Healthcare Financing System in Zambia

Oct 9, 2016 | Advisory Projects, Sub-Saharan Africa

“Our assessment points to a health system that is inadequately self-sufficient in funding; inefficient in flow of funds through the various functions due to leakages; and financial protection and equity in payment, service use and benefits allocation are not achieved.”

Healthcare Financing System in Zambia

As a relatively young nation of 52 years, Zambia has made progress in its healthcare system, witnessing improvements in health outcomes over the last few decades. It achieved its health MDGs in the areas of HIV/AIDS and tuberculosis. Furthermore, the country made advancements in combating malaria and in reducing maternal and child mortality rates. However, its healthcare system still suffers from inadequacy, inequities and inefficiencies.

A health valuing environment is a key ingredient of any well-functioning health system. This takes into account leadership and governance; the political and economic situations; and social determinants of health. In addition to an economic slowdown, Zambia also needs to grapple with housing, sanitation, cultural, energy and geographical challenges which may hinder the attainment of quality, accessible and affordable healthcare for its people. It is not helped by the fact that Zambians have a relatively low willingness to seek and pay for health services.

Compared to peer countries (other lower-middle income countries globally), Zambia is not spending enough on healthcare. Public expenditure on healthcare stood at 11.3% of total government expenditure in 2014, less than the 15% target set by the 2001 Abuja Declaration. Out-of-pocket payment is relatively high at about 30% of total health expenditure in 2014– well above the 20% limit suggested by the WHO.

Our assessment points to a health system that is inadequately self-sufficient in funding; inefficient in flow of funds through the various functions due to leakages; and financial protection and equity in payment, service use and benefits allocation are not achieved.

Freedom to Create worked together with international experts, senior Zambian officials and private sector leaders to conduct “deep dive” research into public healthcare financing in the country.

Our teams of experts made in-country study visits and conducted confidential interviews with a range of public and private stakeholders. This culminated in a research report detailing the policy challenges, possible options, and specific suggestions on next steps.