Africa: Strong System, Financing 'Key' for Zambian Universal Health Coverage

Dr Abel Kabala at the second WHO Africa Health Forum in Praia, Cape Verde.
27 March 2019

Praia — allAfrica's Nontobeko Mlambo is in Praia, Cabo Verde, for the second WHO Africa Health Forum. This year the focus is on attaining universal health coverage for the continent - here she speaks with Dr Abel Kabalo, director in Zambia's department of health, who was on the panel discussing Multisector Collaboration to Improve Health Outcomes .

With a population of over 16 million people, Zambia continues to suffer from malaria and the HIV/Aids epidemic, as well as a significant growth in non-communicable diseases. Although medical care in Zambia is free many still can't afford the best quality care they desire because good and quality medical care is heavily subsidized. Zambia is piloting a National Health Insurance scheme in an effort to improve quality health.

"Our resolve it to ensure that each and every Zambian is covered in terms of health care needs without any catastrophic assault on their income," Dr Abel Kabalo, director of the department of health promotion environment and social determinants in Zambia.

As one of the panelists to discuss  Multisector Collaboration to Improve Health Outcomes at the second WHO Africa Health Forum in Praia, Cape Verde, Kabala says he positive that his country will achieve UHC by the year 2021.

His department is responsible for health promotion, prevention, and control of diseases for improved health outcomes. It also coordinates health promotion and prevention and control of diseases at provincial and district levels.

In 2018, Health Minister Chitalu Chilufya presented the National Health Insurance Bill to Parliament, saying the bill is aimed at providing for sound financing of the national health system and universal access to quality insured healthcare services. Kabalo says the national health insurance that the country is in the process of implementing which is compulsory will ensure that  the country pulls resources in to  the health sector that can be used to respond to any health needs.

Kabalo says strengthening Zambia's systems and healthcare financing is key in insuring that the country attains UHC as the country continues to see improvements on domestic funding.

Despite efforts by the government to end prevent all malaria deaths, three million of Zambians were diagnosed with malaria in 2016, according to the WHO malaria report in 2017.

"We are resolved to eliminate malaria by the year 2021 and we are moving in that direction. We have seen some good progress over the years in terms of the malaria incidents and we have seen that for the past 10 years we have definitely reduced those malaria incidents by 50% and we can see that if we pushed in efforts in an integrated manner with indoor spraying, mosquito nets, effective treatment and then mass drug administration in low incident areas we will find that we can definitely meet the 2021 goal.

"Countries that are succeeding in achieving UHC have proved that multi-sector collaborations and private sector partnerships with governments can eliminate policy implementing barriers holding back UHC coverage for countries," Kabalo said.

'We have repositioned ourselves, we are a ministry of health not ministry of sickness'

Everyone in Zambia is on board and believes that the Social Health Insurance that the government is implementing, which is compulsory, will make sure that each citizen contributes a little towards provisional health services in the country, he says.

Zambia is using an integrated community-based primary health care approach which means Zambians at a smallest unit in the household unit should be responsible or take it upon themselves to contribute towards the wellbeing of the nation by contributing financially and insuring that they keep themselves healthy and not sickly all the time,

"We have repositioned ourselves, we are a ministry of health not ministry of sickness so our entry point in to the health service delivery system is health promotion and diseases prevention so we ensure that we promote health and healthy living, we prevent diseases and for those that fall through the cracks we will treat them and we are ensuring that we up the quality of care that we offer for the curative stage."

Kabalo believes that 90% of all the disease cases in Zambia are preventable, he considers malaria to be one of the "most easily preventable". If you were to be sleeping under a mosquito net and they are not being bitten by those malaria transmitting mosquitoes, it is very easy for them to prevent themselves from getting malaria, also with HIV/Aids if one is sexual active and has multiple partners but uses a condom all the times, they could prevent getting HIV/Aids, he says.

"Flu and diarrhea can be prevented by mere washing of our hands and drinking good water, that you are sure is treated and safe for drinking. With regard to NCDs, we can prevent diabetes and the most common one which is type 2 which comes in mostly because of lifestyle, hypertension is also mostly lifestyle-related, cancer can be prevented by early screening and early treatment. also reducing on bad lifestyle choices like alcohol abuse and smoking."

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