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TI Zambia launched the TISDA report themed ‘Watching Your Health: Mapping Transparency and Integrity Risks in Health Service Delivery in Africa’

Transparency International Zambia, through the Transparency and Integrity in Service Delivery in Africa [TISDA] project launched the survey report on integrity and transparency in the Delivery of Health Services in Zambia on 10th November 2011 at Cresta Golf View Hotel in Lusaka. The launch was officiated by the Ministry of Health [MOH]. This project is part of the programme being implemented in eight [8] African countries namely; Cameroon, Ghana, Kenya, Nigeria, Senegal, South Africa, Uganda and Zambia and is focusing on the Education, Health and Water sectors.

In Zambia the study investigated governance in the Health Systems Building Blocks by assessing Integrity, Transparency, Accountability, Institutional performance, Corruption and Public participation. The report brought out among others the following issues;

i. Weakened local oversight structures at district and health facility level have reduced accountability of health facilities to communities and have diminished public participation and community voice in health service delivery decision making processes
ii. Lack of downward information flow on approved plans, budgets and actual financial disbursements; weak financial management, and non adherence to approved plans and budgets are impacting negatively on the delivery of effective health services
iii. Ineffective drug management monitoring mechanisms at district level has led to poor adherence to prescribed drug management procedures
iv. Inadequate health staff [operating at plus/minus half of the establishment] coupled with duo job holding policy in the health sector has impacted negatively on the delivery of effective health services
v. Inadequate service users’ quality assurance mechanisms and inadequate information flow on service availability to users has contributed to loss of confidence in public health care systems by the users

In view of the following issues, Transparency International Zambia [TIZ] makes the following recommendations among others;

  1. MOH should ensure that existing governance arrangements build in a strong element of accountability by which health providers will be more accountable to NHCs and other stakeholders.
  2. MOH should provide a framework of community participation that includes accountability mechanisms aimed at increasing flow of information between health workers and community governance structures and should expedite the development of terms of reference for community governance structures to guide their operation.
  3. District Health Office [DHO] should disseminate information on disbursement of fund and changes in the budgets to the DHMT by MOH need to be disseminated to all facility managers and community groups such as the NHCs
  4. MOH and DHO should ensure that financial oversight role [audits] is strengthened at health facility level
  5. MOH should ensure that mechanisms for monitoring medical products management at health facility level are strengthened
  6. MOH should review the policy of dual job holding in relationship to how it impacts on the issue of absenteeism
  7. Provincial Health Office [PHO] and DHO together with partners should empower local stakeholders such as NHCs and communities to measure and monitor progress on action plans and evaluate progress so as to form a basis for campaign for improvements in service delivery.


For any press enquiries please contact

Goodwell Lungu, Executive Director
Transparency International Zambia
T: 260 1 290080
F: 260 1 293649
E: tizambia@zamnet.zm