Submission ID 131875
| Issue/Objective | Zambia faces escalating health security challenges, particularly from climate-sensitive diseases like cholera and malaria, intensified by floods and droughts. These shocks strain an already burdened Primary Health Care (PHC) system. Resilience the ability to prepare for, withstand, and adapt to such shocks is critical for maintaining Universal Health Coverage (UHC) progress. This study assesses the resilience of Zambia's PHC system to climate-related health emergencies and identifies key strengthening points. This work is relevant to Sub-theme 3 because translating evidence into impact requires practical tools to assess and build health system resilience at the local level. |
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| Methodology/Approach | A mixed-methods case study was conducted in two districts: one highly affected by seasonal flooding (Lusaka's peri-urban areas) and one facing drought (Southern Province). The assessment utilized the WHO Health System Resilience Toolkit. Data collection included: (1) Desk reviews of emergency response plans and surveillance data; (2) Key informant interviews (n=20) with district health managers, environmental health officers, and clinic-in-charges; and (3) Focus group discussions with community health workers (CHWs) and community members. The study timeframe was six months (January to June 2025). |
| Results | The study revealed fragmented resilience. While the national level possesses contingency plans, operational gaps persist at the PHC level. Critical vulnerabilities included: inadequate cold chain infrastructure for vaccine storage during power outages, limited surge capacity for human resources, and weak integration of meteorological data with early warning systems. Key strengths were the adaptability of CHWs and existing community-based surveillance structures. The lack of a dedicated budget line for climate adaptation within PHC was a significant barrier. |
| Discussion/Conclusion | Zambia's PHC system requires deliberate, practical interventions to build systemic resilience. This study bridges research to practice by offering three implementable solutions: (1) Infrastructure hardening - securing solar-powered refrigeration and water points at clinics; (2) Workforce planning - developing a protocol for rapid deployment of a reserve health workforce; (3) Policy integration - mainstreaming climate change adaptation into district-level PHC planning and budgeting. Strengthening PHC resilience is not just about crisis response but a fundamental investment in safeguarding UHC gains against future shocks. Scaling options include replicating this assessment toolkit across other climate-vulnerable districts in Africa. |
| Presenters and Affiliations | Mulemwa Sharon Simushi MULESA RESEARCH CONSULTANCY Mulemwa Sharon Simushi MULESA RESEARCH CONSULTANCY |
