REPUBLIC OF ZAMBIA MINISTRY OF HEALTH - HRH Global Resource Center

REPUBLIC OF ZAMBIA MINISTRY OF HEALTH

Human Resources for Health Strategic Plan (Draft) (2006 - 2010)

December 2005

Table of contents

DRAFT

Foreword

i

Acknowledgement

iii

Executive Summary

iv

Mission and Aim

xiii

1 Introduction

1

2. Human Resources in the Zambian Health Sector

6

3. Current Initiatives to Resolve the Human Resource Crisis

22

4.Guiding Principles for the HRH Strategic Plan

23

5. Objectives and Strategies

24

6. Options for consideration in the implementation of the HR plan

37

7. Key Assumptions With The Strategies

41

8. Risks

43

9. Resourcing the plan

45

10. Implementation of the strategy

45

11. Monitoring and evaluation

46

Annexes

49

DRAFT

List of tables Table 1: Current numbers of staff by cadre in the public sector and staff to

population ratios

6

Table 2: Staff distribution by province

10

Table 3: Current Staff Levels versus Recommended Establishment

12

Table 4: Composite Monthly Pay before tax of a sample of health workers 13

Table 5: Summary costs of workforce projections and costs 2005 ? 2011

39

Table 6: Areas for further investigation

40

Table 7: Key assumptions associated with the strategies

42

Table 8: Indicators for monitoring and evaluation of the strategy

46

Table 9: Annual review and revision cycle for the HR strategy 2006-2010 and

responsibilities

48

List of Abbreviations

DRAFT

APAS BKw CBoH CDE CP CPD GDP HR HR HRH HRM/D HSSP HTCC IST M&E MoE MoH MSTVT MTEF NGO PE PHC PMEC PMP PRSP PSRP PST SIDA SWAp UNFPA USAID UTH WHO ZHWRS

Annual performance appraisal system Billion Kwacha Central Board of Health Casual daily employee Cooperating Partners Continuing professional development Gross Domestic Product Human resource Human resource(s) Human Resources for Health Human resource management and development Health Services and Systems Program Health Training Coordinating Committee In-service training Monitoring and Evaluation Ministry of Education Ministry of Health Ministry of Science, Technology and Vocational Training Medium Term Expenditure Framework Non-government organisation Personal Emoluments Primary health care Payroll Management and Establishment Control Performance management package Poverty Reduction Strategy Paper Public Sector Reform Programme Pre-service training Swedish International Development Agency Sector Wide approach United Nations Population Fund United States Aid for International Development University Teaching Hospital (Lusaka) World Health Organization Zambian Health Workers Retention Scheme

DRAFT

Foreword

Since 1991 Zambia has been pursuing health reforms aimed at providing Zambians with equity of access to cost-effective, quality health care as close to the family as possible. Although there have been some progress towards the achievement of global and national health outcomes, the reforms have not had the intended impact of improving the overall performance of the health sector. One of the major obstacles for Zambia to improve its service delivery and the achievement of the Millennium Development Goals related to child and maternal health and combating priority diseases including HIV/AIDS and malaria is the shortage of human resources for health.

The health sector is facing a major human resource crisis and there are shortages of health workers at every service delivery level. The health sector recognises that human resources are critical in the provision of quality health care and that to address the current crisis it is essential that it ensures an adequate and equitable distribution of appropriately skilled and motivated health workers providing quality services.

Human resource shortages are caused by a number of factors. These include: ? Inadequate conditions of service (pay, allowances and incentives) ? Poor working conditions (facilities, supplies and equipment ? Weak human resource management systems ? Inadequate education and training systems

In order to resolve the crisis and address the key issues the Ministry of Health has developed a Human Resources for Health Strategic Plan, in consultation with key stakeholders. The strategies and activities outlined in the Plan attempt to address the concerns of all the stakeholders consulted and to provide a framework to guide and direct interventions, investments and decision making in the planning, management and development of human resources for health.

The Human Resources for Health Strategic Plan demonstrates the scale of the crisis and highlights some of the key factors that have led to the current situation. It further illustrates the current and ongoing national and district initiatives aimed at reducing the severity of the situation. It outlines the broad objectives, strategies and activities required to address the crisis. The focus of this HRH Strategic Plan is on developing the most appropriate, feasible and cost effective mix of strategies for both achieving improved staffing levels and making jobs in the health sector more attractive by improving conditions of service. The Strategic Plan will be used by the Ministry of Health and its partners in the health sector to mobilise resources and support in order to strengthen human resources for health.

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