ZAMBIA GEORGE B. SAMPA CHIEF PROSTHETIST /ORTHOTIST Demographics: - - PDF document

2015/06/18 1

Policy and Practice Review: ZAMBIA

GEORGE B. SAMPA CHIEF PROSTHETIST /ORTHOTIST

Demographics: Prevalence ZAMBIA

Prevalence: Numeric value: Comments / Additional Notes:

Total population size: 14,638,505 Total Zambian population 2014 estimates

• No. people with physical disabilities

73,192 Representing 0.5% WHO estimates of total population Aetiology / Causes: % 1. Trauma Road traffic accidents Occupational injuries Animal bites 39% Retrospective survey of clients who were attended to from 2010 to 2014 at 3 P&O centres 2. NCDs Diabetes Cancer/Tumours Stroke 36.8% Diabetes has a higher %

• 3. Congenital Deformities

20% Congenital Talipes Equino Varus is prominent

• 4. Infections

10% Gangrene, Osteomyelitis, HIV/AIDS

2015/06/18 2

Demographics: Prevalence ZAMBIA

39.40% 36.80% 10.00% 14% Trauma NCDs Infections Congenitals

Demographics: Mobility Solutions ZAMBIA

Mobility Solutions: Number: Comments / Notes:

• No. people with physical disabilities needing

solutions 54,894 75% of the total number of PWD

• No. people with physical disabilities

currently utilising Mobility aids / solutions 18,298 (25%) Gap analysis by SINTEF study 2006 indicated that 75% People with physical impairment did not receive prosthetics and orthotics devices Types of aids / solutions:

• No. of people
• Walking aids

No data available

• Wheelchairs

“

• Prosthetics

“

• Other

“

2015/06/18 3

Policies and Strategies: ZAMBIA

Policy Overview re: Persons with Disabilities: National Health Policy

• Policy provides comprehensive framework that amalgamates existing polices in the health sector

Rehabilitation Services Objective

• To provide comprehensive medical rehabilitative services at all level of care

Measures

• Strengthen and expand provision of medical rehabilitative services
• Strengthen public awareness on rehabilitative services

Policies and Strategies: ZAMBIA

National Health strategic Plan 2011-2015 Rehabilitative Services

Objective

• To provide optimal care by taking into consideration client needs, organizational and

professional considerations. Key Strategies

• Develop and disseminate Rehabilitation Standard Operating Procedures for all levels of

care.

• Establish procurement plan for essential equipment and consumables.
• Train rehabilitation professional at all levels of care
• Purchase basic equipment, consumables and other accessories for rehabilitation

services.

2015/06/18 4

Policies and Strategies

• Provide appropriate infrastructure to support rehabilitation services.
• Create adequate positions for professionals in all rehabilitation services.
• Sensitise the public on rehabilitation

National Policy on Disability 2012

• Government recognizes that persons with disabilities ought to have equal rights and
• pportunities as people without disabilities
• Specific framework to comprehensively respond to needs and challenges of PWD

Objectives

• Prevention of Disability
• Develop and Promote programmes that prevent and reduce incidences of disability
• Habitation and Rehabilitation
• Promote and provide access to technical aids, assistive devices, equipment and facilities

habitation and rehabilitation of PWD

Policies and Strategies

National Social Protection Policy

• To protect and promote the livelihoods and welfare of people

suffering from critical levels of poverty and deprivation Overall Objective

• To contribute to the well being of all Zambians by ensuring that vulnerable people have

sufficient income security to meet basic needs and protection from worst impacts of risks and shocks Disability Objective

• Safeguard and promote the realisation of the right to an adequate standard for people

with disabilities

• Ensure equitable access to opportunities by persons living with disabilities

2015/06/18 5

Disability Support Service Delivery:

ZAMBIA

Overview of Health System and how services are structured and care delivered for Rehabilitation and Disability Support National level

• Prosthetics & Orthotics unit is under rehabilitative services which sits under the Directorate
• f Clinical Care and Diagnostic services
• Rehabilitative services unit comprises Prosthetics & Orthotics, Physiotherapy and

Occupational therapy Functions of the Unit

• Develop and disseminate national technical guidelines
• Plan and coordinate the provision of Prosthetics and Orthotic services
• Monitor and evaluate the implementation of Prosthetic and Orthotic services
• Initiating of continuous professional development

Disability Support Service Delivery

Provincial / Regional level

• No representation at this level
• Representation at Hospital level is through Head Clinical Care

District / Local level

• Not represented at this level
• P&O services are found only at tertiary and 2nd level hospitals
• Physiotherapy services are available from health centre to tertiary level
• Faith based organization compliment government at local level –
• Cheshire home society,
• Fly spec Zambia involved in outreach and supported by NGO, 500 miles
• The highest level of Prosthetist employment in Government is Chief Prosthetist/Orthotist and

he/she is involved in policy determination

2015/06/18 6

Ministry of Health: Functional Organisation Structure

2015/06/18 7

Ministry Of Health: Directorate of Clinical Care and Diagnostic Services

DIRECTOR, CLINICAL CARE & DIAGNOSTIC SERVICES MDS/1 Deputy Director, Laboratory Services MDS/2 Deputy Director Clinical Care & Clinical Support Services - MDS/2 Deputy Director Pharmaceutical Services - MDS/2 Rehabilitative Services Unit Medical Equipment Unit Clinical Care & Quality Assurance Unit Chief Biomedic al Scientist MS/1 Chief Biomedic al Scientist MS/1 Chief Physiothera pist MS/1 Chief Prosthetist Orthotist MS/1 Chief Medical Equipmen t Officer MS/1 Clinical Care Specialist MDS/3 Chief Nursing Services Officer MS/1 Mgt & Practice Chief Medical Imaging Officer MS/1 Principal Pharmacist Logistics Management & Administration MDS/3 Principal Pharmacist Pharmaceutical Care & Rational Drug Use MDS/3 Deputy Director Medical Imaging MDS/2 Chief Medical Imaging Officer MS/1 Deputy Director Nursing Services GSS/2 Chief Nursing Services Officer MS/1

2015/06/18 8

Disability Support Resource Allocation:

ZAMBIA

SERVICE DELIVERY UNIT Resource Type: Total Number Ratio of Persons with Disabilities: Units Total Units Full workshops with Academic link None Full workshops with no Academic link 6 12000:1 Satellite Unit 4 18000:1

Service Delivery Units

2015/06/18 9

Disability Support Resource Allocation:

ZAMBIA

HEALTH CARE PROFESSIONAL Resource Type: Number of Posts Number of Incumbents Prosthetist / Orthotist holding Degree qualification 3 3 Prosthetist / Orthotist holding Diploma qualification 6 7 Technician holding certificate qualification 4 6 Bench / Workshop Assistant holding no formal qualification 10 10

Disability Support Service Delivery:

ZAMBIA

Known Gaps or Challenges in Service Delivery and Resourcing for persons with disabilities: 1. Inadequate trained human resources 2. Inadequate service delivery points Measures Taken

• A position paper for training in P&O was developed
• Currently 4 officers are in Tanzania for BSc and diploma training
• Pre-service training is receiving active attention

2015/06/18 10

PROVINCE Population coverage Currently available P&O trained staff* Required number of trained P&O staff Required training level

• f

qualifications Lusaka Province University Teaching Hosp 1,654,579 Nil 2 Degree (category 1-ISPO) 5 6 Diploma (category 2-ISPO) Copperbelt Province Hospital Arthur D, Hosp 1,911,572 1 2 Degree (category 1-ISPO) 1 8 Diploma (category 2-ISPO) Southern Province, Livingstone Central Hosp 1,483,654 1 1 Degree (category 1-ISPO) 1 6 Diploma (category 2-ISPO) Northern Province Kasama Gen hospital 1,586,753 Nil 1 Degree (category 1-ISPO) Nil 7 Diploma (category 2-ISPO) Eastern Province, Chipata Gen hospital 1,632,583 Nil 1 Degree (category 1-ISPO) 1 7 Diploma (category 2-ISPO) Western Province Lewanika Gen Hosp. 901,299 Nil 1 Degree (category 1-ISPO) Nil 4 Diploma (category 2-ISPO) Luapula Province Mansa hospital 945,868 Nil 1 Degree (category 1-ISPO) Nil 4 Diploma (category 2-ISPO) Central Province Kabwe Gen. Hosp 1,237,251 Nil 1 Degree (category 1-ISPO) Nil 5 Diploma (category 2-ISPO) Northwestern Province Solwezi Gen.Hosp 711,127 Nil 1 Degree (category 1-ISPO) Nil 2 Diploma (category 2-ISPO) Total 10 60 11 at degree level and 49 at diploma Estimated distribution of Trained P&O personnel versus provinces/ population (2010)