Organization and functions of the ministry of health
The Ministry of Health holds the central responsibility for medical care and preventive care services through its wide network of public health institutions, countrywide. In this regard, the MoH undertakes a package of basic health care services (attach BPHC) through its 11 programme areas, namely Epidemic Preparedness, Provision of 1st level referral services, Roll Back Malaria, HIV/AIDS/STIs, Tuberculosis, Integrated Reproductive Health, Child Health, Environmental Health, Mental Health, Oral Health and Nutrition (see section 2.3).
Other ministries and external entities are involved in the health system. Main ones include:
- The Ministry of Local Government and Housing works in close collaboration with the MOH regarding public health aspects in urban areas (cities and municipal councils), especially with respect to food hygiene, environmental health, and water and sanitation.
- The central Government cabinet office is held responsible of HIV/AIDS coordination, policy guidance and mobilization of resources, due to the cross-cutting nature of the epidemic. However, the Ministry of Health remains as the major implementer of HIV/AIDS programmes.
- The Churches Health Association of Zambia (CHAZ) is a privileged partner and receives grants from the MOH for delivering health services through their network of health facilities (approx. 30% of nationwide public health facilities with up to 50% in rural areas) through a Memorandum of Understanding.
The Ministry of Health holds a number of specific functions concerning the public health provision in the country, in coordination with peripheral levels and partners. These include:
- Regulation – The MOH holds the central responsibility regarding regulation, either be standard setting, policy making, definition of target, procedures, monitoring and evaluation, etc. Yet cooperation partners play a key role through the SWAp arrangements. Some functions are also delegated to provincial level with (complement… in case some regulation function are actually delegated!)
- Planning – Planning takes a bottom-up approach, starting from health facility with gradual consolidation at district, provincial and ultimately central level. In turn, according to the indicative planning budget obtained from Ministry of Finance and National Planning (MoFNP), the MOH and SWAp partners develop a planning and budgeting framework, which is divided for each province. The provinces themselves determine indicative planning figures to the district level; and districts to health facilities
- Service provision – Delivering defined packages of health service. When approved, the budgets from the above planning exercises are released on a quarterly basis to MoH, who in turn send to the provincial health offices, who in turn send to the district health offices. The 72 district health offices then send the funds to health facilities for service delivery.
- Financing – Mobilizing funds from Ministry of Finance and Donors. This is the role of MoH-HQ, with money coming largely from MoFNP and the international donor community.
- Administration – Administering the resources in the health system
- Monitoring and Evaluation – A Health Management Information System (HMIS), containing all prioritized indicators has been developed and the data captured at all public health facilities is sent to the national level for compilation into an HMIS on a quarterly basis. The HMIS data is compiled into an Annual Health Statistics Bulletin to inform all stakeholders of performance and progress on health indicators.
The HMIS captures data from health facilities to help with planning and implementation activities. Policy and implementation is guided by a balanced combination of top-down and bottom-up approaches, relying on the strategic principles of leadership, accountability and partnerships at all levels of the health system; with MoH serving a stewardship role in these processes.