Improving health policy and services in Zambia

Mr. Mumba Tembo

Zambia has made progress in growing its economy and improving health outcomes, despite a high burden of disease. This is characterized by high levels of maternal, neonatal and child morbidity and mortality as well as a high incidence and associated impact of communicable and non-communicable diseases. This burden is further elevated by an under-resourced health system, poor infrastructure especially in the rural areas, and a 63 per cent population that is multidimensionally poor, with poor access to safe water and sanitation, malnutrition, gender discrimination, limited access to electricity and weathering negative effects of climate change (WHO Country Cooperation Strategy).

A majority of the population cannot afford the out-of-pocket fees charged in health facilities, and thereby, creating financial barriers to health access. Mr. Mumba Tembo, an Australia Awards alumnus who has worked in the Ministry of Health since 2000, aspired to address the policy and structural bottle-necks in the health system that hinder health access. He understood that reducing the negative health indicators in Zambia required better planning and financing mechanisms, increased national health resources and improved health financing through contributing to the establishment and proper management of a social health insurance.

After graduating with a Master of Health Economics from the University of Queensland in 2014, Mr. Tembo, as one of three Ministry health economists, guided the drafting of the National Health Insurance (NHI) Bill, which was signed into law by Zambia’s President in April 2018. The Act finances health care services using mandatory financial contributions by those formally employed, as the primary source of funds.

Mr. Tembo drew on his collaboration skills to engage with diverse stakeholders to understand their priorities and concerns related to health financing. The views of the diverse set of stakeholders (including business associations, employers, government, informal marketers and unions) ensured that the policy was inclusive of all in society. He used the negotiation skills he had gained in Australia to manoeuvre through the delicate political environment that characterises the policy-making process. Mr. Tembo asserts, “This policy is expected to increase public health insurance coverage rates in Zambia from 3 per cent to between 35 and 40 per cent of the population in the initial stages of implementation.”

Additionally, he led in the development of technically sound proposals for addressing challenges related to midwife training and Tuberculosis (TB) services in Zambia. Following a transfer to Copperbelt Province in 2015 as a Senior Planner, Mr. Tembo helped to source a grant to train Community Health Workers on TB prevention and treatment. In 2016, he was transferred to the Northern Province where he drafted a proposal and secured funding to convert an abandoned leprosy centre into a midwife training facility – a demonstration of his proposal writing, and critical thinking skills gained during his time in Australia. The facility has been providing one-year training courses since mid-2017 and has trained a total of 160 midwives as at end of 2018.

Currently, Mr. Tembo is a Chief Planning and Research Officer for the Ministry of National Guidance and Religious Affairs in Lusaka where he leads planning, research and evaluation activities. He also coordinates engagement between his Ministry and both Parliament and the Cabinet, allowing him to participate in discussions with the most influential parts of Zambia’s government. Though his links with Australia are mostly social, he remains connected to networks of returned scholars and classmates across Africa.