were held, 44% of
staff mentioned that there was an improvement in the condition and availability of health
facilities. This has been seen in the construction of Health Posts, Rural Health Centres, and
upgrading of Rural Health Centres to become fully functional facilities. Up to 3,000 Health
Posts have been planned across Zambia to be constructed and rehabilitated with at least 1
Health Post per Chiefdom. With the construction of Health Posts, attempts to increase
availability of health care services will mean travel distances to access health care are
shortened. This is important to achieve relative ease and timeliness in access to health care.
Having better facilities and equipment will also be conducive to the population's health and
attracting health workers to rural areas.

Promoting Health Education and Awareness

Varying from other recommendations, promoters of the report on SDGs for Zambia suggest
that widespread education and awareness of health issues and the methods of burning
oneself can serve as a known factor in increasing accountability and responsiveness of both
the public and private sectors in health. Employing an unrationed communication strategy,
including a blue book, pamphlets, and education through traditional chiefs, has increased
awareness of issues in the health system, spanning from poor working conditions and
absenteeism of health workers, particularly in rural areas, to the adequacy and fairness of
resource distribution. An increase in awareness of health issues is directly related to citizen
and patient expectations of services offered. This, in turn, increases the inward pressure for
change by the electorate and fosters a joint coalition of leaders in health and other sectors
to improve the health delivery system.

Conclusion

Zambia's current national health plan is well constructed and aims to address many of the
issues present within Zambia. By aligning certain parts of the national health plan with
certain SDGs, Zambia can closely monitor some of its progress towards health. EQHA has
attempted to provide some insights into where the health pathway in Zambia may lead. This
modelling work provides use of some key time-based targets. Unfortunately, in reality, some
of these targets may not be achieved (e.g. raising life expectancy to 55 by 2018) and
therefore there may be some need for further reformulation of the health pathway. Further
to the current national health plan, more attention and resources need to be diverted
towards the development of the rural health and community health sectors. The community
health assistant (CHA) program is integrative in improving rural health, however, safe
motherhood action groups, village health and sanitation committees need further
revitalization

References

Brow K. Hyer, N (2010) Health systems delivery. 7th Edition. McGraw Hill: Irwin

Seabert, D. McKenzie, J.F Sterns P.N, et.al (2009) An Introduction to community health and
public health. 17th Edition. Oxford University Press. UK

(https://Merriam-wesbster.com/dictionary/sustainable), accessed on 12th April, 2024,

10:15hrs.