THET

Zambia

The health sector is challenged by a number of factors that present significant obstacles to health service delivery, including: critical shortages and unbalanced distribution of qualified health workers at all levels of the public health system; shortages and irregular supply of essential drugs and medical supplies. (www.afro.who.int)

Life expectancy at birth in Zambia is only 42 for males, and 43 for females
The probability of children dying under the age of five is 182 per 1,000 live births

THET in Zambia
Zambia THET has been appointed the management agent for a project aimed at strengthening the capacity of Zambia health training institutions to train health workers. This is funded by the Department for International Development, but has had significant support from the Department of Health who provided support for the initial scoping of the proposal.

The School of Medicine – University of Zambia (UNZA) has been successful in establishing MMed programmes in a number of postgraduate medical specialties including Surgery, Orthopaedics, Urology, Obstetrics and Gynaecology, Paediatrics and General Medicine. Retention of fully trained doctors in Zambia has improved significantly with this strategy.

In addition, increasing opportunities for private practice are developing in Lusaka permitting senior doctors to augment their income making it financially practical to live and work in Lusaka. However the Medical School has particular difficulties in accessing lecturers in pathology, psychiatry and anaesthetics and thus there are no in-country training programmes in these three specialities.

Nurse training on the other hand is undertaken in a number of dispersed nursing schools throughout the country (run by either the public or NGO sectors). With a revised curriculum for nurse training envisioned in 2009 the standards are set to improve. However there are huge challenges in retaining trained nurses and nurse tutors in the rural areas which are still perceived as unattractive despite a rural allowance being paid. This affects the quality of delivery of the nursing curricula particularly in rural training institutions.

Strengthening Training and Education of Health Workers in Zambia
Human Resource for health development is the major priority in Zambia and the Ministry of Health (Z-MOH), Zambia UK Health Workforce Alliance, THET and DFID will cooperate to strengthen Zambia’s capacity to train health workers.

This programme aims at contributing to strengthened healthcare service delivery and to achieve progress towards the health MDGS by increasing the availability of health workers in Zambia through:

Providing five volunteer nursing/midwifery tutors to be posted in understaffed rural/provincial schools (from 2010) for a period of three years. As an interim measure to increase the number of tutors, while five local staff are provided with scholarships through this project to pursue BSc courses at the Post Basic Nursing training (University of Zambia) to enable them become tutors.
Providing three interim volunteer lecturers to develop curricula and teach courses in three medical specialties prioritised by Z-MOH (anaesthesia, pathology and psychiatry), leading to the training of Zambian specialists in these fields. The tenure of these volunteers varies from two to three years. These will also be eventually replaced by locally trained tutors.
Providing a volunteer specialist in biomedical engineering to support the development of a curriculum in biomedical engineering for an initial period of four months (renewable subject to availability of funding).
Providing short term volunteers in various specialities particularly to support teaching in the three MMed programmes. These placements will range from a week to a couple of months where necessary.
Constructing accommodation for tutors in five selected (by Z-MOH) provincial nursing schools thus creating an important incentive for the additional local nurse tutors to return after completion of their training.

The long term volunteers are expected to reinforce the quality of training for the courses they will be delivering. They will also impact on the number of staff available in each department and the tutor/student ratio (potentially enabling an increase in student numbers). Each volunteer tutor will be replaced by at least one local counterpart, allowing programme benefits to be sustained beyond the life of the initial programme. The project will have ongoing participatory monitoring and evaluation which shall be complemented by a mid-term and end of project evaluation.

Zambia UK Health Workforce Alliance
The Zambia UK Health Workforce Alliance is a growing network of Zambian-based and UK-based organisations. They work together to promote and improve the coordination and impact of Zambia-UK joint work in health. The Alliance was launched in 11th June 2009 at Guy’s and St Thomas’s NHS Foundation Trust, London, UK. There are 35 founding members. For more information please click here.