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Strengthening Health Systems in Zambia


  • Zambia's health system requires strengthening.
  • Abt led a USAID-funded project called ZISSP.
  • ZISSP provided 9,700 clinical mentoring sessions and protected more than 2.5 million structures against malaria.
The Challenge

Zambia’s economy has grown in recent years, although approximately two-thirds of the country lives in poverty. Improving and expanding health services to all requires strengthening the country’s health systems.

The Approach

Building on long-time work in Zambia, Abt Associates led a USAID-funded project called the Zambia Integrated Systems Strengthening Program. ZISSP ran from 2010 to 2014, funded by USAID.

ZISSP addressed human resource constraints by helping to develop better strategies, tools, guidelines, and systems. The project worked closely with the Zambian Ministry of Health and the Ministry of Community Development Mother and Child Health at the national, provincial, and district levels.

ZISSP’s support to the National Malaria Control Center helped coordinate, expand, and oversee nationwide indoor residual spraying and other malaria interventions. ZISSP also placed staff ‒ clinical care specialists, management specialists, and community health coordinators ‒ in 10 provincial health offices to expand health services to more Zambians. 

The Results

 ZISSP exceeded quantitative targets in most implementation areas:

  • Increased numbers of health workers were trained in infant and young child feeding, integrated management of childhood illness, emergency obstetric and neonatal care, and other critical areas;
  • Strengthened linkages between community volunteers and health centers expanded community-level programs for mothers and children;
  • Quality Improvement committees at health facilities improved health outcomes and conducted more than 9,700 clinical mentoring sessions were with healthcare workers;
  • The health sectors national planning guidelines were revised, Data Quality Audit Guidelines developed, and Zambia Management and Leadership Academy created;
  • More than 2.5 million structures were protected against malaria;
  • Safe Motherhood Action Groups were scaled up and communities participated in an annual health planning process; and
  • 18 grantee organizations increased community involvement in health.