Elevating Country Voices: Zambia

Originally published in the summer 2019 newsletter of the Financing Alliance for Health.

Mr. Mwango Mlenga has been a passionate District Health Promotion Officer in Zambia’s Ndola district for the past nine years. In his current role, Mr. Mlenga is responsible for organizing, planning, budgeting, work allocation, reporting and supervision of CHWs in his constituency. He shared his opinion on the successes and challenges facing the implementation of Zambia’s CHW program.    
                                                   
During a recent field visit to Zambia, Financing Alliance’s Lizah Masis sat down with Mr. Mlenga who, along with his team, is beating the odds to ensure that the Community Health Worker (CHW) program runs well in his district.

A consistent and transparent incentivization system is critical to the delivery of quality services.

What are you most proud of in your role?
“I am most proud of our success in building trust with communities and maintaining a good reputation. This is the most important currency in our line of work. If the community does not trust you, it adversely affects their willingness to cooperate and work with you. Building confidence takes a lot of time and effort. In our line of work, trust is of great value and must be respected, it is something I endeavour not to lose.”

What are your greatest challenges in delivering your mandate?
“There are many challenges that affect how well we do our work. Firstly, and arguably the biggest one, is the erratic supervision of CHWs. This is mainly as a result of inadequate funding. We oftentimes have to sample areas to conduct supervision based on the funding available. I believe this compromises the quality of services offered.

Secondly, while we have good people, there is a lack of standardized incentives to motivate CHWs. A consistent and transparent incentivization system is critical to the delivery of quality services. An example of this is how some organizations pay CHWs 500 Kwacha (about 40 USD) for an activity while the government only pays 30 Kwacha (about 3 USD). It is, therefore, no surprise that CHWs gravitate towards the higher paying institutions. Furthermore, a majority of the higher paying programs are time-bound and hence unsustainable.

Lastly, we do not have standardized reporting tools for CHWs and this results in low-quality data. Data collection in Zambia is also expensive. It costs an estimated 60 Kwacha (about 5 USD) to receive one report. Reporting tools need to be standardized and made easy to use.”

Despite all these challenges, Mr. Mlenga and his team continue to work relentlessly to support Zambia’s CHW program as they know too well of their importance in reaching communities.

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