The 130th Annual Meeting of APHA

Abstract #43526

Anna Chirwa, BSCNrS, RN, RM¹, Edith Bwalya, BSN, RN¹, Rabecca M. Kalwani, MPH, BSCNrS, RM¹, Nosa Orobaton, MD, DrPH¹, and Mary Kaoma, MPH, BSc, RM². (1) ZIHPSERV, Zambia Integrated Health Program/John Snow Inc., Box 37230, Los Angeles Blvd., Long Acres, Lusaka, Zambia, 260-1-254552 ext. 204, annac@zihp.org.zm, (2) ZIHPSERV, Zambia Integrated Health Programme / John Snow Inc., Box 37230, Los Angeles Blvd., Long Acres, Lusaka, 10101, Zambia

The Zambia maternal mortality ratio is 649/100,000 live births (ZDHS 1996). Currently about 26 % of Zambians practice family planning; CPR for modern methods of FP is only 14%. During Zambia’s first 30 years, its socialist government was the sole provider of FP services. With the introduction of democracy in 1991 decentralization of health services and promotion of partnership formation for the provision of health services, District Health Management Teams (DHMTs) shifted their thinking to viewing the private and NGOs as partners in the provision of health services. To achieve this DHMTs are working with NGOs, workplaces, traditional healers and health workers in Private Practice to increase access to FP in their catchment areas. In 12 districts of Zambia with a combined population of 4.6 million, with support from ZIHP (a USAID funded program) DHMTs have through public-private alliances expanded portals of care in public sector numbering 258 or 6/100,000 by an additional 1370 portals from non-public organisations or 30/100,000. The providers in private for profit organisations are not paid by the government and the DHMTs have been able to leverage expertise and additional access to the services. Since 1991, it has become clear that public– private alliances can work at the district level and that policies encouraging growth of private sector and participation of civil society can contribute to increase in access to care (adoption of multiparty democracy may have increased the viability of such alliances). Additionally, the public sector now realises that they are custodians of public health.

Learning Objectives:

• 3. Describe the benefits and lessons learnt in public-private alliances in the provision of family planning services.

Keywords: Family Planning, Public/Private Partnerships

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Government of Zambia Various Private Providers Various NGOs Zambia Integrated Health Programme Various Private Companies
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: I am employed by the Zambia Integrated Health Programme