Systemic Change in Healthcare Delivery in Zambia

In Zambia, the health sector faces many challenges: Inadequate supply and a shortage of skilled health care workers result in high mortality rates. As in many other countries of the Global South, nurses and midwives build the cornerstone of the country’s health care system, especially in rural areas. To improve access to health care for Zambian’s rural population, the Hilti Foundation, together with its implementing partner SolidarMed and local hospitals, have launched in 2012 a vocational training project for nurses and midwives and continuously developed it since then.

The government’s decision to make the decentralized vocational education for nurses a standard and roll it out nationally is a big success, since it entirely changes the way health staff are educated in Zambia. That is, what we always aim for with all our projects: driving a systemic change with impact at large scale,” says Werner Wallner, Managing Director of the Hilti Foundation.

Dual education will now become a national education standard in how health workers are being educated in Zambia.

Closing the gap of skilled health workers

The decentralized model innovates the education system and works by having a large medical school partner with several accredited rural hospitals for practical training purposes. This method not only increases the annual intake of students, as various training classes can be run in parallel, but ensures high-quality education since trainees rotate between different hospitals to gain more clinical experience.

In addition to education, adequate housing is crucial to retaining health care workers in the rural villages. That is why the Hilti Foundation is working with SolidarInvest to build affordable and safe homes for nursing personnel in rural areas. By combining education and housing, the program has become a real success, and the benefits have so far been demonstrated in three of the country's ten provinces.

Adequate housing for health workers is essential to ensure long-term good health services in rural areas.

Zambia’s government has now taken strong ownership of the project: in the next phase, ten colleges will be prepared to become leading institutions in the nationwide rollout of the decentralized nurse training system. Our partner SolidarMed will continue to lead the project with strong support from the Zambian Ministry of Health.

Health Care Sector in Zambia

The Zambian health sector faces multiple challenges. Mortality rates remain very high due to an inadequate supply of health care services and a critical lack of skilled health care professionals. There is currently a shortage of 10,000 nurses and midwives in the country, which is particularly dramatic in rural Zambia since rapid population growth is worsening the challenge. The new training model will double the supply of certified nurses, bringing in 2,000 additional nurses each year and closing the gap by 2026.

Partner organizations

SolidarMed is an international aid organization based in Switzerland, specializing in training medical professionals in East and South Africa, whereas SolidarInvest operates as a non-profit cooperative and builds staff houses for rural health personnel.