Zambia Donor Response

The National HRH Strategic Plan will achieve its goals in a phased approach and is receiving support from the Cooperating Partners such as the Swedish Embassy (SIDA), the Royal Netherlands Embassy (RNE), DFID, USAID, the European Union (EU), World Bank and JICA, as well as other key role players.

JICA: Conducted a comprehensive health facility census (HFC), which included the collection of data on health personnel. Further to the implementation of the HFC, MoH is in the process of conducting the Health Capital Investment Planning (HCIP) support project based on the results of the HFC. JICA is providing technical and financial support to the MoH to facilitate the implementation of the HCIP project. In the next two years, (February 2006 to March 2008), the MoH with support from JICA will be utilizing the HFC results and other related data to develop Health Capital Investment Plans from district to national level".

SIDA: Based on the assessment of the HRH Strategic Plan and the staffing situation in the health sector in Zambia Sida has decided to support the ministry with 16 MUSD over a period of 5 years to implement the plan. The money is disbursed alongside the support to the Expanded Basket, to a HR Basket Account, together with contributions from other partners. Included in the support to the implementation of the HRH Strategic Plan is a TA support to the Ministry of Health, assisting the ministry in the implementation of the plan and other management issues. A component of monitoring and evaluation is also included in the support. The final details of this component have not been worked out yet.

WHO: Supports country plans to improve human resource development through support for improving up to date and accurate data base on the available human resource; support policy development for human resource retention; contribute to human resource development through provision of fellowships for training; and provide support for retention of the pool of trainers of health workers through provision of 'retention allowance' for lecturers at the School of Medicine at the University of Zambia. To date, the WHO has provided support for retention of skilled trainers; lecturers at the University of Zambia School of Medicine; fellowship for training; the establishment of the Observatory for Human Resources for Health; the adjustment of the national health workforce development plan to HIV/AIDS universal access requirements; and skills building through support for nationals to attend short courses and international seminars.

European Commission: The EU Strategy for Action on the Crisis in Human Resources for Health in Developing Countries was approved in December 2005, as a Commission specific response to the planned decade of action on human resources proposed by the 57th World Health Assembly. Funding is provided in terms of budget support, which is labeled through disbursements that are clearly linked to the assessment of progress in the implementation of the HRH for health strategic plan. The available budget, in total US$ 10m is set in two fixed annual tranches (2006 and 2007) and two variable tranches in 2008. The Benchmarks for the 2006 tranche amongst other things were dependent  on the creation of the Government of Zambia Budget of one or more budget items specifically devoted to the implementation of the Human Resources for Health strategic plan, for the 2007 tranche on the development and implementation of a central and provincial level HRH information system, indicators for monitoring and evaluating implementation of the HRH plan, agreement and formalized mechanisms for selective incentives for health workers in underserved areas ; and for the 2008 tranche improvement in the ratio of health professional population/staff (enrolled nurses); and progress in the integration of the MOH payroll of staff (including support staff).

DFID Support: DFID supports the Health Sector in Zambia through budget support in line with the Fifth National Development Plan and National Health Strategic Plan - to which the Human Resources Strategic Plan is central. DFID is currently not providing resources directly for Human Resources for Health. DFID is a member of the Human Resources Technical Working Group.  Within this group, DFID attempts to integrate the Health sector issues with our involvement in the Budget Support (£25m in 2007), Public Expenditure Management and Financial Accountability (PEMFA) and Public Service Management (PSM) programmes.  The Government of Zambia has therefore been working with other partners in ensuring adequate health sector financing (under the MTEF) and included Human Resources for Health discussion in the relevant budget support reviews.  Under the Joint Assistance Strategy for Zambia, three partners have been identified to lead the health sector; SIDA, DFID and WHO.  For 2007, DFID provides overall coordination of cooperating partners.   DFID supports the work of other partners to ensure effective lesson learning and best practice dissemination from other countries in similar situation.  In 2006, DFID organised a mission with Government and other partners to Malawi to review their emergency human resource plan. DFID is also supporting the development of institutional links between UK and Zambia health institutions and is working with Britain’s Department of Health and National Health Service to reduce the brain drain of health workers from Zambia to the UK. NHS contributes to capacity building in Zambian health facilities and training institutions, through the attachment of staff from the NHS to work for short periods in Zambian health facilities, and to provide training in training institutions in Zambia.

CIDA Support: The Canadian International Development Agency (CIDA) is currently finalizing its new Health Sector Strategy in support of the National Health Strategic Plan (NHSP) which incorporates the Human Resources for Health (HRH) plan. In relation to the above, CIDA has planned a direct investment to the sector through the Ministry of Health (MoH) Expanded Basket. A financial contribution of $20 million over two years, of which $5.5 million will be earmarked for support to the HRH plan, particularly concentrated on enhancing the presence and authority of women in decision making in the sector. CIDA has further demonstrated its support for HRH, through the Integrated Management of Childhood Illness (IMCI) project, implemented by CARE International in close partnership with MoH, where frontline health workers receive training in Child Health.  Secondly, the Agency has taken a pivotal stand recently in launching its African Health Systems Initiative (AHSI), which focuses on the strengthening of HRH. CIDA’s main contribution to human resources in the sector, besides financial support, will be its participation and value-added in policy dialogue, as well as monitoring for risks and results as member of the human resources, procurement and child health technical working groups.

MACEPA/PATH Support: (information forthcoming)