Zambia launches Household Health Expenditure and Utilization Survey Report

LUSAKA-Zambia's health challenges are reported to culminate from social determinants of health than the usual attribution to Communicable diseases.

In response to this reality, the Zambian government through the Ministry of Health working with the Central Statistical Office and the University of Zambia with support from the Department for International Development and other cooperating partners undertook the Zambia Household Health Expenditure and Utilization Survey (ZHHEUS) in order to estimate the household health expenditure and utilization levels in the country.  

Officiating at the ZHHEUS Report launch, Minister of Health Dr. Chitalu Chilufya assured the nation that government is addressing the challenges highlighted in the report and has since pledged to address the status quo by adding the revealed evidence to planning and policy.

Dr. Chilufya responded to the human resource challenge noted in the report that government is up to the task and will recruit 7,400 health workers in 2017 of which over 5,000 have already been given provisional letters pending finalization of payrolls slated for January 2017.

According to World Health Organization (WHO), social determinants of health are the conditions in which people are born, grow, live, work and age.

“These circumstances are shaped by the distribution of money, power and resources at global, national and local levels” WHO reports “The social determinants of health are mostly responsible for health inequities - the unfair and avoidable differences in health status seen within and between countries”

Health seeking behavior is one other key facet in answering the question of what majority of people do in the country when faced with ill health.

The report revealed that about 38.3 percent of the population of 15 million Zambians do not report illnesses and only about 21.3 percent do report illnesses.This is mainly due to factors like cost of health service, distance to facility, religious reasons and perceived poor quality of health care services. Self-medication and perceptions are also reported to be high.

An Analyst from the University of Zambia, Department of Economics, Bona Chitah said that it is surprising to find that households do not seek medical interventions despite them realizing ill health.

“There is a tendency of not seeking medical intervention” said Mr Chitah “Households are spending a large amount of money on health care”

He adds that one of the key findings of the survey is that utilization rate of health facilities is relatively low. The public health system is by far the largest due to affordability concerns. 

“(Government) should quickly move in to reduce the imbalances in terms of major expenses” said Dr. Chitah

UN/Zambia Partiners to Fight NCDs

LUSAKA-The United Nations has challenged its member states including Zambia to heighten efforts in the fight against Non Communicable Diseases reported to be on the rise world over. NCDs are capable of decreasing the labour force, reducing productivity and ultimately reducing economic growth, the UN said.

This was revealed during the Joint UN Interagency Taskforce on the prevention and Control of Non-communicable Diseases to the Republic of Zambia from 4^th to 8^th December, 2016.

Taskforce head, Dr. Nick Banatvala, who is also leading the Secretariat of the UN Interagency Taskforce on NCDs at the World Health Organization-WHO Headquarters in Geneva has challenged Zambians to adopt healthy lifestyles in order to prevent NCDs.

Dr. Banatvala said that Zambians can prevent NCDs by engaging in regular physical exercises and improving their nutrition. He adds that child obesity is also on the increase in Zambia which has the potential to eventually lead to more cases of adult obesity if not controlled.

Meanwhile, WHO Country Representative Jacob Mufunda told journalists during a Joint UN Interagency brief in Lusaka that Zambia is hit by four major NCDs which are cardiovascular diseases including heart diseases and strokes, cancers, diabetes and chronic respiratory diseases.  

Dr. Mufunda further calls for a multi-sectoral approach in this battle adding that NCDs are mostly socially determined.

It is reported that over 38 million people die from NCDs each year, including 16 million people who die prematurely before their 70^th birthday. Most premature NCD deaths are from four main behavioural risk factors which are tobacco use, harmful use of alcohol, physical inactivity and unhealthy diets.

Government, through the Ministry of Health, recently launched the National Health Week with emphasis on disease prevention in the bid to drive to the Ministry of Health vision “A Nation of Healthy and Productive People”

Anthrax Outbreak in Chama District

There has been an outbreak of Anthrax in Chama District of Muchinga Province. So far, seven people are being treated for the disease with the first case reported last week on Thursday, 22nd September, 2016. I am happy to inform the nation that there has been no deaths from this outbreak.

The source of this disease is an Anthrax outbreak in the Hippo population in the Luangwa River. I wish to assure the nation, particularly the people of Chama District, that there is no need for alarm because the Ministry of Health, working in conjunction with other government agencies and departments, including the Department for National Parks and Wildlife have mounted a vigorous response to contain the outbreak.

Anthrax is a serious disease that affects animals and can be transmitted to humans when people touch, cut, cook and eat meat from infected animals. The source of the current outbreak in Chama, is due to people in the area coming into contact with Hippos that have died of Anthrax.

Anthrax is caused by a bacterium, called Bacillus Anthracis, which can last for extremely long periods in the environment. When animals or humans come into contact with these bacteria, they can become infected. There are three (3) forms of Anthrax in humans:

1. Cutaneous or the “Skin” form of Anthrax. This appears as sores or blisters on the skin in the parts of the body that have come into contact with the bacteria.
2. Inhalation or Pulmonary Anthrax. In this form, the person breathes in the Anthrax Bacteria and the lungs get affected. The person presents with flu-like symptoms such as sore throat, mild fever, general body aches and pains, and a cough which may later lead to shortness of breath and coughing up of blood. If not treated early, the person may die.
3. Gastro-intestinal Anthrax. In this form, the Anthrax Bacteria are swallowed and the patient may develop fever and chills, sore throat, stomach pains, diarrhea or bloody diarrhea. The person could possibly die from this form if not treated in time.

In the current Anthrax outbreak in Chama, only the cutaneous or “skin form” of Anthrax has been reported so far. All the people infected have handled either the carcasses of the Hippos that have died of anthrax, or prepared and/or ate meat from such carcasses.

Let me take this opportunity to strongly discourage people from eating or handling meat of ANY animal that has died from unknown causes. Please DO NOT in any way, handle or eat meat from animals that have died from an unknown cause or from any infections as this could lead to severe illness or even death.

For those who may have handled, or indeed eaten meat from a Hippo or any animal that may have died from unknown cause, I encourage you to visit your nearest health center. The health care staff in our health centers have both the capacity and medication to treat you.

Let me take this opportunity to also inform the nation that apart from the Anthrax Outbreak in Chama District, there are also outbreaks of Cholera and Typhoid diseases in Kapiri-Mposhi District, of Central Province and Mbala District of Northern Province respectively.

Fifteen cases of cholera have been recorded in Kapiri-Mposhi District with the first case reported on the 11th of September 2016. Unfortunately, one person died from this outbreak whilst one other person is still undergoing treatment. The 13 others are well and have since been discharged. All the cases, were treated at Waya health Centre in Kapiri-Mposhi District. Most of the cases came from the Lukanga Swamps.

Meanwhile, a total 125 cases of Typhoid have been recorded in Mbala District of Northern Province with the first case, presented to Kasama General Hospital, on the 28th of July 2016. So far, a total of 124 patients have been treated and discharged and there have been no new cases in the last nine days. Unfortunately, there was also a death reported in this outbreak.

Both the Typhoid outbreak in Mbala District, and the Cholera outbreak in Kapiri-Mposhi District have been contained and are under control. I however, wish to strongly encourage members of the public in the affected areas to seriously maintain personal hygiene by keeping their surroundings clean. Water for drinking, cooking and for other household use must thoroughly be boiled or chlorinated. Washing of hands with clean water and soap before eating or after using the toilet MUST be strictly adhered to and taken by the community as a norm.

Finally, I would like to reiterate that the Ministry of Health has highly trained personnel with the capacity to respond to any outbreaks. I therefore urge all Zambians to be health conscious and to seek early treatment when feeling unwell. Do not engage in anything that puts your health at risk. Remember, prevention is always better than cure.

Road to decongest UTH

LUSAKA-“Government, through the Ministry of Health, remains committed to providing quality healthcare in the country,” Said Dr. Reuben Kamoto Mbewe, Ministry of Health Spokesperson in an interview “It is fully aware of the challenge of congestion at the University Teaching Hospital (UTH) and measures to this in the short and long term development have since been employed.”

I have tried to explore the question “Can UTH be decongested?” coupled with “is Government doing anything to decongest the national referral hospital?”

In this write-up, culminating from a query by a local reporter and subsequent response by Ministry of Health Spokesperson, who believes efforts have already been employed to significantly reduce on an expected traffic at the University Teaching Hospital (UTH) in the near future, I highlight some of these interventions. 

The above questions are obviously not new to the Ministry of Health spokesperson. Many journalist, reporters, writers and other analysts have flooded the Ministry with such questions.

The University Teaching Hospital being a tertiary hospital caters for the whole nation as a referral hospital. Over the years, the population of the country has increased resulting in increased demand of services by health facilities including the UTH. Equally of note is the exponential increase in population of Lusaka province which is estimated at about three million with Lusaka district where the UTH is located having a population of about two and half million.

Coupled with the above scenario is the fact that for a long time, apart from referrals from all parts of the country, patients were also referred directly from health centres in Lusaka to the UTH. It is also common knowledge that patients and clients shunned health posts and clinics opting to go directly to UTH. Needless to say, this remains a huge challenge for the Ministry of Health and causes unexpected congestion.

Dr. Mbewe has assured that government through the Ministry of Health aims to improve all facets of the health sector like infrastructure development, human resources development, state-of-art medical equipment and adequate primary health care provision.

In the last few years, the Ministry has been seen to have been tirelessly laboring towards putting up adequate infrastructure to improve service delivery.

Dr. Mbewe adds that there is infrastructure development going on at UTH. “Among the various infrastructural projects is the Adult Medical and Emergency Unit (AMEU) under construction at the moment. Equally important to mention is the completion of phase 2 Cancer disease hospitals which caters for both adult and paediatric cancer patients. This will decongest the wards from cancer patients. New surgical wards are also being constructed in the UTH grounds which will undoubtedly contribute to the reduction in congestion at the hospital.”

Other infrastructural developments such as the construction of the 650 health posts across the country are believed to be lasting solutions to the problem at hand. This is expected so because it will also contribute to the decongestion as Lusaka is also a beneficiary of the health posts some of which are operational.

“About 44 hospitals are being constructed countrywide and Lusaka province were UTH is situated has also benefited. This means that patients who were referred from say Chongwe and Kafue health centres directly to UTH are attended to in their districts at the recently built first level hospitals.  In particular is the completion of the upgrade of Matero and Chilenje to level 1 hospitals with support from JICA infrastructure development program.  Upgrade of Chawama, Chipata and Kanyama under the same program is slated to start in 2017” Said Dr. Mbewe

In Lusaka, the construction of Levy Mwanawasa General Hospital serves the purpose of decongesting UTH. Plans are underway to expand Levy Mwanawasa General Hospital by increasing number of bed spaces. Furthermore, plans have reached an advanced stage to build another hospital in Lusaka West known as L85. This will be a third level hospital with a fully-fledged nursing school and staff accommodation.

Modernization of the University Teaching (UTH) Hospital remains at the heart of the Ministry’s effort both in the short and long term development as the goal is to make UTH a true national referral hospital to deal with complicated cases that cannot be handled in facilities below it. With the efforts going towards decongestion of UTH, the Minsitry is confident that this will sooner than later become a reality.

Another side of the Ministry’s effort is that of reducing the disease burden in the country. “Preventive measures to reduce the disease burden on the population is key in reducing traffic on UTH and other facilities. Therefore, the Ministry remains resolute to awareness creation on how the population can prevent diseases such as the efforts towards the elimination of malaria and efforts to prevent transmission of HIV and other communicable and non-communicable diseases.”

Client/customer satisfaction is another aspect attracting the attention of the Ministry. Therefore, Government is pledging to continue to hire more health workers to provide quality services. The Ministry posted consultants or senior registrars to run Level 1 Hospitals so as to attend to cases that can be dealt with within these facilities and only complicated ones should be sent to UTH.

The Ministry of Health spokesperson concluded with a reminder that focus on the vision of "A Nation of Healthy & Productive People" through the mission "To provide equity of access to cost effective quality health services, as close to the family as possible in a Clean, Caring and Competent environment" still remains the fastest vehicle to achieving it and will be achieved soon.

Zambia Health History: The past 52 years

I will soon send to you the story on the quality time I had with the Minister of Health in Zambia, Dr. Joseph Kasonde who among other things gave an in-depth reflection on Zambia's health reforms in the last fifty-two (52) years.

Dr. Kaosnde was one of the first  indigenous medical doctors  in Zambia. He served as Permanent Secretary of Health in the early 80's and has seen Zambia undergo various health reforms. He is the current Minister of Health of Zambia whose vast experience has no doubt benefited Zambia's health sector.

His passion for 'A Clean Nation is a Healthy Nation' stands the chance of being one of his lasting legacies.