Improving Access to Healthcare in Rural Zambia

On Call Africa aims to  improve access to healthcare in rural Zambia. We work to strengthen and augment, rather than replace, the capacity of existing health services. We do this in three ways: Treating, Teaching and Training.

During the last 3 months we have placed a particular emphasis on the training element of our work, which is key to building capacity and ensuring that our work has a sustainable impact, and brings long term change for the communities that we work in.

On Call Africa aims to achieve a system of sustainable healthcare in the areas we work in by increasing the capacity of community health workers (CHWs) to attend to the health needs of their village. Our volunteers train CHWs directly and help to make sure they are motivated to perform their role effectively, as well as working to improve their access to essential medicines and to better integrate their role with existing health services. 

We recently completed our mid term review with 14 CHW's who are currently undergoing training. During the review training was delivered over the course of a week by On Call Africa volunteer doctors in partnership with nurses from the Rural Health Centers that our CHW's represent. During the week we held lectures, and ran interatcitve workshops and focus groups on: serious illness, gastrointestinal diseases, respiratory disease, and malaria with a focus on how to identify and diagnose conditions, and how to determine whether the patients can be treated locally, or whether they need to be referred to their Rural Health Centers, or the District Hospital.

In addition to covering these key topics, the CHW's were also trained on delivering key health education messages relating to nutrition, clean water and malaria with the aim of reducing the prevalence of diseases and illness related to these areas.

We are delighted to report that our cohort of 14 CHW's are all progressing well with their training, and we cannot thank our supporters enough for supporting our work and enabling us to embed high quality CHW's into the existing health systems, ensuring that our work will have a long term and sustainable impact in Southern Zambia.

Over the last three months over 1000 people have participated in health education classes run by On Call Africa.

We’ve been joined on our team by an experienced practice nurse who identified some key topics for learning over the last term. Our programme has been based on discussions with local nurses, community health workers and headteachers from village schools. Oral hygiene, clean water and good nutrition have been the three main themes.

Health education is offered to two groups. Firstly, schoolchildren aged 7 to 17 have had specially developed lessons to help them learn about. Secondly, people waiting in the queues for our clinics have been able to access teaching about these same themes. By reinforcing the messages across the community we hope that a whole family approach to hygiene and nutrition will be embedded in home life.

Feedback from participants has revealed some insight into what the participants have learnt. Following teaching about cleaning teeth participants said: “This is really useful – I did not know that you should brush up and down”, and “We did not know about sugary drinks being bad for the teeth.” Encouragingly many were saying:“We will start to brush our babies’ and children’s teeth.”

Health education sessions on water led one young man to reflect: “I thought cola drinks are good but it contains sugar and acid which is bad for teeth.” From across the sessions we heard people feeding back that: “We have learnt what happens to water in the body,” and “I will try drinking more water for my headache.” There was clear leaning about the wider benefits of proper hydration with several people reporting: “We have learnt about drinking more water for breastfeeding and for constipation,” as well as the observation that “Alcohol is bad for causing dehydration.”

 Evaluation of the health education programme from over the past three months is feeding into planning and preparation for health education next term. Continuity and progression in understanding should follow from continuing developments in liaison between health workers and teachers as well as our volunteer team.