Moses Magadza
Ndola, Zambia-Zambian members of parliament have undertaken oversight visits to health and educational facilities and conducted public hearings as they move from rhetoric to grassroots action to advance sexual reproductive health (SRH).
The oversight visits and public hearings were undertaken with financial support from Sweden and Norway which are funding a SADC Parliamentary Forum (SADC-PF)-led four-year Sexual and Reproductive Health, HIV and AIDS Governance Project in seven SADC member states that include Zambia.
Implemented through and with national parliaments, the SADC-PF project seeks to build the capacity of women MPs in particular and that of national parliaments in general, to advocate universal access to SRH, HIV and AIDS governance-related services and commodities.
Recently, staff from SADC-PF joined Zambian MPs when they conducted site visits to two health facilities and held public hearings with hundreds of citizens in Kitwe and Ndola over two days to assess Zambia’s preparedness in terms of achieving Sustainable Development Goal (SDG) 3 with a special focus on SRH. Overall, SDG 3 seeks to ensure healthy lives and promote well-being for all at all ages.
The public hearings were the climax of an intense process of oversight which began much earlier with Zambia’s Parliamentary Committee on Health, Community Development and Social Services receiving presentations from non-governmental organisations, civil society organisations, faith-based organisations, community-based organisations and officials from the line ministries of health and education.
An assessment of the capacity of selected health facilities to provide SRH as it relates to family planning, antenatal services, prevention of mother to child transmission of HIV, safe abortion care, management of teenage pregnancies, prevention and treatment of sexually transmitted infections, screening for cervical cancer, among others, followed. The assessment was done at different levels of care facilities from the University Teaching Hospital – a tertiary health care facility – to the smallest clinic, which is a primary health care facility.
Dr Jonas Chanda chairs Zambia’s Parliamentary Committee on Health, Community Development and Social Services. He led a group of eight MPs during the public hearings and oversight visits, during which access by ordinary people to health facilities, services and commodities was a key issue.
In an interview, Dr Chanda said the site visits had exposed the need to revisit the basis for deployment of human resources for health.
“In Lusaka, for example, we visited a clinic in a densely populated compound called Kanyama with a catchment of about 200 000 people. Each day, between 35 and 40 women give birth there. This is more than what obtains at the University Teaching Hospital. In fact, Kanyama has the highest number of deliveries in the country, yet it is a very small, first level health facility,” Dr Chanda said.
The oversight visit to Kanyama revealed, also, that in spite of the high numbers of women giving birth there, there was a serious dearth of midwives and related services, which abound at the University Teaching Hospital.
“This means that a tertiary health facility is offering primary level services such as dispensing condoms, family planning tablets and seeing routine antenatal cases. This should happen at a primary health care facility like a clinic. Tertiary institutions must focus on specialised care,” he said.
He opined that this disparity could explain huge unmet SRH needs in Zambia. For example, the national uptake of contraceptives in Zambia is estimated at 45 percent.
“Maybe the long distance to the University Teaching Hospital is deterring some people from accessing family planning. Queues at the teaching hospital are normally long. If we are to achieve SDGs, we must take services to the people. Primary level services should be near where people stay,” Dr Chanda said.
• Moses Magadza, who wrote this article, is a communications and advocacy specialist at SADC Parliamentary Forum head office in Windhoek.