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Background
- Socio-Economic Background
The population of Zambia is approximately 10.3 million. The annual population growth rate of 2.9 percent is comparable to that of sub-Saharan Africa. Infant mortality is currently 95 per 1,000 live births and maternal mortality was 729 per 100,000 live births in 2000 (UNAIDS 2004). According to the Zambia Demographic and Health Survey (DHS) 2001-2002 (Central Statistical Office Zambia et al. 2003), the total fertility rate decreased from 6.7 in 1990 to 6.0 in 2000.
Zambia had an estimated gross domestic product (GDP) per capita of $359 in 2002. An estimated 73 percent of Zambians are classified as poor; the level of poverty is greater in rural areas, where 83 percent of the population is considered poor, as opposed to 56 percent in urban areas (Central Statistical Office Zambia et al. 2003).
The real GDP growth rate is 3.7 percent, less than the targeted rates of 8 percent for the Millennium Development Goals and 4 percent for the Poverty Reduction Strategy Paper (PRSP). Transition from a state-controlled economy to a privately controlled one has increased poverty levels, and the attempt to diversify the economy, thus minimizing dependence on copper, has not achieved the desired economic results.
- National Health Accounts: The Process
National Health Accounts (NHA) is designed to give a comprehensive description of financial resource flows in a health care system, showing where resources come from and how they are used in the health sector. To understand the availability and utilization of total financial resources in the health sector, and thus to better inform policymakers and advisors on the resource flows, in 1998 Zambia conducted a NHA which examined health expenditure estimates from 1995 to 1998. The government of the Republic of Zambia formed the NHA Core Team in July 1998 to conduct the NHA exercise. In 2003, the Ministry of Health (MOH) began another round of NHA in collaboration with the USAID-funded Partnerships for Health Reformplus and the World Health Organization, again to identify the magnitude of health financing resources and show how health funds flow through the health system. An additional component of this activity was using the NHA framework to study the sources and uses of funding for HIV/AIDS.
The objectives of this Zambia NHA are:
- To apply NHA as a tool to evaluate the resource flows in the Zambia health system;
- To document the magnitude of sources, flow, and uses of funds within the public and private health care sector in Zambia; and
- In particular, to identify the magnitude of health sources and uses, as well as the flow of health funds related to HIV/AIDS in Zambia.
A workshop was held in August 2003 with the NHA Core Team to provide an update on the NHA methodology and to introduce the HIV/AIDS methodology. Primary data collection instruments, including HIV/AIDS patient and provider surveys, were reviewed by the team and revised to supplement secondary data sources. A data plan also was developed to enable team members to gather secondary information from the public and private sectors in a way that would complement and round out primary data.
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- 413Kb ~ 2 min (39 pages)
