Zambia has made some gains in growing its economy and improving its health outcomes. However, an elevated diseases burden, under resourced health system and poor infrastructure in its rural areas has stunted its progress in reducing the spread of HIV, malaria, and child and maternal mortality. According to the World Health Organization, children in Zambia still die from preventable diseases such as diarrhea, malaria, pneumonia, HIV/AIDS and malnutrition. Poverty still remains the major factor in combating the country’s health challenges.
In Zambia, healthcare is the responsibility of state and non-state actors, which includes NGO’s and Faith Based Organizations (FBO). The Zambian government has introduced policies to address some of its most pressing issues such as human resources shortages and decreasing its burden of diseases. These policies mainly address HIV/Aids and malaria, which have higher prevalence rates in the population. Although the government is responsible for setting policy and provision of care, non- governmental and faith based organizations play a major role in the provision of healthcare in Zambia. Despite progressive policies, challenges such as limited funds for healthcare, high burden of disease and staff shortages, the rates of poverty, inequality, and poor distribution of resources in rural areas impact the healthcare system as these are intrinsically tied to economic policies and infrastructure development.
The field of innovation in Zambia has been dominated by science and technological innovations. The government ministries, public and private research, and development institutions and universities are the major contributors and supporters of innovation. The Ministry of Education, Science, Vocational Training and Early Education sets the policy frameworks with regard to innovations, science and technology. Policy development in the area of innovations has been evolving since 1996 where the main statute guiding innovations, science and technology was the Policy and the Science and Technology Act No. 26 of 1997. The Sixth National Development Plan for the period 2011 to 2015 has cited innovation as a key component of the country’s development. However, there are challenges such as resource duplication and lack of locally based innovations means that there is a great need to develop innovative solutions in the areas of healthcare, water and sanitation, and education.
The Zambian government’s commitment to innovation creates a fertile environment for entrepreneurship in the healthcare sector, especially since as it currently stands there is a huge gap and poor diversity of service providers in the healthcare sector for different income tiers. Secondly, there is a strong pull towards government-initiated action versus Zambian provinces are not similarly activated. Community based innovations can be a more sustainable method of introducing healthcare to communities. Although technology is a highly prioritized area for innovation, much of Zambia’s population is left out due to concentration in rural areas, and innovative solutions need to be decentralized, human centred, and driven from the ground up, not only to increase capacity but also help communities be self-sustaining.
OPPORTUNITY 1: TRAINING NON-STATE ACTORS TO ALLEVIATE HUMAN RESOURCE SHORTAGES
A number of services are still provided by NGO’s and FBO’s, and this presents a variety of challenges for the Zambian government. The first is that this is not sustainable in the long term as donors may pull out and this can be devastating for those who are dependent on these services. Strengthening its health system through capacity building can inject a boost into its health system. This can be regulated and managed by the state with the support of the organizations already providing services in the health sector. Scaling up training of health workers alongside government health workers can increase access to healthcare, especially in rural areas and this would also mean people invest their efforts into their own communities and they would be already familiar with the context and the communities’ needs.
OPPORTUNITY 2: DIVERSE FINANCING MECHANISMS
Zambia has already made progress in attempting to reach universal coverage for its population through social insurance. According to the WHO, “in 2006, 42% of the health sector expenditures [came] from donors, 27% from households, 24% from government, 5% from employers and 1% from others” (www.aho.afro.who.int). The most recent statistics suggest that about 4.2% of Zambians earn wages in the informal sector (http://www.worldbank.org/, accessed 3 July, 2015). Although this sector may be difficult to regulate, there is an opportunity to formalize services for people working in the informal sector and earning flexible income. Diversifying its private sector can provide different options for its working population and those in the informal sector.
This is Post 2 in the Bertha Centre for Social Innovation and Entrepreneurship's Country Profiles. See the first post on South Africa here.