World Health Organization : Year 1997 ; World Health Organization, Analysis, Research, And Assessment, No. 97.2: Towards an Equity-Oriented Policy of Decentralization in Health Systems Under Conditions of Tureulence ; the Case of Zambia

By Katele Kalumba, Dr.

Book Id: WPLBN0000142539
Format Type: PDF eBook
File Size: 2.0 MB
Reproduction Date: 2005

Title:	World Health Organization : Year 1997 ; World Health Organization, Analysis, Research, And Assessment, No. 97.2: Towards an Equity-Oriented Policy of Decentralization in Health Systems Under Conditions of Tureulence ; the Case of Zambia
Author:	Katele Kalumba, Dr.
Volume:
Language:	English
Subject:	Health., Public health, Wellness programs
Collections:	Medical Library Collection, World Health Collection
Historic Publication Date:
Publisher:	World Health Organization


Citation APA MLA Chicago Dr, K. K. (n.d.). World Health Organization : Year 1997 ; World Health Organization, Analysis, Research, And Assessment, No. 97.2. Retrieved from http://gutenberg.cc/

Description
Medical Reference Publication

Excerpt
A brief acknowledgement I wish to express my deep gratitude to my colleague, the former Minister of Health, Dr Boniface Kawirnbe, and Dr K. Kamanga, the former Permanent Secretaiy, for having tolerated my reformist approach. And a great debt goes to the staff of the Ministry of Health, particularly Vincent Musowe, Director of Health Planning, MOH; Dr Sam Nyaywa, Director of Health Services Commissioning, Central Board of Health (CBoH); Dr J.J. Banda, Regional Director North-Eastern Health Region; Dr E. Nangawe, PHC Adviser; Dr Rose Sunkuntu, Manager Systems Development Division (CBoH), and to my dear wife Lumba Kalumba, for their collective intellectual stimulation, To health workers across the country, this has been a testing moment and I thank them for daring to ty. Zambians are judges of all that is described in this manuscript. Together with all our national cooperating partners who have invested money in this effort, I can only ask for their patience. Finally, special credit to Katja Janovsky for pushing me so hard and encouraging me to put the Zambian experience on paper, and to all the editing staff, particularly Phyllida Travis, for making it finally readable. Originally, the idea was conceived as part of my contribution to the South African government's reform agenda, where Katja recruited me into some strange group later named the Forurn on Health Sector Reform. To my colleagues in the Forum, I hope this long awaited Zambian manuscript adds to our collective commitment to continue pursuing this agenda for global reform of health care, and in particular to start addressing the administratium in all bureaucracies we are associated with and know too well. While acknowledging my indebtedness to many who have had a influence on how I think about health reform, I bear personal responsibility for any weakness conceptual or otherwise that this manuscript may contain.

Table of Contents
Table of Contents INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1 IDEOLOGICAL TRENDS AND OPERATIONAL REALITIES: The international and national background to reform . . . . . . . . . . . . . . . . . . . . . . . 1 1.1 The impetus for health sector reform . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1.2 Policy reforms. and their implications for the distribution of power . . . . . . . . . . . . 3 1.3 Zambia during the 1970's and 80's: a pattern of macroeconomic turbulence and decline ........................................... 5 1.4 Zambia's health sector before 1991 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 2 ZAMBIA'S 1991 HEALTH SECTOR REFORMS . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 The new political and economic context . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 The new health sector reform policy: direction and underlying principles . . . . . . . 9 The main features of the reform . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 The process of reform . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Essential health care packages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Financing the reforms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Establishing regular monitoring and evaluarion of the reforms . . . . . . . . . . . . . . . . 27 An assessment of the progress so far in implementing the reforms . . . . . . . . . . . . . 27 3 1996: THE SECOND AGENDA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 CONCLUSION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 REFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 ANNEXES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37