National Hospital Accreditation Program
Country of Operation
SummaryZambia's accreditation program - developed under the leadership of the Zambian Central Board of Health (CBoH) in 1997 with initial funding from the U.S. Agency of International Development (USAID) - was one of the first of its kind in sub-Saharan Africa.
Key program components
The program was developed within the broader context of comprehensive health sector reforms undertaken by the Zambian government in 1993. Reform was viewed as particularly necessary for hospitals, which were suffering from failing infrastructures, labor strikes, and increased pressure to treat new epidemics. The accreditation program was seen as a potential solution to these problems because it would provide technical assistance and education instead of focusing solely on inspections. It would also link financing to performance by defining acceptable quality standards and helping hospitals achieve those standards.
The program developed in 1997 aimed to help hospitals improve health care quality and the health outcomes of their patients by standardizing quality indicators, measuring hospital performance on the basis of these indicators, and providing training and technical assistance to hospitals. To accomplish these goals, an initial consultative survey and additional accreditation surveys were distributed to participating hospitals. Both types of surveys assessed hospital performance against 35 predetermined structure and process indicators approved by the Zambia Health Accreditation Council (ZHAC).
Through this program, Zambia has been able to successfully develop relevant hospital standards that are potentially achievable by its hospitals. Half of Zambia's 79 hospitals have received educational surveyes, and 12 have also received the full accreditation survey. A 2005 program evaluation revealed that one to two years after joining the accreditation program, 20 Zambian hospitals have substantially improved their performance in terms of achieving the accreditation standards.