The document proposes recommendations to improve Zambia's health care system. It suggests: 1) Involving communities in assessing their needs and potential solutions; 2) Increasing taxes on foreign companies to fund health care, education, and infrastructure while requiring the companies to employ more Zambians; 3) Creating an agency to ensure occupational health and safety regulations are followed. It also recommends: 4) Providing education to increase health workers; 5) Prioritizing research on sustainable agriculture; and 6) Enhancing education with a focus on history, culture, and wealth generation. The government is charged to implement the recommendations and periodically evaluate their impact.

1. NETWORK:
WORKING TO IMPROVE THE HEALTH OF
ZAMBIANS
Proposal for Zambia's Health Care System Development
Project 2014

2. Introduction
 The goal of this health care system
development proposal is to address the
needs of the people as the country
undergoes development in partnership
with Chinese business entities, while
ensuring public health for the constituents.
 This proposal details the health care
system improvement plan created by the
People’s Health Development Network
group based in Lusaka, Zambia.
• Significant progress made in Zambia in relation to the decrease of
under-five mortality and infant mortality rates, maternal mortality
ratio, and deaths attributed to TB and malaria
• Prevalence of TB and incidence of malaria are high compared to
the sub-Saharan Africa regional rates.
• The main causes of death among adults in Zambia are HIV/AIDS,
lower respiratory infections, malaria and diarrheal diseases.

3. Background
 Currently, the country is
working on expanding its
markets and developing its
infrastructure.
 The Zambian government
has employed foreign
companies to construct
roads and facilities.
 There are also foreign
entities set up and run
businesses in Zambia.

4. Background
 Since 1964, when Zambia signed diplomatic relations with China,
economic cooperation and opportunities have continued to grow.
 The Chinese investment in Zambia is in the billions and thousands of job
opportunities have been created in various sectors including: Mining,
Manufacturing, Construction, Tourism, Agriculture, Real Estate and
Telecommunications.
 The Chinese hold the major share in Zambia’s only nickel mine and are
heavily invested in copper and other minerals.
 This investment in Zambia has led to China having a more influential role
in the growth of the global economy

5. Background
 Maize is the national stable food crop due
to its low maintenance and sustainability.
 The old food security policy was centered
on government subsidy provided to maize
(corn) producers. Planters were
encouraged to lower maize prices and
were offered subsidy differential payments
by the Zambian government.
 Zambia’s new agricultural food security
policy liberalizes the agricultural market
and encourages planters and citizens alike
to grow a variety of crop plants suitable to
one of its three ecological regions of which
they reside.
 These crops are sold and taxes are paid to
the government. Although this new policy
has been introduced acceptance is slow
and maize continues to be the country
stable.

6. Involving the People in the Process of Developing
the Health Care System
 Zambia faces a high disease burden,
inadequate medical staff, and poor training;
challenges with the logistics of managing drugs
and medical supplies.
 We recommend another layer of assessment to
probe the community to identify not only
additional needs, but also potential solutions
from the perspective of the community.
 This process needs to involve the grass roots in
the process.
 It should also involve conducting a needs
assessment in a variety of both rural and urban
communities to assess how the people feel
about the current health care system.
Recommendation 1:

7. Regulation of Businesses and Foreign Companies
 Implement higher taxation for foreign
companies and individuals from China and
other countries who wish to set up businesses
in Zambia.
 Institute tariffs for importation and exportation
of goods, especially by foreign companies, to
create revenue, support its indigenous
planters and to establish its own markets in
regard to free trade.
 Foreign companies and businesses will be
required to re-invest in the country by
designating 20% of their mid to top level
positions for Zambians.
 The revenue generated from this tax & tariff
scheme will be designated to fund the
development of the country’s health care
system, education and infrastructure. This will
address unemployment issues and improve
general welfare and health of local citizens.
Recommendation 2:

8. Occupational Health and Safety
 The Zambian Government must
work to institute food safety
standards to ensure the health of its
people, by sanctioning companies
to provide meals for workers and
fine them for allowing unsafe food
handling by its employees.
 Zambia must increase and expand
its food relief program toward a
National Food & Nutrition Program.
 The Zambian government must
establish a resource that not only
feeds its needy but provide
nutritious supplements in addition to
nutrition education.
Recommendation 3:

9. Occupational Health and Safety
 The government should create an
agency that monitors the practices of
foreign companies and businesses to
ensure worker safety
 This agency will provide oversight and
monitoring to ensure that occupational
health policies and regulations are
maintained, companies that violate
workers’ rights and safety will receive set
fines and may be subject to being shut
down.
 Workers should not be made to scoop up
spilled oil with their bare hands, they
should not be subjected to hazardous
work environments without protective
equipment, and they should have
benefits that cover them in case they are
sick and need time off.
 The govt. should encourage advocacy
for workers through labor unions and
advocacy groups involving public health
specialists that will be charged to
educate and protect the public.
Recommendation 3:
Con’t

10. Increasing Health Care Capacity
 Since the numbers of healthcare workers
within the country are limited, the
government needs to provide
opportunities through free or subsidized
education, for preparation and training of
healthcare workers like public health
professionals, doctors, nurses, pharmacists,
etc.
 The individuals who benefit from this
scheme would be obligated to give back
in service the number of years that they
received monies for training (for example,
a nurse who completed a five year
program through the government’s
training scheme, would be obligated to
work for five years in a government
hospital).
 In addition to health care workers, this
scheme can also be expanded to include
other professionals such as farmers,
engineers, community planners, etc.
Recommendation 4:

11. Improving Nutrition, Food Security and Agriculture
 The Zambian government must prioritize
research to create ecological and
environmentally sound farming
techniques that will yield a greater
variety of sustainable crops that in order
to provide a variety nutrient for its
constituency.
 The Zambian government must prioritize
funding dollars for the education of its
people in the area of agriculture which
will create jobs and it must also support
agricultural research that will entail its 3
main rain fall areas in order to discover
best practices for yielding a variety of
sustainable crops.
 The key is to implement efficient
agricultural techniques and practices as
advocated by the Green Belt
Movement of Kenya, which will result in
sustainability of the agriculture industry.
Recommendation 5:

12. Improving Nutrition, Food Security and Agriculture
 Social Service policy to increase
nutrition and food security for the poor
should be created that goes far
beyond that of just food relief.
 It is essential to create an economy
that allows for the creation of jobs
which would increase wealth
distribution.
 The Zambian Government must
establish an educational system that
allows, supports and prioritizes its poorer
citizens, access to fields of study such
as agriculture and other sciences that
will reinforce knowledge around food
production and entrepreneurship, and
increase access to both food and
wealth.
Recommendation 5:
Con’t

13. Enhancing the Educational System
 The Zambian government must implement an
educational scheme that serves its people well.
 The government should implement free primary
education and free/subsidized secondary level
education.
 The educational system must also strongly
emphasize elements of Zambian history, culture,
and wealth generation.
 Students should be taught how to create and
maintain wealth, how to become entrepreneurs,
how to manage businesses and how the economy
works.
 The educational system should also be equipped to
expose students from primary to tertiary levels with
the skills necessary to compete in today’s market,
economy and technologically focused industries.
Recommendation 6:

14. The Zambian Government’s Role
 We are charging the Zambian
government to establish an agency that
will see to it that the above
recommendations are implemented,
monies are allocated in the country’s
budget to meet the necessary demands
and that periodic evaluation of the
different sectors will be carried out to
determine impact on the health of the
people, on the economy and the overall
outcome for the country.
 The government should also consider
diversifying their economy by tapping into
unchartered markets in the country that
will generate wealth and lead to
sustainability of the economy, which will in
turn impact health and health system
development.

15. Questions