Zambia, a landlocked country in Southern-Central Africa, faces several ongoing health challenges. In 2017, Zambia’s public health expenditure was 4.47% of the GDP, one of the lowest rates in southern Africa. Two ministries that provide information about health and deliver health services, administer public healthcare in Zambia. These are the Ministry of Health and the Ministry of Community Development, Mother and Child.

Problems in the Healthcare System

As public healthcare in Zambia remains incredibly underfunded, pharmacies in Zambia are not always well-stocked, and many deem emergency services inadequate. Additionally, inequities in public health care service access and utilization exist in the country. While 99% of households in urban areas are within five kilometers of a health facility, this close access occurs in only 50% of rural areas.

As a result of these deficiencies within the system, UNICEF reports that Zambia’s under-5 mortality rate is 57.8 deaths per 1,000 live births. In 2009, 980,000 people lived with HIV/AIDS in Zambia, and 45,000 of those people died the same year due to the disease.

Lack of clean water has resulted in water- and food-borne diseases and epidemics that have been devastating Zambia for decades, including dysentery and cholera. These issues mainly affect impoverished areas, as overcrowding leads to sanitation issues. In the Kanyama slum in Lusaka, 15 households share one latrine when the weather is good. During the rainy season, Kanyama’s high water table causes the filling of 10,000 latrines with water. Areas like Kanyama require long-term infrastructure measures, such as sanitation, sewage lines and piped water.

The Path to Development

Centers for Disease Control and Prevention (CDC) established an office in Zambia in 2000 to address HIV, tuberculosis, malaria and other diseases. CDC support in Zambia includes expanding academic and clinical training programs with advanced technology at the University of Zambia and the University Teaching Hospital, and the development of a National Public Health Institute to strengthen public health surveillance. Moreover, CDC instituted a Field Epidemiology Training Program (FETP) to train a workforce of field epidemiologists to identify and contain disease outbreaks before they become epidemics. Exactly 42 epidemiologists have graduated from the program since December 2018.

In 2018, Zambia presented to the World Health Assembly in Geneva regarding the cholera outbreak by citing its efforts regarding vaccination, water safety and waste management. Additionally, Gavi, the Vaccine Alliance, worked with Zambia to fund and deliver 667,100 oral cholera vaccine doses to Lusaka slums after an outbreak that affected more than 5,700 people.

Looking Ahead

Most recently, Zambia embarked on the first round of its annual Child Health Week campaign from June 22- 26, 2020 to deliver child survival interventions to protect children and adolescents from deadly diseases. Furthermore, to promote fairness and equality, the campaign aims to improve children’s health by ensuring essential services reach children who do not benefit from routine health services. This campaign accelerates the country’s progress toward attaining the U.N. Sustainable Development Goals (SDGs) for reducing child deaths by two-thirds by 2030, improving healthcare in Zambia overall.

The infrastructure for healthcare in Zambia is overall poor due to a lack of funding, poorly maintained facilities and supply shortages of medications and medical equipment. However, one step to a better healthcare system is to ensure equitable access to health services, especially for those who live in rural areas or slums. To reduce inequities, Zambia must strengthen primary facilities that serve the people who live in these regions and dismantle the existing barriers.

– Isabella Thorpe
Photo: Flickr