Health in Zambia

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Zambia faces a number of ongoing health challenges. The health status of any country to a large extent is assessed or determined by the availability, accessible of health services; this article outlines available health facilities and the health status of Zambia.

Health infrastructure[edit]

There are two ministries in health care delivery: the Ministry of Health (MoH) and the Ministry of Community Development, Mother and Child Health (MCDMCH) that provide information pertaining health and deliver health services.[1] In 2010, public expenditure on health was 3.4% of GDP, among the lowest in southern Africa.[2]

Health facilities[edit]

The health service delivery system has following structures: 1st level: generally the lowest health delivery services at community level- District hospitals, Health Centres and Health Post ; 2nd level - Provincial or General hospitals; and 3rd level : Central or specialist hospital.[3] In some cases the 1st level can be disbundles into three levels: level 1 strictly District hospital,Health centres and the lowest level of health care delivery being the health post.[4]

Roles of the Ministries[edit]

The Ministry of Community Development, Mother and child was created following the shift in Government policy in 2013 that brought about stream-lining of the Ministry of Health thus re-alignment of Primary Health care Services; all General hospitals, health centres and Health post fall under this ministry.[5] On the other hand, the Ministry of Health has a role to supervise Provincial Health offices, 2nd level hospital and 3rd level hospital.[3]

Health facilities[edit]

In 2012, there was a total of about 1762 health care facilities in Zambia. The largest health facility, the University Teaching Hospital serves both as a specialist hospital and a training site for future health workers, it is a 3rd level hospital. Other 3rd level Hospitals include Kitwe Central Hospital, Ndola Central Hospital, Arthur Davison Children's Hospital, Cancer Disease Hospital and Chainama Mental Hospital.[3]

The 2nd and 1st level hospitals throughout Zambia include: Levy Mwanawasa General Hospital,[6] Chipata General Hospital, Konkola Mine Hospital, Lubwe Mission Hospital, Macha Mission Hospital, Mtendere Mission Hospital, Mukinge Mission Hospital, Mwandi Mission Hospital, Nchanga North Hospital, Chikankata Salvation Army Hospital, Kalene Mission Hospital, St Francis Hospital, and Luke's Mission Hospital.[7] Others are Lewanika General Hospital, Kabwe General Hospital.[5] There are very few health facilities in rural or remote places in Zambia, where most communities rely on small government-run community health centres and rural health posts.

In 2013, the Government embarked on a project to upgrade a number of health facilities in different parts of the country and JICA was signed a grand agreement to provide aid.[8]

Summary of number of Health facilities in Zambia in 2012[4]

Province 3rd level 2nd level 1st level UHC RHC HP Total
Lusaka 3 1 15 182 51 42 294
Copperbelt 3 4 11 148 55 29 250
Central 0 2 8 29 129 26 204
Luapula 0 1 6 3 125 10 145
Eastern 0 2 7 5 143 49 206
Northern 0 2 2 8 102 34 148
North-western 1 1 10 6 135 11 163
Southern 0 4 11 19 178 41 253
Western 0 1 10 5 144 34 194
Muchinga 0 1 4 4 69 21 99

UHC-Urban health centre,RHC-Rural health centre, HP-Health Post

Water supply and sanitation[edit]

Access to improved water supply and sanitation, in 7 Sub-Saharan countries, from 1990 until 2008.[9]

In 2010, 61% of the population of Zambia had access to an improved water source and 48% had access to adequate sanitation, according to UN data.[9]

87% of urban areas had access to an improved source of water supply. In urban areas, 41% have access to water connections in their house or yard and 49% rely on water kiosks and standpipes. The share of those with access to house connections has actually declined, while the share of those served by kiosks has increased.[9]

Water supply in urban areas is intermittent, with an average supply of 16 hours per day in 2010.[10] Concerning sanitation, 29% of the urban population are connected to sewers and 30% are served by septic tanks or improved household-level latrines. While these figures are low, they are actually higher than the average access in Sub-Saharan Africa.[9] In rural areas, 46% of the population had access to an improved water source in 2010.[9] 43% of the rural population had access to adequate sanitation in 2010.[9]

International support[edit]

Since 2010 the Zambia UK Health Workforce Alliance has promoted global cooperation to support health in Zambia through the global forum HIFA-Zambia (Healthcare Information For All).

Health status[edit]

Life expectancy[edit]

The 2014 CIA estimated average life expectancy in Zambia was 51.83 years, with men having a life expectancy of 50.24 years and women 53.45 years.[11]

HIV/AIDS epidemic[edit]

Further information: HIV/AIDS in Zambia

Zambia faces a generalised HIV epidemic, with an estimated prevalence rate of 13.5% among adults (ages 15–49) in 2009.,[12] which has remained the almost same 2014 at 13.3 %[13] HIV incidence in Zambia has declined by more than 25% from 2001 to 2010, an indication that the epidemic appears to be declining.[14] The HIV incidence is measured using a proxy,[15] which the prevalence of HIV in the age 15-24 year and the prevalence in this age group was 6.6% in 2014[13]

Attainment of MDG on HIV[edit]

Further information: Millennium Development Goals

The Millennium Development Goal target for HIV was to keep HIV prevalence below 15% and it has been meet.[16]

Maternal and child healthcare[edit]

The 2010 maternal mortality rate per 100,000 births for Zambia is 470. This is compared with 602.9 in 2008 and 594.2 in 1990. The under-5 mortality rate, per 1,000 births is 145 and the neonatal mortality as a percentage of under 5's mortality is 25. In Zambia the number of midwives per 1,000 live births is 5 and the lifetime risk of death for pregnant women is 1 in 38.[17]

Zambia may not attain its goals for reducing Maternal Mortality ratio to 162/100,000 live births. For Under 5 Mortality rate and infant Mortality rate, the target are 63.3 and 35.7 respectively.[13] In 2014, the Maternal Mortality ratio was 389 with Under 5 mortality rate being 75 and Infant mortality rate 45.In addition the proportion of 1 yeaar old children immunized against measles is 84.9%,which is at least a good coverrage[13]

Malaria[edit]

Zambia is still endemic to malaria despite the interventions or control/preventive measures in place, Malaria prevalence as reported by the Malaria Indicators Surveys has shown a slight decrease to 14.9% in 2012 compare to 2010, 16% but when compared to the prevalence in 2006, 21.8%, the decrease is significant.[18]

Attainment of MDG on Malaria[edit]

There is a reverse in the malaria prevalence as shown and the Zambia Health and Demographic Survey shows that the percentage of children sleeping under an Insecticide Treated Nets has increased from 6.5%in 2001/2 to 40.6% in 2014.[13]

References[edit]

  1. ^ "Ministry of Health". moh.gov.zm. Retrieved 5 Sep 2015. 
  2. ^ Forecast provided by International Futures. Historic data points from the World Bank.
  3. ^ a b c "The 2010 health facilities in Zambia" (PDF). www.moh.zm. Retrieved 3 September 2015. 
  4. ^ a b "Zambia Country Report" (PDF). www.rad-aid.org. Retrieved 6 September 2015. 
  5. ^ a b "Ministry of Health". www.moh.zm. Retrieved 3 September 2015. 
  6. ^ David Smith in Lusaka. "Chinese hospital heals sore spot in Zambia | Global development". theguardian.com. Retrieved 2014-04-11. 
  7. ^ Tycoon powers hospital in a remote area of north-west Zambia. ukzambians.co.uk. 11 September 2007
  8. ^ "Topic&event=www.jica.go.jp". Retrieved 6 Sep 2015. 
  9. ^ a b c d e f "WHO / UNICEF Joint Monitoring Programme: www.wssinfo.org". wssinfo.org. Retrieved 26 May 2015. 
  10. ^ NWASCO. "Urban and Peri-Urban Water Supply and Sanitation Sector Report 2010/11" (PDF). Retrieved 27 August 2011. 
  11. ^ "CIA - The World Factbook Life Expectancy". Cia.gov. Retrieved 2014-06-24. 
  12. ^ "The World Factbook". cia.gov. Retrieved 26 May 2015. 
  13. ^ a b c d e "Zambia Demographic Health Survey" (PDF). www.dhsprogram.com. Retrieved 4 September 2015. 
  14. ^ "UNAIDS World AIDS Day Report 2011" (PDF). UNAIDS. 
  15. ^ Ghys, P D (1 April 2006). "Measuring trends in prevalence and incidence of HIV infection in countries with generalised epidemics". Sexually Transmitted Infections. 82 (suppl_1): i52–i56. doi:10.1136/sti.2005.016428. 
  16. ^ "Millennium Development Goals" (PDF). Retrieved 3 Sep 2015. 
  17. ^ "The State of the World's Midwifery" (PDF). United Nations Population Fund. Retrieved August 2011.  Check date values in: |access-date= (help)
  18. ^ http://www.nmcc.org.zm/files/FullReportZambiaMIS2012_July2013_withsigs2.pdf name="Zambia National Malaria Indicator survey 2012">|accessdate=September 2015