The health sector in Zambia has long been burdened with policies that undermine equity, professionalism, and efficiency. A glaring issue is the entrenched belief that leadership in healthcare is synonymous with being a medical doctor, regardless of competence or capability. This narrow view is perpetuated by policies like the restructuring initiative spearheaded by Dr. Chitalu Chilufya, which mandated that to ascend to leadership positions, one must first hold a medical degree. Other qualifications, regardless of their relevance or value, have been reduced to mere “added advantages.”
This policy has disproportionately favored medical doctors, often at the expense of other highly qualified and experienced professionals. For instance, newly graduated doctors with minimal experience are frequently placed in leadership roles at district levels, sidelining seasoned professionals with years of expertise. This approach not only disrupts the balance within the healthcare system but also undermines morale among non-medical staff.
A troubling example of this is the composition of the Health Professions Council of Zambia (HPCZ) board. Instead of embracing the diverse range of health professionals in Zambia, the board’s composition disproportionately favors medical doctors, leaving other professions underrepresented. This exclusivity contradicts the principles of inclusivity and collaboration that are essential for a robust healthcare system. HPCZ, a regulatory body meant to represent the interests of all healthcare professionals, has been manipulated to serve the dominance of a select few.
The current state of affairs has led to growing frustration among health professionals across various fields. Many have called for the intervention of President Hakainde Hichilema to address the systemic issues plaguing the Ministry of Health and its associated bodies. Former Minister of Health Sylvia Masebo’s struggles to implement reforms, and the uncertain future of her successor, signal the urgency for change. Without immediate intervention, the healthcare system risks becoming fragmented, driven by favoritism rather than meritocracy.
To address these challenges, the government must prioritize equity and inclusivity in healthcare leadership. Here are some steps that should be taken:
1. Revise the HPCZ Bill: The government should defer the current HPCZ bill and initiate a broader consultation process involving all healthcare professional associations. This would ensure that the bill reflects the diverse interests of all stakeholders.
2. Establish an Independent Oversight Body: A neutral body, such as the Auditor General’s Office or the Law Association of Zambia (LAZ), should oversee the restructuring of healthcare policies. This would prevent undue influence from any single professional group.
3. Promote Merit-Based Leadership: Leadership positions in the health sector should be based on competence, experience, and merit, not merely on holding an MD. This would create a level playing field for all health professionals and improve overall efficiency.
4. Foster Interprofessional Collaboration: A healthcare system thrives when all professionals—doctors, nurses, pharmacists, laboratory scientists, and others—work together. The government must actively promote policies that encourage collaboration rather than division.
5. Address Systemic Rot: The Ministry of Health must be overhauled to eliminate oppressive practices and favoritism. This includes revisiting past policies that have contributed to the current inequities and ensuring that future policies are more inclusive.
The “sick ministry,” as it has been dubbed, does not require superficial remedies—it needs a comprehensive overhaul. This is not a problem that can be resolved by a primary health facility; it requires the expertise of a referral system, possibly extending to international consultants. The time for action is now. If Zambia’s healthcare system is to meet the needs of its people, it must embrace reform, equity, and inclusivity at all levels. Only then can the sector truly achieve its goal of extending longevity and improving quality of life for all.
Gadiel Simpungwe Economist/EHT
6 responses
The current government has a very good opportunity to make a name by bringing healing to the ill Ministry of health starting with it’s structures
I am not a medical personel but its stupidity to allow doctors alone to handle everything allow other professionals to also help in certain positions
HPCZ is another animal which needs restructuring let ever profession sit on the HPcZ board
This is somehow true, most strategic positions are held by medical doctors, given they tend to be the most ‘learnt’.. this happens every industry, but here multiple other positions given to non doctors. Otherwise an overhaul is needed
The author of this article is a leader of a professional association for Environmental Health Technologists, with help from Joseph Kamfwa, a leader of clinical officers. It’s disappointing that these individuals, driven by selfish desires, are accusing the government of only supporting doctors. These same individuals have failed to account for the resources in their association. The clinical officer association collects over K500,000 from member contributions every month, but they haven’t explained how the money is used. Instead, Kamfwa is buying houses, gambling, and purchasing different Mercedes-Benz cars. They’ve created an association constitution that keeps them in leadership positions indefinitely, allowing them to profit from the poor clinical officers and EHTs. They claim the association’s funds, which members don’t audit or report on, are used to influence policy and attend high-level meetings, including trips abroad to learn about CO practices in Ghana and other countries.
They have been opposing a comprehensive bill that includes all professionals on the board. The government has been inclusive in leadership positions within primary health care at DHOs, PHOs, and hospitals. The teams leading these institutions include doctors, hospital administrators (with degrees in social science), nurses, COs, public health scientists, EHTs, medical licenses, pharmacists, and more. These professionals form management teams. It’s puzzling why people would accuse the current and past governments of favoritism. Globally, and in institutions overseeing health matters, doctors are placed in top positions due to their skills and training. For example, in Southern Africa, ministers of health, PS, and top hospital leaders are doctors. The World Health Organization leader is a doctor, and the health consultant for the US government is a doctor. While this may not sit well with some, these are top-tier professionals in the health industry.
Areas that continuously need address and engagementz to better health services are as follows
1. Vigilance in pharmacy and drug stocking areas like what the current minister is doing
2. Better salaries for all health workers and improve on percentage of allowances such as housing allowance, most staff now can’t rent a descent house in those amounts
3. Strengthening community structures to enhance public health
4. Build more facilities to reduce long distance of walking for pregnant mothers especially in rural areas
5. Procure more medical equipment for all provincial hospital so that patients don’t have to travel from kaput to lusaka for a CT scan
6. Continue to employ more health workers to bridge the gap.
These are the things we should be talking about not fighting doctors daily that’s not progress, doctors have their own problems they are facing.
Happy new year
The claim that clinical officers association has failed to account for a K500000 which is being suspected to have been used in buying houses and different mercidiz Benz clearly shows how baseless and irrelevant the claim can be.logically you can’t buy different cars and houses from a K500000.
For such claims to come out from someone who seem not to have received the objection to the ill bill that the minority want to implement to save their selfish interests clearly shows how much the Ministry needs the reform.
Time has come to address real issues affecting the Ministry.
The claim from Gershom Kunda sounds more of a Justification. If he has evidence that the money Kamfwa uses to buy cars and houses is from the Clinical Officers contribution, why not report him. The issues rised are not about how these mentioned association manage their respective funds but Ministry of health selfish governance. I think the Author of the article outlined things that clarified the “virus” in the ministry of health and talked about the new Bill…and that @kunda’s comment is so irrational and just proves how correct the author’s analysis is.
Things need to Change…