Project News

To achieve universal health coverage (UHC), the World Health Organization (WHO) aims to ensure that all people receive high quality basic health services without financial burden. Zambia introduces free health care in principle. Life expectancy becomes longer by 18 years between 1996 to 2016. Zambia faces rapid population growth, aging, lack of medical personnel, etc., that is the current situation where the government has some challenges to provide adequate health care services.

The Project for Strengthening Basic Health Care Services Management for Universal Health Coverage in Zambia, together with the Ministry of Health, aims to strengthen management ability for service provision through technical support to the District Health Offices for planning, implementation, monitoring & evaluation, and improvement of health action plans based on regional settings.

Specifically, a three-year health activity plan has been drawn up and supported on sites in four target districts in two provinces (Lusaka Province and Southern Province). The project named this health activity plan as District Specific Action Plan (DSAP) and provided technical support for the revision of national planning guidelines.

DSAP is created in line with the Plan-Do-Check-Adjust/Action (PDCA) cycle, which is a management cycle aimed at improving activities and processes. Health administrators are empowered with management skills through the operation of DSAP implementation. The Ministry of Health and Provincial Health Offices not only provide technical support but also strengthen collaboration at the district level.

In the DSAP process, at first, situation analysis is performed, and the Heat Map (which is a visualisation matrix that expresses values by color) is developed to analyse locally specific issues. Once the situation analysis is conducted, the next step is to identify the issues to be addressed. Then, assign scores and prioritise issues as well as interventions. Lastly, the mutually agreed priority intervention measures are dropped into a Gantt chart (a planning table). Eventually, the PDCA cycle, such as planning, implementation, monitoring & evaluation, and adjustments can be carried out.

Mr Peter Muleya, the Principle Planner from the Lusaka Provincial Health Office, is a key figure in the context of planning in Lusaka Province. He says, "The resources available to Lusaka are limited, and issues need to be prioritised and addressed." It is important to think about how to use limited resources and maximise the results. He added, "We have a role in supporting District Health Offices. We want to work closely with the Ministry of Health for better management and supervision."

Mr Kalaluka Mutemwa, Planner in charge of the Kalomo District Health Office, has a key role in developing DSAP. One of the health issues in Kalomo District is the sample referral system due to the vulnerability in infrastructure. "The DSAP process has helped us to improve our district health planning capabilities. In Kalomo District, maintenance and inspection of motorcycles, human resource development, and tuberculosis sample referral were the top three priorities," he mentioned. "For example, training for motorcycle maintenance reduced the number of motorcycles that were no longer used and was able to improve indicators regarding sample referrals," he continued. He concluded by saying, "During the DSAP process, the sample referral system had been improved, which had led to the strengthening of health management in the entire district."

Mr Peter Muleya, Lusaka Provincial Health Office

Mr Kalaluka Mutemwa, Kalomo District Health Office