Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #118349

Hilary Francis Mwale, MPA BA, Human Resources, Health Services and Systems Programme, PO BOX 39090, Rhodespark, Lusaka, 10100, Zambia, 2601254555, hmwale@yahoo.com and Jere Mwila, BA, Human Resources and Administration, Ministry of Health, Po Box 30205, Lusaka, 10101, Zambia.

In February 2004, the Mid Term Review of the Zambian NHS Strategic Plan noted that:

‘Health care is a labour intensive industry and cannot be delivered only through action plans, physical facilities or supplies. Without addressing this issue, we fear that most if not all of the essential indicators can be expected to deteriorate, to a point where the public health sector would be in danger of collapse.'

This observation captures the essence of the current crisis facing the health service. Essentially, too few staff are struggling to provide care to a population of 10.9 million that faces massive deficiencies in maternal and child health and rampant epidemics of HIV/AIDS and malaria. All these major scourges are in addition to the customary range of other health conditions requiring treatment.

An absolute shortage of key personnel represents only one critical challenge to meeting the human resource needs in Zambia. Other challenges include the appropriate distribution of staff, the migration of health care workers, the retention of trained personnel in their positions and/or the facilities were they are trained; working conditions and occupational safety, stigma attached to working on HIV/AIDS and most notably the impact of HIV/AIDS on staff itself.

Whilst the GRZ has been the fortunate recipient of financial support to assist with many of these challenges, the funds have frequently failed to address the core issues of the supply of trained labour required to deliver the targets to which they relate. The consequence is that major programmes, such as the millennium development goals, are unlikely to be fulfilled, whilst the basic package of care will be unavailable to vast numbers of Zambian people.

This critical situation is posing a challenge to politicians and partners as well as to the health services. A solution requires imagination and courage to move beyond conventional responses. This research paper will contain further details to illustrate the current difficulties. It will also indicate the steps already being taken to address the crisis and details areas for additional support in which further local, global assistance and solutions are urgently required.

Learning Objectives: At the conclusion of the session the participant will learn

• How globalisation has adversely affected the human resources for health situation in poor sub-saharan African countries.
• How the effects of HIV/AIDS have exacerbated an already crisis situation for human resources for health.
• The estimated training costs lost by the Zambian Governments as a result of qualified health workers leaving for greener pastures in the western world.
• The estimated man-working days lost through illnesses and death due to HIV/AIDS.
• The suggested strategies to advocate and introduce global policies that ensure equity of access to health and reimbursement of training costs by the beneficiary western countries.

Keywords: Advocacy, Equal Access

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.