Remarks by USAID Health Office Director John Kuenhle During the Systems for Better Health End-of-Project Meeting

Remarks by USAID Health Office Director John Kuenhle
Systems for Better Health End-of-Project Meeting
Taj Pamodzi Hotel, Lusaka, Zambia
August 28, 2019 

(as prepared for delivery)

Dr. Kennedy Malama, Ministry of Health Permanent Secretary (Technical)
Ministry of Health Directors
Provincial Health Directors
Cooperating Partners (Embassy of Sweden, DFID, UNFPA)
Implementing Partners
Ladies and Gentlemen

Good morning. I am honored to be here on behalf of the United States government and the U.S. Agency for International Development (USAID). I bring you greetings from the U.S. Ambassador to Zambia, Daniel Foote, and the USAID/Zambia Director, Sheryl Stumbras.

As we prepare to close out the Systems for Better Health (SBH) project, I’d like to congratulate our implementing partner, Abt Associates, their project staff, and the Government of Zambia (GRZ), for their commitment to making this initiative a success.

The United States is committed to building the capacity of partner countries to increasingly manage and resource their own development and become self-reliant partners in the global community. A five-year project, SBH launched in October of 2015 to help Zambia on its journey to self-reliance and promote resilience in the health sector.

Its primary goal was to improve health outcomes for Zambians by strengthening systems that underpin the delivery of high quality health services, and increasing the utilization of high-impact health interventions at the district and community levels.  Thanks to the collaboration among project staff, the Ministry of Health (MOH), and the 25 non-governmental organizations (NGOs) and community based organizations (CBOs) funded through SBH, the project yielded impressive results.

Operating across 81 districts in eight provinces, SBH worked hand-in-hand with the MOH to strengthen capacity in human resource planning and management, quality assurance/quality improvement, performance management, public financial management, and data use for better informed decision-making.

Among their many accomplishments, the SBH team developed and updated national health guidelines, strategies and tools for enhanced service delivery, including the National Health Strategic Plan, Treatment Flow Diagrams for ART, and the Community Health Quality Improvement Training Manual.

SBH also provided technical assistance to the development of Zambia’s National Health Insurance (NHI) scheme, and drafted the NHI bill, which was signed into law in April of 2018. SBH supported the training of 833 health workers at five midwifery and two Community Health Assistant (CHA) training schools through curriculum review and revision, provision of learning materials including procurement of lab equipment, training of tutors/instructors in the use of lab equipment, and provision of transport for students.

SBH also provided technical assistance to strengthen Provincial Health Office and District Health Office capacity in the six provinces where the U.S. government-supported programs are working in partnership with the MOH to improve reproductive maternal, newborn, child, and adolescent health and nutrition.

As one of their most notable accomplishments, SBH awarded $1 million in sub-grants to 25 local NGOs and CBOs in nine districts to help strengthen community systems. The grantees built the capacity of 2,500 individuals from 126 Health Center Committees (HCCs) and 931 Neighborhood Health Committees (NHCs) in the areas of community leadership and governance, community planning, quality improvement, and social and behavioral change communication.

As a result, these NHCs and HCCs – which serve a total population of approximately three million – now understand their roles and responsibilities, can hold effective community meetings, review key performance indicators, develop work plans and coordinate work done by CHAs.

As we acknowledge the progress in health-systems strengthening, the United States urges the Zambian government and Ministry of Health to continue to recruit healthcare workers to improve the patient-to-provider ratio. In Zambia, the current ratio of clinical health workers to population is 15 per 10,000, compared to the WHO recommended ratio of 23 per 10,000. Additionally, we ask that MOH continue to work with our cooperating partners to implement the NHI to ultimately ensure health-care coverage for all.

Finally, just as the United States, through USAID, is applying a data-informed approach to understanding where each of our partner countries are on their development journey, we encourage the MOH to use data systems such as the human resource information system to optimize the engagement of any and all available human resources.

On behalf of the United States government, we look forward to continuing to partner with the government and people of Zambia to improve health systems for higher quality services and increased uptake.  Thank you for your time today and we are honored to celebrate the successes of the Systems for Better Health project.