Zambia’s Acute Healthcare Staff Shortage
The Zambian healthcare system suffers from a severe shortage of human resources. To improve the number and quality of healthcare personnel, the Hilti Foundation and its partner SolidarMed, have established a vocational training system for nurses and midwives. The decentralized education program has shown great success and prompted the Zambian government to take ownership for a nationwide rollout. There is an associated massive need for adequate housing for students and trained healthcare workers, which is a key aspect to retain skilled workers in the region. The initiative’s dual approach, of combining training and housing, aims to bring about sustainable change in Zambia’s rural healthcare system.
Empowering a rural healthcare workforce
In Zambia, like many other countries in the Global South, nurses and midwives are vital to the healthcare system. Yet, with a weak system the country faces a dramatic shortage, especially in rural areas, with only 11.2 healthcare workers per 10,000 people. That means that if you live in rural Zambia, you have to travel for hours to see a nurse if you can find one at all. To improve access to healthcare for the rural population, we are working successfully with SolidarMed, and the government to fill a gap of 10,000 vacancies.
However, housing emerges as a key retention factor. SolidarMed Housing Project Manager Nzila Lubinda notes that healthcare workers prioritize housing over salary or education. And Sister Valeria, longtime head of the nursing school at St. Luke's College, emphasizes: “Without housing, there is no proper healthcare system because there would be a lack of staff. Adequate housing is crucial for retaining healthcare workers, attracting students, nurses, educators and doctors alike to stay and improve healthcare for Zambia's rapidly growing rural population.”
Revolutionizing nursing education across Zambia
Recognizing the importance of housing, a decade ago we partnered with SolidarInvest to launch the Ubuntu Homes program with a pilot project in Lusaka Province that built affordable and safe homes for healthcare workers in rural areas. Ubuntu, which means "I am because you are" in Zulu, and the 112 staff housing units built to date have demonstrated the importance of safe housing in retaining healthcare workers. The initiative also addresses the need for student accommodation, creating a conducive learning environment.
Working with the Ministry of Education and the National Nursing Council, we are committed to this decentralized nursing education system, combining education and housing, which has shown great success in three of Zambia’s ten provinces.
From vision to reality
The ambitious vision is unfolding with the expansion of a successful pilot project: The Zambian government has taken ownership, planning a nationwide rollout to fill healthcare gaps and emphasizing the need for student housing. The rollout plans include the construction of ten dormitories by 2024, and an additional 30-50 over the next five years at accredited training hospitals. The aim is to transform the healthcare landscape in Zambia. Therefore, Ubuntu Homes has been established as a financially self-sustainable student housing organization.
The government’s decision of standardizing and rolling out the decentralized vocational education will transform the way healthcare workers are trained in Zambia. That’s what we strive for with all of our initiatives: to drive high-impact systemic change.
Strengthening Zambia's healthcare system
Given the challenges in Zambia's healthcare system, our initiatives will not only double the number of nurses, but also improve the quality of nursing education and the retention of personnel to provide the rural population with access to healthcare. Through strategic partnerships, innovative solutions and a commitment to sustainability, they are paving the way for a healthier and more resilient Zambia.
“We want to strengthen the Zambian health system and reinforce our commitment to nurturing a well-equipped and dedicated healthcare workforce,” says Hilti Foundation Managing Director Werner Wallner. “With our innovative vocational training system and Ubuntu Homes as a financially independent institution, massive educational interventions are possible in the future, creating a pathway to institutional sustainability and systemic change.”
Health situation in Zambia
Zambia faces a severe shortage of healthcare workers, with only 18.7 per 10,000 people in urban, and 11.2 in rural areas, falling far below the WHO standard of 40. For comparison’s sake, Switzerland has a ratio of 103 per 10,000 people. The country also grapples with a housing deficit of 1.5 million units , needing 35,000 in the healthcare sector alone, half of which are in rural areas. The Hilti Foundation is addressing these challenges with two initiatives: one for nurse training and another for providing housing, which aims to increase both the quantity and quality of healthcare workers in rural areas.
Ubuntu Homes: A path to systemic change
Ubuntu Homes is an independent social enterprise, initiated by the Hilti Foundation and SolidarMed, offering an affordable housing solution for public sector workers, particularly in Zambia's rural healthcare sector. The dual nursing education program, expanding nationwide across ten provinces, includes one college and four accredited training hospitals per location. Adequate accommodation for students is crucial for the program's success, with 35 sites requiring housing in the next five to ten years.
Eco-footprint and social impact
Through Ubuntu Homes, environmental impacts are minimized by adopting eco-friendly practices, utilizing alternative building materials, harnessing solar energy and employing sustainable construction methods. The commitment to sustainability includes a goal of reducing carbon emissions by at least 35%, fostering a greener future for Zambia's healthcare and education systems.
Additionally, SolidarMed is improving the community's economic environment by implementing a masonry training project. Masons learn and work with local contractors, earning a vocational diploma and a nationally accredited certificate. This empowers them to find a job or start a business, with some graduates already serving as construction supervisors.