2. zambia v231110
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Zambia is a landlocked country in central Africa with a population of 12 million. It relies heavily on donor funding for its health sector but has experienced issues with transparency and accountability. The withdrawal of donor funds has negatively impacted service delivery and collapsed the health system. Performance-based financing is proposed to help reduce dependence on donors, allow providers to efficiently allocate resources based on their needs, and incentivize a motivated workforce to improve health outcomes.
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Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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2. zambia v231110
- 1. ZAMBIA LAND OF THE VICTORIA FALLS
- 2. NATIONAL STATISTICS Population 12 million Area 752,614 square KMs Home of- The world famous Victoria Falls Languages 72 Landscape hilly plateau, marshland arable & semi -arable Transport Urban semi-developed Economy 68% live below National Poverty line HIV prevalence exceeds 10%
- 3. BACKGROUND Zambia is a landlocked country in central Africa with a population of about 12 million people. Zambia’s health sector has undergone several reforms since it’s independence in 1964 with several attempts to introduce health insurance without much success. The Central board of health was formed under 10 years ago but disbanded 3 years ago due to conflicts with the Ministry of health. No autonomy was given to health centers and operations were centralized. Until last year funds were channeled through the ministry of health Gross misappropriation of Donor funds have since taken place causing the Donor community revoke funding. The withdrawal of donor funding has grossly impacted negatively on the service delivery therefore collapsing the health system.
- 4. PROBLEM ANALYSIS The over-reliance on Donor Funding has ultimately reduced any effort in sourcing or supporting the Health sector from local funds. Lack of transparency and proper accountability of funds where available have been recorded. (A recent case of embezzlement involving over $28 million by an individual and his associates is still in court) De-motivation and poor conditions of service for the public caregiver has led to massive brain-drain and poor service delivery…..
- 5. cont…PROBLEM ANALYSIS There are shortages of Medicines in hospitals and this has led to importation of generic drugs which are at times expired and discarded by the Authorities. There are no incentives to develop drug manufacturing locally, as cheaper generic drugs are all imported while no incentives are given to local manufacturers. Pharmaceutical companies went under. Currently good health facilities are only accessible by the middle earning class and critical cases are referred to or flown to the neighboring South Africa or India if one can afford.
- 6. WHY PBF IN ZAMBIA? The Performance Based Financing will help reduce the over-dependence on Donor Funds whose output is usually left un-checked until the expected result is not achieved. PBF will allow the Service provider to identify and determine their needs and allocate resources efficiently. This will effectively reduce the cost of holding unwanted materials which end-up being wasted. PBF is a new Concept in Zambia and the incentives offered will bring out a motivated and result oriented workforce and encourage an evenly spread of qualified service providers across the country should the program be rolled out. A successful PBF program will help re-build the confidence amongst the Donor community . PBF will bring-out the desired result against set targets.
- 7. POSSIBLE SOLUTIONS Definitions of roles for the Government and Public Sector activities to avoid Conflict. With the withdrawal of donor support, it’s imperative that Private Public Partner (PPP) takes route and PBF programs acts as a tool to deliver this. An introduction of mobile hospitals recently can easily be scaled down once the PBF program is rolled out. This would be a cost saving measure and lead to an improvement in service delivery. Implementation and buy-in of PBF by the Government to allow for successful & sustainable programs.
- 8. CHALLENGES OF PBF Lack of political will or ‘buy-in’ could halt successful launch and implementation of PBF. Communities who traditionally have been used to receiving free medical services may not embrace it and thus shun participating institutions. Fund holder inability to execute prompt payment can slow down the whole process and throw benchmarks out of context. Lack of access to modern banking facilities can also slow down the successful implementation of PBF.