WHO, Country Cooperation Strategy (2017-2021)

Abstract

The attainment of the highest possible standard of health for all remains the major commitment of the WHO. This third generation of the WHO Country Cooperation Strategy (CCS) for Zambia will cover the years 2017-2021. It articulates WHO’s role and renewed commitment to collaborating with the Government of the Republic of Zambia for the next five years.

This Country Cooperation Strategy (CCS) is the result of an extensive and inclusive process and a systematic analysis of documents, interviews and interactions with multiple stakeholders in health. The strategic direction was defined by considering WHO’s comparative advantage in relation to national health priorities.

This CCS takes into consideration agreed international and regional development goals, including those in the United Nations Millennium Declaration, World Health Assembly resolutions, African Union (AU) and SADC Health Strategy and WHO Africa. Regional Committee resolutions and recommendations. The Strategic frameworks which also inform the direction of WHO’s strategic agenda at national level are: Zambia Vision 2030, the Seventh National Development Plan 2017-2021 and the Ministry of Health National Health Strategic Plan 2017-2021. It is also anchored on the Transformation Agenda of the World Health Organization Secretariat in the African Region, WHO’s 12th General Programme of Work 2014-19 and the United Nations Sustainable Development Goals Partnership Framework (UNSDGPF) 2016-2021.

Zambia’s health profile reveals that there is an observable high disease burden, characterized by high levels of maternal, neonatal and child morbidity and mortality, high incidence and impact of communicable diseases, and a rapidly growing burden of Non-communicable diseases (NCDs). Zambia’s Human Development Index (HDI) stands at 141 out of 187 countries and territories. In spite of this progress, like many other countries in Sub-Saharan Africa, Zambia’s human development indicators have been disappointing. Zambia has high levels of inequality: when the country’s HDI value 0.56 is discounted for inequality, it falls to 0.365. About 62.8% of the population is multi-dimensionally poor, meaning that such households suffer overlapping deprivation in education, health and living standards.The monitoring and evaluation framework was further strengthened. The District Health Information System (DHIS) was upgraded to DHIS-2, with improved features and functions. All earmarked surveys and reviews were conducted, including the 2013-14 Zambia Demographic and Health Survey (ZDHS), Mid-term review of the National Health Strategic Plan 2011-2016, Mid-term review of the National Malaria Control Programme (NMCP), National Malaria Indicator Survey and the National Tuberculosis prevalence (TB) survey.

Since Zambia’s admission as a WHO Member State in 1965, the WHO Country Office in Zambia (WCO) has seen its work portfolio and internal organization grow considerably. The office celebrated the golden Jubilee of WHO’s presence in Zambia in 2015. Today, the WCO operates from the UN Annex in Rhodes Park, renting premises owned by the UNDP. The total number of staff is 38. Some of the challenges facing the country office include inadequate office space, limited funds to adequately implement all activities in the technical cooperation programme including other emerging needs, inadequate human resources in the Ministry of Health as well as little synergy among health development partners.

A review of the previous CCS for 2008-13 revealed that the Country Office made considerable achievements in the area of health systems strengthening and prevention of communicable and non-communicable diseases, maternal and child health and health promotion. Despite the achievements made, the country did not achieve most of the targets of the health- related Millennium Development Goals (MDG) except the one on child mortality. This is largely attributed to many factors such as weak health systems and limited resources. The unfinished agenda of the MDGs has been incorporated in the new CCS. It has also been domesticated in the Sustainable Development Goals (SDGs) agenda for Zambia which is aligned with the National Health Sector Strategic Plan (2017-21).

The WHO will strive to create a conducive environment needed for successful implementation of its strategic agenda. In order to adequately respond to the identified priority needs in the Zambian health sector, the new strategic agenda identifies the following five strategic priorities for the period 2017-21: to provide support for achieving and sustaining universal health coverage through and revitalized primary health care approach and sustained health service delivery through strengthening of health systems; accelerating achievement of the unfinished MDGs agenda relating to reduction of maternal, newborn , child and adolescent mortality; reducing further the burden of AIDs, Tuberculosis, Malaria, NTDs, Hepatitis and other communicable diseases; strengthening the prevention and control of NCDs including strengthening preparedness surveillance and effective response to disease outbreaks. Furthermore, the country office commits to enhancing the level of understanding of WHO’s role and mandate in Zambia, and will support the Ministry of Health in building and strengthening Partner coordination while fostering private public partnerships. Finally, WCO aims to enhance its collaboration with other UN Agencies.

The progress made in implementing this strategic agenda will be assessed through regular monitoring and evaluation activities that will be carried out at both strategic and operational levels. At the strategic level, this will include annual and mid-term reviews and evaluations at the end of the lifespan of the CCS. At the operational level, biennial plans will operationalize the strategic priorities and corresponding strategies using clear indicators and targets.