Human Resource Shortages in the Zambian Health Sector & its Impact on HIV/AIDS care

Emmanuel M. Makasa MD, MPHZambia Medical Association

Lusaka, Zambia

emakasa@yahoo.co.uk

Given to the Infectious Diseases Division of

Brown University School of Medicine at

Miriam Hospital, Providence RI, USA

21st May 2009

Human Resource Shortages in the Zambian Health Sector & its Impact on HIV/AIDS care

OBJECTIVES:

Describe healthcare system & infrastructure in Zambia.

Discuss impact of HIV & effect on health sector.

Examine interplay of human resource shortages & HIV care in Zambia.

Relevance of human resources issue to ID in the USA A man ravaged by AIDS is bathed at a

hospice in Zambia (www.Time.com)

Human Resource Shortages in the Zambian Health Sector & its Impact on HIV/AIDS care

Zambia’s location in the world: Country Profile:

Landmass ≈752,612 Sq Km Population – 12million Declining life expectancy @ birth

of 37.5 years. High dependency ratio- 47% pop

aged <15yrs. Fairly urbanized – 34.7% in urban

areas. Administrative 9 provinces. Weak social economic position

(among least developed) Democratic gov. (two 5 yr terms)

Source:www.witiger.com

Zambia’s Healthcare System:

Centralized (Ministry of Health)

Three levels of healthcare.

Free public healthcare for all.

Small private sector.

Inadequate funding (<15% of national budget)

Zambia’s Healthcare Infrastructure:

Inadequate & poor state of essential infrastructure, equipment & transport.

Continued shortages & erratic supply of essential drugs & medical supplies.

High disease burden with critical shortages of qualified health workers at all levels of health service delivery.

Human Resource Shortages in the Zambian Health Sector & its Impact on HIV/AIDS care

Human Resource Shortages in the Zambian Health Sector & its Impact on HIV/AIDS care

Human Resource Shortages in the Zambian Health Sector & its Impact on HIV/AIDS care

Zambia’s HIV/AIDS statistics & Response:

1, 100, 000 people living with HIV(Total Pop. 12 million)

15.2% Adult prevalence rate (15 – 49 yrs)

980,000 Adults living with HIV (15-49yrs)

560, 000 Women living with HIV (>15yrs)

95,000 children living with HIV (0 – 14yrs)

56, 000 Deaths due to AIDS

600,000 Orphans due to Aids (0 – 17yrs)

Impact of HIV/AIDS on Zambia

General: Retarded national development Disrupted extended family system Lowered life expectancy to 37.5 yrs

On Health Sector: Increase disease burden Shortages of health facilities, supplies

& staff Morbidity and mortality of health

workers from AIDS

NOTE: Impact worse in rural areasSource: Epidemiological Fact Sheet on HIV & AIDS, 2008

Human Resource Shortages in the Zambian Health Sector & its Impact on HIV/AIDS care

Progress towards universal access:

Source: Ministry of Health, Zambia

Human Resource Shortages in the Zambian Health Sector & its Impact on HIV/AIDS care

Human Resource Shortages in the Zambian Health Sector & its Impact on HIV/AIDS care

Human Resource Shortages in the Zambian Health Sector & its Impact on HIV/AIDS care

Source: Ministry of Health, Zambia

Human Resource Shortages in the Zambian Health Sector & its Impact on HIV/AIDS care

Human Resource Shortages in the Zambian Health Sector & its Impact on HIV/AIDS care

Impact of HIV/AIDS and Human Resource Shortages on Zambia’s healthcare delivery.

Human Resource Shortages in the Zambian Health Sector & its Impact on HIV/AIDS care

HIV/AIDS+

Malaria &TB

HRH•Weak

Retention•Death from

AIDS•Inadequate

training

Increased Disease Burden

Human Resources for Health Shortages

HealthcareDelivery in

Crisis

Inadequate & poor state of

Health infrastructure and medical

supplies

The way forward:

Make human resources for health a priority in the fight against the HIV/AIDS.

Rural areas of Zambia should NOT be ignored as they are affected the most.

Although we need help as a country from international partners to build capacity, our future lies in our own hands.

Need for more Zambian political will and commitment to overcome the challenges we face.

Human Resource Shortages in the Zambian Health Sector & its Impact on HIV/AIDS care

What does this mean for you:

Practice & do research abroad?- Awareness of situation helpful.-Human resource issues should be part of research.

How does the Zambian situation affect you & your careers?- While there are opportunities for short term work, long term

work is what is needed the most. - The role of teaching and training locals should also be a priority.

Without tackling this issue, your work in trying to fight HIV, especially in Africa, is greatly held back .

Human Resource Shortages in the Zambian Health Sector & its Impact on HIV/AIDS care

Acknowledgements:

Division of Infectious Diseases

Dr. Flanigan, ID Division Chair

Susan M. Tootell & Dalila Zachary

All of you for attending

Human Resource Shortages in the Zambian Health Sector & its Impact on HIV/AIDS care

References:

1. World Health Organization. The World Health Report 2006 – Working together for health.

2. UNAIDS. Zambia – Country Response. Available at: http://www.unaids.org/en/CountryResponses/Countries/zambia.asp. Accessed May 19 2009.

3. Makasa E. The Human Resources crisis in the Zambian Health Sector – a discussion paper. Med J Zambia 2008;35(3) 81-87.

4. Ministry of Health of Zambia. Joint Annual Review for 2007 Main Report. Available at: http://www.moh.gov.zm/?q=node/publications. Accessed May 19 2009.

5. Ministry of Health of Zambia. National Strategic Plan 2006-2010. Available at: http://www.moh.gov.zm/?q=node/publications. Accessed May 19 2009.

6. Central Statistics Office Zambia. Main Zambia Census Report 2000. Available at: http://www.zamstats.gov.zm/census.php. Accessed May 19 2009.

Human Resource Shortages in the Zambian Health Sector & its Impact on HIV/AIDS care