DELIVERY of
HEALTH SERVICES
Presented by:
Mrs. A.Silondwa

SPECIFIC Objectives
BY the end of this course, the student will be able to:
 Describe the roles of hospital and health centers
 Discuss public/private partnership
 Discuss equity of access in health service delivery
 Describe the priority setting in health

Course Content
 Overview
 Roles of the hospitals and health
centers
 Public/private provision of health
services
 Equity in health services delivery
 Priority setting in health

Overview
 A well functioning health system
working in harmony is built on having
trained motivated health workers a
well maintained infrastructure and a
reliable supply of medicines and
technologies backed by adequate
funding strong health plans and
evidenced based policies

Overview (1)
Mission Statement: To provide
equitable access to cost effective,
quality health services as close to
the family as possible
 Efficient and Effective health
service delivery
 Reliable, transparent and
acceptable governance systems and
structures

Overview (2)
 Reliable, timely and comprehensive
information systems
 Adequate infrastructure, medical
equipment and other technologies
 Competent health workers at the
point of services delivery
 Stable predictable and equitable
financing

Overview 3
 Service delivery is when the inputs are organized
and managed to ensure improved access to
services
 Delivery of health services should have an impact
on peoples health
 People should be covered by a broad spectrum of
health services from preventive health services to
curative services, rehabilitative services and
palliative care for peoples ends of lives
 Ensuring services are of good quality, safe for
people to consume including continuity of care
across services as people interact with the health
system

Delivery of Health Care
Services
Basic essential
health care package
at each level of
care in order to
achieve WHO three
major goals

Roles of health centres
 Health centre (primary level) the first contact level where people
first interact with the overall health system
 WHO and many world public health emphasizes the vital
importance of primary health care in improving health centers
 Essential health care based on values of universal access, equity,
participation and intersectoral action, working with other sectors
that impact on health

Roles of District Health Office
 Primary management unit in the decentralised
health system
 Administer the affairs of the district health
services
 Responsible for planning for the district
 Responsible for ensuring that local priorities are
recognised and addressed
 Responsible for coordinating with other sectors
e.g. agriculture, local government, etc.
 Responsible for monitoring performance of HCs
and level 1 hospitals against established standards
 Responsible for providing training to district staff

Roles of Hospitals(2)
Hospitals have certain unique roles and attributes
 The improvement of community health status
 The integral relationship of the hospital within
the community
 Access to care for those in need of services
 The obligation to provide high quality health care
services
 Recognition that public expectations from non
profit and public hospitals are unique
 The importance of fiscal responsibility in ensuring
the long-term commitment of hospitals to their
communities

Roles of hospitals(3)
 The maintenance of traditional values of
compassion and charity
 Voluntary governance and accountability to the
community. The governing body of the hospital
provides the critical linkage between the values of
the community and the day-to-day operations of a
complex health organization
 The physician-hospital relationship - The
leadership and hospital management work in
partnership with the medical staff to create the
delicate and vital balance between institutional
imperatives and professional

Private/Public Health
services
The health sector in Zambia is liberalised and
embraces diversity in ownership, including:
 Public health sector - health facilities and
programmes under the MOH, and some government
line ministries and departments;
 Faith-based health sector, under the coordination
of CHAZ;
 Private sector: for- and not-for profit health
services, owned by private investors and Civil
Society Organisations (CSOs);
 Traditional and alternative health service
providers,
ALL operate informally and are not regulated or
monitored by MOH.

Equity in health services
 Mission Statement:To provide equitable access to cost effective,
quality health services as close to the family as possible
 Vision: To improve the health status of people in Zambia in order to
contribute to socio-economic development
 Key Principles: Primary Health Care (PHC) approach; Equity of access;
Affordability; Cost-effectiveness; Accountability; Partnerships;
Decentralisation and Leadership; Clean, Caring and Competent health
care environment

Equity in Health Services(2)
Efforts aimed to improve access to health services are:
 Abolition of user fees in 54 rural districts,
 Construction and renovation of health facilities
across the country,
 Investments in medical equipment and transport,
 Availability of essential drugs and medical supplies
 Scaling up of outreach health services
 Health promotion and education
 Equities in income levels at household level.

Priority setting in Health
1.Public Health Priorities :
 Primary health care services.
 Maternal, neonatal and child health.
 Communicable diseases, especially malaria, HIV and
AIDS, STIs and TB.
 Non-Communicable Diseases (NCDs).
 Epidemics control and public health surveillance.
 Environmental health and food safety.
 Health service referral systems.
 Health promotion and education

Priority Setting in Health (2)
2.Health System Priorities:
 Human Resources for Health (HRH).
 Essential drugs and medical supplies.
 Infrastructure and Equipment.
 Health information.
 Health care financing.
 Health Systems Governance

CONCLUSION
Health service delivery and improving services = quality of services
 Measuring out patient attendance or deliveries of babies in health
units is not good enough.
 Services will only have an impact on peoples health if they are
efficient ,effective, safe and good quality health care
 Measuring the quality of service involves; technical quality, medicines
work and consumer’s perceptions (treated with dignity, seen on time,
friendly)

Thank you