Myriad of Health Care Financing Reforms in Zambia: Have the Poor Benefited?

Chitah, Bona; Chansa, Collins; Kaonga, Oliver; Workie, Netsanet Walelign

doi:10.1080/23288604.2018.1510286

Cited by 12 publications

(24 citation statements)

References 19 publications

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“…There has been similar support and sentiments from other parts of Africa [2,3,4]. The logic behind this position is based on the fact that Zambia's health care system has various shortcomings which can be seen from its consistent failure to effectively handle a plethora of illness such as malaria, malnutrition, diarrhea, cancer and HIV/AIDS [26,27]. Therefore a further covid19-precipitated increase in patientnumber without any expansion in capacity of the healthcare system risks collapsing it.…”

Section: Discussionmentioning

confidence: 94%

“…Therefore a further covid19-precipitated increase in patientnumber without any expansion in capacity of the healthcare system risks collapsing it. Covid19 patients require adequate human resource, availability of Personal Protective Equipment (PPE), ventilators and a constant supply of electricity, all of which were already in short-supply in Zambia [26]. There were several catastrophic predictions of deaths estimated in the range of one hundred to three hundred thousand in African countries like Zambia that still registered high HIV prevalence rates [28,29].…”

Section: Discussionmentioning

confidence: 99%

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COVID19 Response in low-income country: The case of a Lockdown in Zambia

Muzyamba¹

2020

Preprint

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Abstract Background The onset of the covid19 pandemic has sparked heated debate among scholars on the relevance of lockdowns. There are those in favor of the lockdown and others who are critical of it. However, despite the increased interest in understanding the relevance of lockdowns, there still has not been much focus on its relevance in low income countries like Zambia. Thus with the help of the SRT, we set out to explore and document the local characterization of the lockdown by residents of Lusaka, Zambia. Methods A qualitative study in the form of interviews was conducted in Lusaka, Zambia involving a sample of 68 participants. Due to the lockdown measures that were in place during the study, the interviews were conducted via phone calls and the data collected were later analyzed by use of thematic analysis technique. Results The lockdown was on one hand lauded for slowing down the incidence rates, preventing fatalities, and for protecting the healthcare system from collapse. On the other hand, it was criticized for exacerbating poverty levels, unemployment rates, increasing the rate of mental health problems, aiding gender based violence, and intensifying political repression and corruption. The results speak to the complexity in the characterization of the lockdown as a response to covid19 in Zambia. This observation demonstrates the folly of viewing, applying and characterizing the covid19 lockdown as a ‘one-size-fits-all’ approach in Zambia. Conclusion Thus rather than definitely establishing the lockdown as an incontestable good, as it is depicted by some scholars or as useless by its critics, our findings instead demonstrate the diversity and complexity in how it is locally viewed by Zambians. The study provides grounds for caution on simplistic and binary characterization of lockdowns. It indicates the need for careful dialog between the designers of lockdowns and citizens in order to tailor such interventions to local realities in context-specific ways. It also shows that though the development of such interventions, all the various and complex elements it embodies must be taken into account in order to realize optimum outcomes.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

COVID19 Response in low-income country: The case of a Lockdown in Zambia

Muzyamba¹

2020

Preprint

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show abstract

“…There were similar support and sentiments from other parts of Africa [ 5 ]. The logic behind this position is since Zambia’s health care system had various shortcomings which could be seen from its consistent failure to effectively handle a plethora of illness such as malaria, malnutrition, diarrhea, cancer and HIV/AIDS [ 18 ]. Therefore, a further COVID-19-precipitated increase in patient-number without any expansion in capacity of the healthcare system risked collapsing it [ 2 , 21 – 23 ].…”

Section: Discussionmentioning

confidence: 99%

Local characterization of the COVID-19 response: the case of a lockdown in Lusaka, Zambia

Muzyamba

2021

glob health res policy

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Background The onset of the COVID-19 pandemic has sparked heated debate among scholars on the relevance of lockdowns. There are those in favor of the lockdown and others who are critical of it. However, despite the increased interest in understanding the relevance of lockdowns, there still has not been much focus on its relevance in countries like Zambia. Thus, with the help of the Social Representation Theory (SRT), we set out to explore and document the local characterization of the lockdown by residents of Lusaka, Zambia. Methods We recruited our participants through convenient and purposive sampling techniques. This was done through the use of the ZAMTEL public phone records. Initial contact was made to potential participants, and they were asked of their availability and willingness to participate in the interview. Upon agreeing to participate, they were included in the sample. A total of 68 people were selected to take part in this study. Their age ranged from 20 to 76 years old. 33 of them were male and 35 females. After this, we conducted interviews with the 68 participants. Due to COVID-19 restrictions, our interviews were conducted via telephone in conformity with the recommendations from the IRB in Lusaka and the advice of the ministry of health. We anonymized the demographic characteristics and responses from our participants. Later, thematic analysis was used to analyze the data. Results The lockdown was on one hand lauded for slowing down the incidence rates, preventing fatalities, and protecting the healthcare system from collapse. On the other hand, it was criticized for exacerbating poverty levels, unemployment rates, increasing the rate of mental health problems, aiding gender-based violence, and intensifying political repression and corruption. The results speak to the complexity in the characterization of the lockdown as a response to COVID-19 in Lusaka, Zambia. This observation demonstrates the folly of viewing, applying and characterizing the COVID-19 lockdown as a ‘one-size-fits-all’ approach in Lusaka, Zambia. Conclusion Rather than establishing the lockdown as an incontestable good, as it is depicted by some scholars or as useless by its critics, our findings instead demonstrate the diversity and complexity in how it is locally viewed by Lusaka residents. The study provides grounds for caution on simplistic and binary characterization of lockdowns. It indicates the need for careful dialog between the designers of lockdowns and citizens in order to tailor such interventions to local realities in context-specific ways. It also shows that though the development of such interventions, all the various and complex elements it embodies must be taken into account in order to realize optimum outcomes.

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“…However, these attempts, largely spearheaded by Ministries of Health have been slow and intermittent as reflected in the slow and/or forward and backward movements in the reform processes [16,[20][21][22]. The process of introducing comprehensive National Health Insurance Scheme (NHIS), for example, has been ongoing in the last 2 to 3 decades in Uganda, Kenya, Zambia and South Africa [16,[20][21][22][23][24]. In South Africa, Uganda, Kenya and Zambia, Health Insurance Bills were (or have been) drafted, however they have not reached parliament for legislation.…”

Section: Introductionmentioning

confidence: 99%

How has sustainable development goals declaration influenced health financing reforms for universal health coverage at the country level? A scoping review of literature

2021

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Background Achieving universal health coverage (UHC) requires health financing reforms (HFR) in many of the countries. HFR are inherently political. The sustainable development goals (SDG) declaration provides a global political commitment context that can influence HFR for UHC at national level. However, how the declaration has influenced HFR discourse at the national level and how ministries of health and other stakeholders are using the declaration to influence reforms towards UHC have not been explored. This review was conducted to provide information and lessons on how SDG declaration can influence health financing reforms for UHC based on countries experiences. Methods We conducted a rapid review of literature and followed the preferred reporting items for systematic review and meta-analysis (PRISMA) guideline. We conducted a comprehensive electronic search on Ovid Medline, PubMed, EBSCO, Scopus, Web of Science. In searching the electronic databases, we combined various conceptual terms for “sustainable development goals” and “health financing” using Boolean operators. In addition, we conducted manual searched using google scholar. Results Twelve articles satisfied our eligibility criteria. The included articles were analyzed thematically, and the results presented narratively. The SDG declaration has provided an enabling environment for putting in place necessary legislations, reforming health financing organization, and revisions of national health polices to align to the country’s commitment on UHC. However, there is limited information on the process; how health ministries and other stakeholders have used SDG declaration to advocate, lobby, and engage various constituencies to support HFR for UHC. Conclusion The SDG declaration can be a catalyst for health financing reform, providing reference for necessary legislations and policies for financing UHC. However, to facilitate better cross-country learning on how SDG declaration catalyzes HFR for UHC there, is need to examine the processes of how stakeholders have used the declaration as window of opportunity to accelerate reforms.

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Myriad of Health Care Financing Reforms in Zambia: Have the Poor Benefited?

Cited by 12 publications

References 19 publications

COVID19 Response in low-income country: The case of a Lockdown in Zambia

COVID19 Response in low-income country: The case of a Lockdown in Zambia

Local characterization of the COVID-19 response: the case of a lockdown in Lusaka, Zambia

How has sustainable development goals declaration influenced health financing reforms for universal health coverage at the country level? A scoping review of literature

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