Improving Primary Health Care Efficiency in Zambia
UHC effective coverage relative to total health expenditure per capita
Contents
Over time, Zambia’s health system achieved efficiency, in part, by consistently prioritizing primary health care (PHC) in resource allocation and by orienting its health system toward the provision of PHC services, particularly preventive interventions.
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Primary health care is a whole-of-society approach to effectively organize and strengthen national health systems to bring services for health and wellbeing closer to communities.1 Researchers estimate that high-quality care via PHC could prevent more than half of excess deaths in low- and middle-income countries each year and could avert as many as 60 million deaths by 2030. Effective PHC can also reduce health care costs by lowering hospital admissions and rates of emergency department use. Finally, experts believe strengthening PHC is essential to achieving universal health coverage worldwide.2 |
Despite the complexity of improving PHC in resource-constrained settings, Exemplar countries like Zambia have implemented a range of complementary health system reforms focused on financing, governance, access to care, and performance and accountability. As a result, compared to their peers they have performed better over the past 20 years relative to their total health spending.
Exemplars research distinguished three broad ways, or pathways, in which Zambia’s reforms improved PHC performance and efficiency:
Pathway 1
Zambia enabled financial flows, local program planning and oversight, and the increased use of local data.
Reforms working through this pathway prioritized and coordinated PHC spending. These interventions enabled the predictable flow of financial resources to frontline health providers for regular service delivery. They also strengthened local capacity for planning, oversight, coordination, and data-driven decision-making.
Pathway 2
Zambia optimized the health workforce by focusing on staff productivity and attitude through incentives.
Reforms working through this pathway focused on mechanisms to improve overall working conditions and geographical distribution, including by relying on community health workers in remote areas.
Pathway 3
Zambia improved access to care and expanded outreach-based service delivery models.
Reforms working through the third pathway improved access to care and increased equitable PHC services coverage by bringing health services closer to the community, thereby decreasing geographic barriers to care.
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1
World Health Organization (WHO). (2019, June 18). Primary health car. https://www.who.int/health-topics/primary-health-care#tab=tab_1
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2
World Health Organization (WHO). Primary health care fact sheet. WHO website. Published April 1, 2021. Accessed November 27, 202. https://www.who.int/news-room/fact-sheets/detail/primary-health-care
Improving Primary Health Care Efficiency in Zambia
