
Countrymen and Women, Members of the Press,
Happy festive season to everyone!
First of all, I would like to express my gratitude to the Almighty God for keeping us safe throughout the year 2023. I firmly believe that His grace will continue to sustain us in the coming year.
Countrymen and Women, Members of the Press,
The purpose of this statement is to highlight the accomplishments of the Ministry of Health in 2023. You may recall that the Ministry is mandated to provide equitable access to promotive, preventive, curative, rehabilitative, and palliative quality healthcare services at all levels of service delivery. To translate this mandate into a clear mission statement, the Ministry developed and is implementing the 2022-2026 National Health Strategic Plan, which is aligned to the 8th National Development Plan and the UPND manifesto.
The mission of the Ministry of Health is to provide equitable access to cost-effective, quality health services that are as close to the family as possible, with a focus of Leaving No One Behind. The Ministry’s drive towards quality universal health coverage is strengthened by the decentralisation of health services to local the authorities. The Ministry aims to improve the health status of people in Zambia and contribute to increased productivity and socio-economic development.
Countrymen and Women, Members of the Press
Before I go further, I would like to state that the performance of the Ministry, which I am about to highlight, has been largely facilitated by domestic resources and contributions from partners. The budget allocation for 2021 was K9.2 Billion and it was increased to K12,4 billion in 2022 representing 35% increment. In 2023, the total budget for Ministry of Health was K16.1 billion, representing a percentage increment of 30%, out of which K14.7 billion was from GRZ and K1.3 billion from Cooperating Partners. The Personal Emolument was allocated K7.7 billion while the Non-Personal Emolument had a total budget of K8.4 billion which is inclusive of K1.3 billion from Cooperating Partners through their direct budget support. It is important to note that several donors provide off-budget support which also made significant contributions to the success of the Ministry this year.
These resources were utilised transparently and prudently, through strengthened internal controls that ensured accountability. Going into the future the Ministry aspires to have zero audit queries through the introduction of guidelines to strengthen internal controls.
Countrymen and Women, Members of the Press,
Let me proceed to highlight the key achievements under Health Service Delivery focusing on the following programmes:
- Reproductive, Maternal and Adolescent Health
- Community and School Health Programmes;
- HIV and AIDS;
- Malaria;
- Tuberculosis (TB);
- Non-Communicable Diseases including mental health; and
- Health Security.
Countrymen and Women, Members of the Press,
Under maternal health, the Ministry’s goal is to ensure that pregnant women deliver their babies in a health facility under the care of trained health personnel. I am happy to report that our data for the years 2021 to 2023 shows a steady decline in home deliveries.
The number of home deliveries declined from 790 in 2021, to 588 in 2022, and finally 467 in 2023. This shows that the various interventions are bearing fruit leading to positive social behavioural change in our communities. These include:
- engagements with the political, civic, traditional, religious and community leaders; and
- increased the number of trained community-based volunteers and community health assistants as safe motherhood action groups to encourage pregnant women to deliver at health facilities.
Further, there has been a significant improvement in the number of pregnant women who attend their first antenatal care appointment in the first three months of pregnancy. This figure has increased from 31% in 2022 to 61% in 2023, which indeed is a positive development for maternal health.
Attending antenatal appointments early can help detect any potential pregnancy complications. This increase can be attributed to various factors such as increased community engagements and better access to healthcare services. In 2023, the Ministry procured blood safety commodities through ZAMMSA for all the ten provincial centres. These initiatives underscore our unwavering dedication to ensuring safe, accessible, and high-quality blood transfusion services for all Zambians. This ensures availability of blood for the needy patients especially mothers giving birth and cancer patients to mention but a few. Further, the expansion and deployment of automated integrated technologies to provincial blood centres stand as a testament to our commitment to innovation and efficiency. Notably, the extension of therapeutic Red Cell Exchange Services to all provincial centres equipped with automated integrated equipment signifies a substantial leap in addressing conditions like Sickle Cell disease and other immunological diseases
It is gratifying to also report that this year, over 1700 healthcare workers received training in adolescent health, and more than 1,500 young individuals attended the Youth INDABAS organized by the Ministry of Health. These meetings with community leaders and healthcare managers across all provinces are aimed at improving access to reproductive health services for adolescents and young people to reduce teenage pregnancies. In 2024, it is our desire to extend these indabas to all the 116 districts.
Countrymen and Women, Members of the Press:
Government is strongly committed to improving child survival. To achieve this, the Government’s top priority is to reduce preventable deaths of newborns and children under 5 years old through proven methods such as immunisation.
In 2023, the Ministry’s Expanded Programme for Immunization (EPI) prioritised stabilising routine immunisation after the COVID-19 emergency phase. This was achieved by ensuring a constant supply of vaccines, expanding and maintaining cold chain equipment, and conducting supplementary catch-up immunisations for vaccine-preventable diseases like polio, measles, and rubella, among others.
Another successful introduction included the implementation of the Human Papilloma Virus, HPV Multi-Age Cohort vaccination campaign with 795,006, that is, 51% of the targeted girls vaccinated.
Countrymen and Women, Members of the Press:
To improve child survival, in 2023, the Ministry procured and distributed nutrition commodities to health facilities across the country. This resulted in improved management of severe wasting malnutrition and contributed to a cure rate above the threshold of 75%. The Ministry of Health through the National Food and Nutrition Commission undertook a survey on Food Consumption and Micronutrient Status and the Survey report will stand as a beacon in guiding our nation’s nutrition programming.
Among other findings were that:
- Vitamin A deficiency among children under 5 years has reduced from 53% in 2003 to 26.2% in 2023, while it stands at 15.7% among adolescent girls and 10.6% among women of reproductive age.
- Iron deficiency anemia in under 5 years children remains high at 10% while women of reproductive age is 6.7% and the prevalence in adolescents is 1.4%.
- Iodine deficiency has been brought under control with urinary iodine concentration being above the WHO cut off of public health concern.
The gains achieved over the years of controlling micronutrient deficiencies must not be lost by relaxing our efforts
Countrymen and Women, Members of the Press:
Prevention, treatment, care and support for people living with HIV are still top on the agenda for my Ministry. In this regard, we have steadfastly focused on preventing HIV transmission through a myriad of interventions, including robust awareness campaigns and testing initiatives. We aim to meet the Joint United Nations Program on HIV/AIDS (UNAIDS) of “95-95-95” targets. The target calls for 95 per cent of all people living with HIV to be aware of their status, 95 percent of those aware of their status to be on antiretroviral therapy (ART), and 95 percent of those on ART to achieve viral load suppression.
As of September 30, 2023, out of an estimated 1.5 million individuals living with HIV in Zambia, 1,282,826 were initiated on Anti-Retroviral treatment (ART), an increase from 1,219,127 in 2022. According to the Zambia Population-based HIV Impact Assessment results, Zambia has exceeded the second and third targets with the performance of 89% PLHIV know their status, 98% are on the life-saving ARVs and 96% are virally suppressed.
This is attributed to intensified efforts in Test and Treatment interventions as well as the strategic utilisation of Index Testing and HIV screening tools being implemented countrywide through Government initiatives and support from our Cooperating Partners. This means that we are on track to meet our goal of ending AIDS by 2030.
Countrymen and Women, Members of the Press:
The National HIV/AIDS/STI/TB Council (NAC) successfully coordinated the multisectoral response through knowledge generation, provision of strategic information and making data available through various studies. The organization provided leadership in the development of the country’s National HIV/AIDS Strategic Framework (NASF) 2023-2027. The National HIV/AIDS Strategic Framework is an overarching guide to the HIV response.
Further, following the successful decentralisation and devolution of HIV functions to the Local Authorities in accordance with the Country’s policy, NAC led the development of a multisectoral HIV/AIDS Coordination Toolkit to facilitate capacity building of the newly employed District AIDS Coordination Advisors under the Local Authorities.
Countrymen and Women, Members of the Press:
Tuberculosis, commonly known as TB, remains a major health concern, and as a Ministry, we have been working diligently to reduce TB. We have expanded our diagnostic capabilities to ensure that TB patients are treated. As a result, there has been an improvement in the number of confirmed TB cases, rising from 49% in 2022 to 56% in 2023.
Notably, the incidence of TB has decreased from 307 cases per 100,000 people in 2021 to 295 cases per 100,000 people in 2022. We have also seen an increase in TB notifications, with 53,156 cases reported by mid-December 2023, surpassing our target of 51,000 cases. This increase in notifications is a good thing because it indicates that we have been able to identify and notify more cases of TB than in previous years. This reflects improved community mobilisation, staff capacity to diagnose suspected TB cases as well as the health facilities’ ability to test for TB using available equipment.
Countrymen and Women, Members of the Press:
The burden of Malaria continues to be a public health concern in the country. In this regard, my Ministry has continued scaling up interventions aimed at eliminating malaria. Some of the interventions include;
- The Ministry is currently distributing over 5 million insecticide-treated nets through Mass Net Distribution and an additional 2 million will be distributed through antenatal care and under five;
- Indoor Residual Spraying (IRS): In 2023, the Ministry commenced Indoor Residual Spraying of 900,000 structures in 33 high malaria-burdened districts. The exercise is ongoing and is expected to protect approximately 8 million people.
- Further, an additional 2,000 community health workers were trained in integrated community case management of malaria bringing the total to 22,398.
Countrymen and Women, Members of the Press:
Approximately 23% of all deaths in Zambia are attributed to Non-Communicable Diseases or NCDs in short. Collaborating with stakeholders, the Government has embarked on a mission to combat NCDs by promoting healthier lifestyles, cancer screening, delivering effective treatment through training specialist doctors such as cardiologists, and providing rehabilitation and palliative care to those who need it.
In 2023, the National Heart Hospital conducted 29 open heart surgeries and performed 93 angiograms and five kidney transplants. This contributed to a reduction of Government expenditure for treatment abroad.
We have also adopted the WHO Package of essential noncommunicable (PEN) disease interventions for primary health care. This is a strategy to build capacity in healthcare workers to manage complicated NCDs at primary healthcare level, thus reducing referrals and deaths due to NCDs.
In 2023, we also embarked on a mission to make mental health services accessible at the primary health care level by training health workers in management of the common mental disorders found in Zambia.
The Zambia Flying Doctor Service is the arm of the Ministry of Health that provides aero-medical services in remote, rural and hard-to-reach areas and other parts of the country in order to combat human diseases and save lives. In order to be able to achieve the stated Medical Evacuations and outreaches, the Ministry of Health had to capitalise the Zambia Flying Doctor Service in order to ensure that the Aviation equipment that was grounded for over 7 years was overhauled and brought back into service. This has greatly enhanced operations and health service provision in the rural and hard to reach areas of Zambia thereby improving the quality of lives for our rural citizens.
In 2023, Zambia Flying Doctor Service undertook a total of 63 outreaches as compared to 23 in 2022. Of the 63 outreaches, 26 were specialised outreaches and serving a total Number 105,433 patients which was a significant improvement from the 11,875 patients serviced in the year 2022. These outreaches were undertaken in all Provinces of the Country in 46 rural districts and 262 health facilities benefiting from these supplementary services. A total number of 88 medical evacuations after referrals from various parts of the country to tertiary medical institutions were undertaken thereby greatly enhancing the referral system through air evacuation.
Countrymen and Women, Members of the Press:
In the field of Epidemic and Outbreak Response, the Ministry of Health, along with our public health security agency, the Zambia National Public Health Institute, is actively taking measures to tackle the outbreaks of various diseases like cholera, measles, anthrax, rabies, and scabies throughout the country. We are working diligently with the Disaster Management Mitigation Unit, other line Ministries, and our Cooperating Partners to address the cholera outbreaks in the country.
Our commitment to addressing the cholera situation is unwavering. Multi-sectoral teams are engaged in active case identification, contact tracing, cholera treatment, safe water distribution and health education. All districts are prepared, with established response plans, prepositioned cholera supplies, and identified treatment centres. The activation of Epidemic Preparedness Prevention Control and Management Committees, along with Public Health Emergency Operations Centers, enhanced coordination for preparedness, response, and recovery in the event of a cholera outbreak.
Let me also give you this update for today. In the past 24 hours nationally, 203 new case were recorded, 11 deaths, 86 discharges and still 292 patients in admission. In the past 24 hours, Lusaka Province recorded 198 new cases and 76 discharges and with 284 in admission. The distribution of new cases in Lusaka province were as follows: Lusaka District 188, Luangwa 0, Chongwe 0, Chilanga 10 , while the deaths 11 deaths in Lusaka province were as follows: Kanyama 2 BIDs and 2 facility deaths, matero 3 BIDs, Chipata 2 BIDs, and Levy Mwanawasa 2 facility deaths.
Fellow Countrymen and Women, Members of the Press
Let me now outline the Ministry’s achievements in health systems strengthening which are meant to support smooth healthcare service delivery and include the following:
- Medicines and medical supplies;
- Human Resource for Health;
- Physical Infrastructure and medical equipment, and
- Health Information.
- Decentralization of Primary health services to the Local authorities
Fellow Countrymen and Women, Members of the Press
Government, through the Ministry of Health, is committed to providing equitable access to good quality, safe, and effective medicines, vaccines, and medical supplies to all Zambians at an affordable cost.
The interventions put in place improved availability and access of quality essential medicines and medical supplies, from an average of 50% in 2022 to 80% in 2023 at health centres and 70% at hospitals.
This achievement includes sustained availability of vaccines, antiretroviral (ARVs), medicines for tuberculosis, and malarial medicines, which are provided continuously at 100% through the following measures;
- Increased allocation of funds for procurement of essential medicines, vaccines and medical supplies from 6 billion in 2022 and K4.6 billion in 2023 representing 32 percent increment and K4.9 billion for 2024.
- Procurement of 42,000 health centre kits to cover 6 months. So far, a total of 14,100 Health Centre Kits have been received and distributed by ZAMMSA to all districts.
- Medicines and medical supplies for hospitals are being delivered to increase the availability of medicines for hospitals to above 80%.
- ZAMMSA has also awarded long-term framework contracts for renal, laboratory commodities, essential medicines and medical supplies, to avert stocking out of key commodities due to procurement processes.
- The Medicines and Medical Supplies Fund that was established under the Zambia Medicines and Medical Supplies Agency Act, No. 9 of 2019 has been operationalised through Statutory Instrument No. 14 of 2023.
- To ensure the availability of quality and safe medicines, the Ministry through ZAMRA has commissioned a state-of-the-art National Drug Quality Control Laboratory. The Quality control testing of medicines and allied substances is done according to international standards.
- My Ministry has developed the Local Pharmaceutical Manufacturing Strategy and revised the National Medicines and Medical Supplies Policy of 1999 to improve the investment climate for meeting local needs and to ensure resilience in Zambia’s supply chain.
Countrymen and Women, Members of the Press:
Human resources for health are a vital component of any healthcare system. Ministry of Health has an approved establishment of 139,590 out of which 75,697 are filled representing 54 percent. This leaves a human resource gap of 63,893, representing 46% of the approved establishment.
In 2022, a total of 13,495 health workers were recruited, with 11,276 being new recruits and 2,295 being replacements. This was a significant achievement in addressing the human resource gap. To maintain the momentum, in 2023, an additional 5,339 health workers were recruited, with 3.000 being new recruits and 2,339 being replacements arising from attrition. In addition, 2,424 in-service health workers were promoted.
Furthermore, the Ministry processed 600 transfers on marital grounds in line with the Government Policy to reunite couples introduced by the new Dawn Administration.
Countrymen and Women, Members of the Press:
The Nursing and Midwifery cadre play a crucial role in medical practice. Ministry of Health through the Nursing and Midwifery Council of Zambia is committed to improving the quality of nursing education, training and practice to protect the public from unsafe practice and preserve the image of the nursing and midwifery profession. In line with this, the Ministry has created a Code of Ethics to improve the conduct of Nurses and Midwives, which outlines the expected standards of professional conduct. The Ministry has also expedited the investigation of all reported cases of professional misconduct and takes appropriate actions against practitioners with inadequate skills and poor attitudes towards patient care.
Moreover, to promote inclusiveness in healthcare, the Ministry of Health has introduced Basic Sign language in the Nursing and Midwifery Curriculum. This ensures that nurses and midwives have basic sign language skills to communicate effectively with clients who have communication challenges in healthcare facilities.
In addition, the Ministry of Health has recognized the critical shortage of Clinical instructors to mentor Nurses and midwives during student training. In 2023, my Ministry trained over 200 Preceptors across the country.
Countrymen and Women, Members of the Press:
In the area of medical infrastructure and equipment, equitable distribution of adequately equipped health facilities is crucial to improve healthcare service delivery to the people. In 2023, Government completed an additional 11 fully equipped health centres, formerly known as Mini Hospitals, bringing the total to 111 out of the planned 115 across all 10 provinces.
Furthermore, Government is constructing 5 district hospitals in Luapula, Eastern, and Copperbelt provinces. One level 1 hospital in Mambwe District of the Eastern province has been completed and handed over, while the others being Nchelenge and Mwansabombwe in Luapula Province, are due for completion in January 2024. The other two on the Copperbelt Province, Chimwemwe in Kitwe and Chifubu in Ndola, are now 80% complete and also expected to be completed in 2024.
Government has also constructed 62 maternity annexes, with 43 built by the Ministry and 19 constructed by Local Authorities using the Constituency Development Fund (CDF).
Government is modernizing the Cancer Diseases Hospital at UTH and decentralizing the treatment services to two additional provinces. In this regard, the Ministry has embarked on the construction of cancer treatment centers in Ndola and Livingstone.
The Ministry has prioritised the acquisition of medical equipment to enhance the quality of healthcare services offered. So far, modern equipment has been received which includes ultrasound scanners, 2 CT scanners (I for Kabwe and 1 for UTH) and digital X-ray machines, among others.
Countrymen and Women, Members of the press
Government has prioritised digital health as a means to manage data for the health system. A landmark development for the Ministry of Health in 2023 is the introduction of the web-based smart care electronic health record system which was launched in Chongwe district, a step towards transforming our health information exchange. The Ministry is planning to expand this initiative to 600 facilities.
Countrymen and Women, Members of the press
I also want to take this opportunity to thank our various donors, whose contributions are partly responsible for the successes that we see today. Let me highlight some successes in this area:
- We finalized funding support mechanisms with two key partners:
- a) The US. Government for TB and HIV activities for one year totaling U$350 million; and the
- b) The Global Fund Grant cycle number 7 amounting U$350 million to cover 2024 and 2025;
- Budget Support: The European Union has agreed to start direct budget support to Zambia. This will also include the Health Sector;
- We also continued to receive on-going support from traditional partners, including the following:
- a) Sweden through the Peace Health Program
- b) The USG through the CDC, USAID, Department of Defence, and Peace Corp
- c) EU: Through various health systems strengthening support:
- d) GAVI: Immunizations;
- e) WHO: Health Security; Normative guidance; and support for international health regulations
- f) UNICEF; and
- g) The World Bank.
- We also explored areas of mutual interest with a number of countries, including:
- a) CZECH Republic for staff exchange and medical camps.
- b) European Union for strengthening local manufacturing and support to ZAMRA.
- c) India: in telemedicine; Local production of drugs and vaccines; and many other areas;
- d) China: Cholera Vaccines and support with ambulances
- e) Egypt: Technology exchange in patient care, procurement of medicines and medical supplies
- f) Algeria – Technology exchange in patient care, procurement of medicines and medical supplies
- g) Angola: Human Resources support to Angola
Countrymen and Women, Members of the press
I would like to conclude my statement by emphasizing that in 2024, my Ministry will continue to strengthen and scale up high-impact, evidence-based health interventions across all levels of care. Our investments will be guided by the main pillars of our healthcare systems, including Human Resources for Health, Health Care Financing, Health Infrastructure, Medical Equipment, Medicines and Medical Supplies, Health Information and Research, and Leadership and Governance.
In 2024, the primary healthcare approach will serve as the foundation for achieving universal heath coverage through decentralisation while ensuring that no one is left behind.
Finally, I wish to pay special tribute to our Cooperating Partners who have been instrumental in their support to the health sector.
I wish you God’s blessings and a prosperous new year.
Thank you
MINISTER OF HEALTH
HON. SYLVIA T. MASEBO, MP